Depression & Anger

So the inflammatory part of the condition pays a big part in these depressive feelings, plus you have spent a very long time on a high dose of 20mgs of Prednisolone which will have aggravated the situation.

As you get lower on the steroids you should feel a big improvement in your mood - meanwhile do try and get out for a daily walk, as far as your pain allows (but no further) as this will help to release those feel-good endorphins and lift your spirits.

However, if your depression doesn't improve, then you must speak to your GP about it as there is medication that can help - don't suffer in silence.

I'm retired, though still only 65 and working at a project that came my way.

My career, and current project, rely on my mind. Been on pred since last April. Down to 6mg (tried 5mg too soon).

I've avoided the deep depression so far. I seem to have a few mechanisms from project management that allow me to be both objective but, importantly in this context, to know that if I work away at it things always get better. Its a deep seated belief based on years of experience in "pulling rabbits out of hats". I haven't a clue what the experts suggest, fortunately I've never been deep enough down to have to find out.

My anger is accompanied with mood swings. Sudden. Massive. Upon me before I can react. And I get sucked in to situations which later come under the heading of "how did that happen". And the deeper I get sucked in the harder to stop.

Probably a life long thing made order of magnitude worse by the preds.

Nothing physical. Hard to think straight.

It takes a huge mental effort to monitor myself. I don't always catch it early enough but when I do the simple action is to remove myself until I achieve a semblance of balance and control. The people I talk to and work with know exactly why I've exited because I've talked to them about "my condition".

One of the effects I blamed on the pred was the loss of my reference points. A sense of losing my objectivity, but no anchor in sight. A very floaty feeling. Just "not myself", without really knowing why or how. Very uncomfortable.

Your post provides me with an opportunity. Its much easier to talk with my wife about someone on a forum has posted about depression and anger from PMR and pred than it is to talk about me.

But talk about it I must. At least those nearest to me know I'm aware of the impact I'm having. And its harder on them than me.

And of course they help.

I've had some previous experience. A back operation about 25 years ago that took a very long time to recover from. Absolutely no energy left over after putting one foot in front of the other. A disaster for project management which requires a lot of mental effort. A disaster for those around me as I struggled to understand what was happening to me.

My second daughter was born not too long after I came out of hospital (no back jokes please ....). We, (wife and I) set a longish term goal, that when I was fit enough, and both our daughters capable, we would walk The Milford Track in NZ. It didn't really matter what the goal was. What mattered was we had one. As our daughters grew older it was good to draw them into the goal, and why we had such a one. Every day was a step nearer. It took 10 years.

We have some current goals to keep ourselves sane. Something to work towards. One small step at a time.

I figure part of the PMR / pred bit is also the inexorable loss of fitness and accompanying tiredness. I tend to force myself to do physical things, so I sleep better, I'm generally more alert. And less likely to explode.

I'm extremely independent. And there's a lot going on inside my head that will never see the light of day. I really don't enjoy being me some days. But them's the breaks and it always gets better.

I can't ever imagine myself approaching expert help for what goes on in my head. But then I've never been as depressed as you sound to me.

As well as the above vague hints about what works for me I'd suggest a bit of expert help. If you were in Aus I'd suggest Beyond Blue. I don't know elsewhere. I would struggle to make a phone call, I'm not good at spilling bits about my inner self to strangers, but I'm guessing they are used to that.

i hope you feel better soon. 

It is hard coping with the depression and mood swings - I feel so sad for my patient husband who has been so supportive throughout this 2 year phase.

I was hopelessly depressed in the beginning of my illness, crying at the drop of a hat - and woe betide any poor soul who - with the best of intentions - tried to comfort me - or even say a kind word.

It was dreadful. I was totally out of it.

In the end I did get anti depressants -after a year am off them again now - still have mood swings, short tempered and so on, but the tears have dried up - they can still be around if I let myself start feeling sorry for myself - so I try and stay positive and have a project - only a small one, I am still working and the worst thing I can do is have too many things that are half finished.

It makes me feel so much better to read this forum, makes me realise that I am not a monster in some sort of permanent situation.

Good luck, hope you feel happier soon.

Someone else has touched on the drop from 20 to 10mg - it may well have been too fast and if 10mg isn't managing the symptoms then there is no point sticking there. The continuing pain makes it all seem worse and part of the answer remains maybe more pred and definitely more rest. Unless the dose is enough you might as well stop taking it altogether and at least avoid the pred side effects. 

In terms of the emotional and psychological effects of PMR and pred, some help can be gained from medication - and there is no shame in that. For the record - the anger could be the PMR or it could be the pred. I had a major problem with rage with PMR before I ever went on pred, always worse when the PMR was worse and even now I can have a real tantrum on a bad day! Lots of people have mentioned bad language! CBT can have a major role to play - although I know there is a massive waiting list for NHS help there are private options.

It DOES get better - my memory was all over the place and I can remember translating stuff and having to back again and again to make sure I'd understood it right. Now my memory is back to normal - I couldn't do what I do on the forums if it weren't. I'm no longer working as a translator, a financial crisis has again made a mess of my business, but I have found other equally satisfying ways of filling my time.

You have to keep hold of that hope. 3 years ago I was doing fine, recovering from torn knee ligaments that had put paid to the previous year's skiing season and skiing again. Then an achilles problem due to pred plus an antibiotic put paid to skiing again just as I was getting really fit (all things are relative!). A few weeks later I tripped, my back went into orbit and I spent 3 weeks in hospital after a horrendous drug reaction - I went in with a bad back and came out with atrial fibrillation and a suitcase of meds. I was totally out of control healthwise for the first time in my life and I felt about 90, I looked it too. My daughter was about to get married and I wasn't going to be much of a "mother of the bride". My GP was faced with me sitting there in tears every month and every time said "it WILL get better". It has. It wasn't overnight but within 6 months my trousers were looser and my hair had started to grow again. Now I AM back to normal, whatever that is!

But I think your first step has to be to talk to your GP and ask for some form of help - even if it is just medication to get you started. Acceptance is the hardest but first step - it doesn't mean giving in at all. It means assessing the situation and readjusting to where on the landscape you are. You are starting from a different place from where you were a year ago. That is a reality. Even if the PMR flew out of the window tonight and you got up 100% non-hurting you are a different person now - if only because of the experiences. Your confidence has been shaken and that will remain in the background for a long time - I'm back to normal yes, but there isn't a day passes where I am not aware how much things have changed. "What if..." wasn't part of my vocabulary before PMRplus 3 years ago. I can't always dismiss it, just most of the time.

I don't waste mental or physical energy on something that I cannot change.  I need all the energy I can muster up for other things, like making dinner.  Your pred drop is massive and you are going through the yo yo effect.  That in it self could be leading to your anger.  I have two sons soon to be 36 and 33 and I have been a single parent  since they were very young.  I taught them that it is ok to feel angry but it's not ok to act angry.  I do hope you get help and I do know that there is light at the end of the tunnel, some tunnels are shorter than other.  All the best Tony.   Pat