Depression with PHN?
Posted , 28 users are following.
Anyone have depression with PHN? I'm a retired psychologist with 26 years of PHN in right eye, forehead and scalp. I have nothing to gain [not looking for patients, I'm retired after 40 years practice]. I have learned very helpful ways to manage depression and PHN, and have worked with many patients with chronic pain and depression. If interested, let me know. I hope I can point some people with this difficult condition in a helpful direction that will improve their lives.
1 like, 251 replies
babs99203 charlie58834
Posted
I've been trying to follow your advice Charlie, but it's been tough. The good news is that the depression, fog, confusion, depression, memory loss AND depression I've been getting as I taper off my gab seems to have missed me this time!! Usually at about days 10-14 it hits for about 7-10 days. I'm on day 16 and tho I've have some odd dizziness, and slight passing anxiety, I'm hoping this will be a good month. Only 16 more to go! I can only drop 100 mg/ day, once a month. I talked in depth (again) with a pharmacist, she agrees there's not much I can do about the gab withdrawal side effects. I seem to be that rare group that has real problems with it.
Thank God, I'm not dealing with it this month, at least so far, but I won't go there. That's because I've got something new on my plate. My PHN is in my back and chest, essentially around the "bra" line, and has been improving. Well, 12 days ago I fell, right on my arm, shoulder and of course my left ribs, same side as my PHN. It took 3 cars and 10 minutes before someone stopped to help. That was a really bad 24 hours, the pain was about as bad as my worst shingles. In a few days there was some relief, as I learned how to get out of bed, a chair, get socks on etc. As you know, there's nothing to be done for a rib injury and I was already on gab, RX anti-inflammatories, Tylenol and Aspercreme. Well, the relief was short lived as I then sneezed 3 times in 8 hours. Back to square one. So, I'm struggling with no longer being able to drive, take walks, or do much of anything.
At least I know that they will heal, but I've been lucky that my PHN has slowly been easing and I feel set back 7 months. Also, I believe my plans for dancing are back on hold--which is my passion, in addition to just being good for me. So, the pity party is better today than yesterday as I'm starting to see improvement. I'll keep plugging away with managing my negative thoughts. Thanks.
ruth57682 babs99203
Posted
Babs, so sorry the ribs are not better by now. I was so hoping for you to go to the dance competition. As you know , I have PHN in the same nerves and I just can't imagine the rib pain on top of that. Maybe it's the change of weather, but I have had a nasty flare up all week. Can you get shingles again in the very same place. Seems like my back is all rash again. Not the deep stabbing pains I had over a year ago when this nitemare started. Just when I think it is slightly better I get these flare ups of a painful itchy rash. Not the blisters that some get. I never did get that. I try to think of Charlie's tips but it's hard when it comes back with a vengeance.
charlie58834 babs99203
Posted
Hey Babs,
Wow! I hear you working well on CBT, even with a fall and broken ribs! I am very impressed, Babs!
I've had broken ribs in the past. Very painful for a few months, but they do heal.
So, here's the good stuff I see you doing:
1. Decreasing gabapentin, which has bad side effects for you.
2. Noticing, to yourself and out loud to us, that you can decrease "gab" and see a decrease in withdrawal symptoms.
3. Noticing that your PHN symptoms have been decreasing, and thinking yourself "lucky."
4. Recognizing that, even though your dancing plans are now on hold for awhile, instead of getting into what you call a "pity party," [what I would call catastrophizing], you work at it and notice that you are thinking a little less negatively and seeing improvement.
Working on the negative thoughts, in other words keeping your thoughts 100% true and helpful to you, is harder for awhile after a setback or difficulty. I try to give myself a break and allow that I can think negatively for a brief time after stressors occur. But then I have to again force myself to be 100% true and helpful in my thoughts. This keeps me from getting into perfectionism, and keeps me working back toward happiness.
Good job, kiddo!
babs99203 ruth57682
Posted
COULD it be another case of shingles in your back? If you've got a rash, I think you could call the doctors. Yours is a question I've often wondered. I know there are recurring shingles, but I've heard of it in the ear/face or in the buttocks area more so. I also wondered if you can have PHN and shingles. I never truly had the rush. Just a few tiny bumps, like prickly heat. However, if I had a nickel for every time I said to my hubby, "are you SURE there's not a rash?"....I say definitely call your doctor, take care!
There's still a chance I'd dance, but it would be after not dancing for a month, so I'd be spending a chunk of money and time, knowing I'd be far from my best. My last one a month ago, was very uneven. I was dealing with the "Gab brain", and really felt out of it and intimidated. Usually I'm nervous, but thrilled to compete. It was quite disappointing.
babs99203 charlie58834
Posted
Thanks Charlie. I'm hoping they're just bruised or whatever and that it will be only 4 weeks. I'm not sure if it's catastrophizing, more just feeling sorry for myself. As what does throw me, unfortunately is "true", I do hurt, I can't do a number of specific things, it has been almost a year since this whole change in our lives. On a slightly different note, we watched a fascinating three part series on Discovery called "First In Human" about the National Institutes of Health, Building 10. They do research on the toughest problems in medicine and people go there for a last resort. And to be the first clinical trial as in the First In Human trial of a drug or treatment. Those patients and family members consciously chose to look at their problems the same way you suggest. I can't find them here, it must be that other thread. If you have a chance to track it down On Demand or on Discovery or Amazon, I highly recommend it. I don't think I could have the courage our resilience these people did.
charlie58834 babs99203
Posted
Thanks Babs. I will try to find the show you mention.
A quick note note on CBT: For a thought to be healthy it must satisfy TWO rules, so not just 100% true but also makes you feel better, not worse. It is common for people to think true thoughts that harm the make them feel depressed or anxious or angry. But the test of a healthy thought is that it is not only true but ALSO makes you feel better, not worse. So thinking "I'm in pain" often is a true thought, but it only gets you to focus on the pain more. To make it healthy you'd have to alter it so it leads you toward some solution. That's your job to find. An example would be " I'm in pain, so I guess I will do a tough puzzle to help me distract from it...eventually I will be in less pain."
babs99203 charlie58834
Posted
Thanks, I copy/pasted that in an email to myself so I'll have it to refer to.
babs99203
Posted
Howdy again Ruth, I can't believe it's been almost a month since we were so active here. How are you doing? My ribs are almost healed, I started dance lessons two weeks ago. We're being careful, but it feels good to be dancing again. I didn't have the nasty side effects of the Gab decrease last month, I'm hoping it won't happen this month either. We'll be at an out-of-town wedding during days 20-23 post reduction, so I'm crossing my fingers.
susan05920 charlie58834
Posted
Yes,
I need help with depression with PHN. I was depressed before this, but am now much worse. I am going to a therapist and am still living in isolation and pain. I can't seem to even have the energy or motivation to get out of my chair. It's awful. Please help.
babs99203 susan05920
Posted
Oh Susan, I'm sorry and I share many of these feelings. Just admitting that can help sometimes. Are you using Gabapentin too? I've had problems with depression (post-partum) and just being a bit more moody and anxious than others. But this damn shingles, PHN and Gab is a whole different ballgame. I'm sure you know the feelings of isolation are connected to the depression, but our health itself does isolate us if we totally give in to it.
I struggle too, and some days I think, "Charlie, you're full of it!", but usually, just thinking of him and others here helps a bit. Are you taking medication? I admit, I don't because I can try the depressive episodes to my currently decreasing the Gab. I'll have about a week of being down, and within that, several days of being REALLY down, but then, snap, it's gone. You should be proud of yourself for reaching out and finding a therapist. I should help, or maybe it's not the right one for you. Keep posting, Charlie is the expert, so I'm sure he and others will be able to help too.
charlie58834 susan05920
Posted
Hi Susan. Welcome to our forum. Sorry you're having such difficulty. Depression is hard to live with, but the good news is that it is very treatable. Yours sounds severe. Is therapy helping? Are you on an antidepressant? If so, which one, what dosage, and for how long on that dosage?
Please be patient with my replies. I'm away from home, in a small town with poor wifi and cell coverage. If I don't get back soon it's because of that.
susan05920 charlie58834
Posted
Thanks for getting back to me. I take trazodone 50mg. and mirtazapine 15mg. at night to help me sleep. I also take 1mg of alprazolam at night. I developed insomnia ten years ago and have a very hard time with insomnia. I had a sleep study done to see if I had sleep apnea and they said no, but they also noted I had very little REM. I feel groggy all day, with even low amounts of antidepressants and have gained back the seventy pounds I lost. I had a knee replacement two years ago, that has now failed and reported it is loosened so I am not able to exercise much. Also, a torn rotator cuff. I am looking at more surgery, that scares me to death, because of what happened to my knee.These injury's, my weight gain and now, back pain from shingles has put me over the edge. I had an od last year, as I just couldn't handle the pain anymore. Gabapentin makes me too confused. I am 67 and live alone. Therapy has helped as it is one of my interactions with another human. Thanks for caring.
babs99203 susan05920
Posted
That IS a lot to shoulder (no pun intended, but if makes you smile, fine!) My daughter too had a sleep study as she had a hard time staying awake. The Zoloft interrupted her REM sleep so they gave her Ambien. It does seem to help her. So, now you have more interaction, with us! It may not be a lot, but I think it helps. How long have you had shingles and/or PHN? I hate that I need the Gab, but in my case, the symptoms got better as I was on it. Many people quit because of the side effects, so it's understandable. Have you tried 4% Lidocaine cream? It works VERY well for me. I buy the roller-ball style as it's easier to put on and you waste less, so it's actually cheaper. I use the brand Aspercreme. I've even used it on my hip, which sometimes is sore and it helps. Many here use it, so if you haven't tried, consider it. Keep coming back!
charlie58834 susan05920
Posted
Hi Susan,
Sorry it took me awhile to respond. I'm on qvacation and traveling. Im not surprised you have no energy and are gaining weight. You are on 3 sedating meds.
Trazodone is an older antidepressant, now used mostly for sleep because it is not really effective with most people for depression. Mirtazepine: not used much for depression either, it is used for increasing appetite, not what you want I think. Alprazolam: a tranquilizer.
Have you tried more modern antidepressants? Like Celexa, Cymbalta, Wellbutrin? These are much more effective for most people for depression, and none of them typically result in weight gain or drowsiness.
Is your primary care doc prescribing, or a psychiatrist, or other?
I'm a big fan of local topical meds for PHN pain relief: like Babs' lidocaine gel or Aspercreme. No side effects for most people, work pretty well for decreasing pain. Nothing will get rid of it, that we know of.
susan05920 charlie58834
Posted
Dear Charlie, you are so kind to write to me, even while on vacation. All of these meds I take are basically for insomnia with a side benefit for depression. I have tried other antidepressants like Celexa, Wellbutrin, and others and have had limited success.I have been using aspercream and also biofreeze.I found a new spot on the side of my spine last night and pray it isn't more shingles.My other rash is scabbed over with lumbar pain.Thanks again.
charlie58834 susan05920
Posted
What dosages were you on with Celexa and Wellbutrin, and for how long? Most docs under-prescribe antidepressants, then switch to a different one rather than up the dosage. That produces a slew of patients who erroneously say "antidepressants don't work for me." Family doc or psychiatrist?
babs99203 susan05920
Posted
Susan, how are you doing now? We haven't been posting here much, so I thought I'd check in with everyone.