Depression with PHN?

Glad to hear you are doing well, jjb. 

Hi Judycat! 

So glad you found this website and thread.  As you say, it really does help to know there are others who understand PHN, because it is so hard for folks who do not have it to understand how painful and difficult it is.  Even better, people on this site share things that work fairly well. 

On this particular thread, I've written a lot.  I'll try not to bore you by repeating, knowing that you are reading all of what came before this.  Main points to get:

1. PHN gets better with time, slowly, but it does.  My trigeminal neuralgia is way better than it was 26 years ago, but at 4 1/2 years it didn't seem like it was getting better.

2. Look for small improvements.  It's important not to discard things because they don't completely get rid of the pain.  Nothing does, so if you give up partial solutions, you'll give up all solutions.  KEEP THE THINGS THAT WORK PARTIALLY!  THEY ADD UP TO IMPROVED MANAGEMENT.

3.  You have to get control of the depression in order to manage the pain.  This is because depression magnifies pain, depressed people think very negatively and focus on the problem rather than the solutions, and depression can affect your overall health and can kill you.

So, it is clear that since you are seriously considering suicide, you are severely depressed.  I'm a psychologist, I've dealt with thousands of depressed people, so I know this stuff really well.  With severe depression, you have to treat it aggressively.  I don't know if you are in treatment with a therapist/psychologist.  If not, get into treatment.  Use the websites online to find someone in your area who sounds good.  I suggest Googling "CBT Therapists in [your city/town/area]."  Then read about them.  CBT is explained above in earlier parts of this thread.  It is the most effective therapy for depression and anxiety as demonstrated by lots of research.  

Also, get on a modern antidepressant.  Citalopram is one, but there are other good ones.  Despite what you may have heard from some people, they work well with most people.  BUT, you have to give it time.  They take about 3 weeks or so to BEGIN working, and more to find the correct dosage for you.  Work with your doc to find that dosage.  If one antidepressant isn't working well after a good effort of a couple months or more, or it has side effects for you, again work with your doc to find one that is better.  There are lots of good ones.  

Most important:  SUICIDE IS A CRUMMY OPTION!  It transfers your pain to everyone who cares about you, and that's the legacy you leave:  They hurt a lot, for a long time.  BOTH DEPRESSION AND PHN ARE MANAGEABLE, so take charge and get both under better control.  Starting NOW. 

I want you to keep in touch with me and others here, on this.  Don't just stop writing here and leave us all to wonder what's happened, please.  Let's keep in touch at least until you are improving well.  OK?

To everyone else on this thread:  Can we help Judycat to find solutions and to begin thinking less of how difficult this is, and more about how things can and will get better?

Charlie, may I call you Charlie? 

?Thank you.  I've stopped sobbing after reading your post. While I'm married to a realy wonderful man for over 40 years, he doesn't get it.  He tries but it is beyond his experience. Today I don't feel so alone.   Its a new day and a new year.  The sun is out and I'm still breathing.  I'm retired on a very fixed income, and mental healthcare is a bit of a luxury on Medicare.  I'm not being cavalier, the $200+ per visit is outside my realm of possibility.  But I can read.  So I'll start hunting for CBT readings that might help.

?I will stay in touch.  This forum is the first bright spot in a  long time. 

?Judy

Judycat,

Thanks for responding!  You are right that it is harder to afford mental health care when on a limited budget and Medicare.  However, you are mistaken to think it is "outside your realm of possibility."  But, you need to know of several resources. 

1. $200+ per visit is what some therapists in private practice ask, not necessarily what they get.  Most responsible therapists offer some discount to those who cannot afford treatment at full rate.  This is often called a "sliding scale," which bases the rate on a person's income.

2. Even if the sliding scale rate is too high to afford, a private practice therapist may adjust the fee lower if you explain your situation and ask. 

3. Private practice therapists are not the only therapists available to you.  Since you mention Medicare, I'm thinking you are probably in the US.  That means that a community mental health center is available to you.  These are centers partially supported by public funds, and they charge on sliding scale.  Look online or in a phone book under "counseling."

4. Medicare does pay for mental health treatment.  But not all therapists in private practice accept it.  You have to hit the telephone and ask a lot of them.  Some do take it. 

Your idea of reading about CBT is a very good one [but you should also see a therapist!].  You might look on Amazon for "CBT books," and look at ratings, descriptions, and samples of each book.  Then buy the book there or elsewhere.  Some you might check out:

Mind over Mood, by Greenberger and Padesky.

Cognitive Behavioural Therapy for Dummies, by Branch and Wilson.

Feeling Good, The New Mood Therapy, by Burns [this has been out since the 70's.  It was new then].

The Feeling Good Handbook, by Burns.

Do not be afraid of therapy.  Most people are terrified of it.  Truth is, most people get better and feel better in a few sessions.  And most find it enjoyable, to their surprise.  Just do it. 

Hi judycat!  I am a Judy also, who is getting a kitten the end of this week after being pet free for several years.  I lobbied for the kitten to help with the lonliness all day and the depression.  I am fairly new to PHN, having had it only three months, but it is getting better.  The first month I spent mainly screaming into a pillow and crying, waiting for the cocktail of drugs to put me to sleep.  I told my husband and doctor there was no way I was going to live with chronic pain, and I would do whatever it took to end my life.  That swiftly got me to an excellent pain mgt doctor who has been creative with the prescriptions and taught me how to guage what drug is working & what isn't.  There are many things I'm taking, but the main things I contribute to the healing are R-Lipoic Acid Stabilized Bio-Enhanced capsules from Geronova Research (which I found on my own, after my PA hinted to me to do some nerve regeneration research) and Dronabinol / Marinol, which is legal in FL.  I cannot say enough good about the Marinol!!!!  Gabapentin was dropped in favor of Tegretol, which has no side effects for me.  I've reduced 40% of my original meds, and I am clearer of mind and am slowly beginning to drive again.  Each day is different with the pain, and I medicate based on the pain level, which means I have to tough it out for 30-45 minutes for the meds to start working.  That is preferable to taking the max meds to stay ahead of the pain, which leaves me as a vegetable.  The other thing that is super important to me is to get outside in the sun and walk for as long as I can.  That's easy in FL, but bundle up whereever you are, and try to get the sun on your face, and move your body.  Be mindful of everything you see in your walk - funny stickers on a car, leaves scuttling in the breeze, a cloud that looks like a face, a passing jet.  Be forceful in making your mind talk about what you are seeing.  I do a set of stretching exercises in bed as I wake up, then some more stretches when I stand up, then just five push ups on the floor.  I take 200 mg Tegretol and 150 mg Lyrica before bedtime, which allows me to sleep throughout the night and minimal pain thru the morning exercises.  I'm thinking positive things for you, judycat!!!!  Although your budget is tight, this forum alone offers therapy and healing - a free method of talk therapy, in a way.  Hang in there, Judy!  From one Judy to another - we'll help each other as much as possible.  Keep in touch!

Hi Judycat , I'm Paul

Welcome to our club.

I have PHN for 3 yrs after getting some relief I know have

Night Pain comes around 10-11Pm goes around 4-5 am.

As they're reducing my fentanyl patch dr told me no more

meds call the reps of the spinal cord stimulator he impanted

in 3 months ago.   In the beginning it did reduce some pain

but now at a stand still.

Never have I had a dr brush me off off and show no compassion.

Well in 2 weeks is dr # 4 I refuse to give up and please dont think

about the end think about the beginning.   I purchased coloring

books for adults which now I see that you can download the

pictures for free.  Just the pens are expensive but you can use pencils.  Keeps my mind occupied.

I wish you and everyone a pain free future

Happy and Healthy New Year

Paul

Hello Judy.  Thank you for taking the time to write.  It surprises me and warms me to realize total strangers actually care.  I've been a pessimist forever and now I see its contributing to my situation.  Again thank you.

?Congratulation on the new kitten.  Cats have been a constant joy in my life for as long as I can remember.  From a high of 9 at one time, attrition has me down to just Harriet.  She's 18 this year and really has been what has gotten me through the last 5 years of PHN.  At 18 I know our time is limited, so I cherish every moment with her. 

?You talk about getting out and moving.  That is something I've got to do more of.  Pre-Shingles, I was swimming a mile every day.  I've never been an athletic, but in my own speed and time I worked up to a mile.  After the Dr. said I coulld get back in the pool I was stunned to discover I couldn't tolerate either a cap on my head or the water rushing across my face and hair.  I haven't  been able to swim since.  The weight seemed to skyrocket.  More weight, less movement.  Less movement, more weight.  So this morning I did a short walk and am going out again when I'm done writing.  This is new for me.  I've been shut down and lost in the pain and nearly non-functioning with the meds.  Getting off the meds (duloxetine and gabapentin) was terrible.  Panic, paranoia (i don't think that is the right spelling) hallucinations, anger, insomnia. the list keeps going.  So now just the canabis and it is the best so far.  This summer I'll be moving back to WA State where its legal.

?I'll look into the R-Alpha Lipoic Acid.  It sounds promising.  I just re-read this and I see I'm very scattered in my thinking today, but I guess that I'm actually thinking is a good thing.  Yes I'll try to stay in touch.  All good wishes to you.  Thank you for writing...

judy 

 

Well, I hadn't even thought of how swimming will go, and a mile is certainly a stretch, but a gentle breeze across my face sometimes feels like a blowtorch to the skin.  I have to gently eeze the shower on part of my head, after thinking it could never touch it.  So you could try gradual conditioning of splashing the water on your face and trying a bit of the swimming cap on every day.

Judy and Judycat,

I like your ideas of gradual conditioning to exercise.  I too have had severe pain with showers, or breezes, or walking into one of those supermarkets that have the strong blowers at the entrance to keep flies out.  I guess after 26 years of it, I've just made myself do things even if they hurt. 

The exercise really helps with fighting depression and increasing energy.  Starting with a little and gradually increasing it is the way to go, I think. 

One of my drs told me if your over weight ( I am) the imflamation

runs wild in your body so hence back on weight watchers.

He said it will not cure you PHN but might help the pain some what

It's har for me to wear shirts. jackets as they touch my nect and shoulder which drives my pain to 6/7.  A brezze makes me nuts.  I need to get something to dull that pain

try a cream with 4% Lidocaine. I find that helps, I do need to reapply after 5-6 hours. I had shingles from my spine to my navel. Was unable to wear bra for weeks. I just wore light weight cotton layers. You end to avoid rubbing in your affected area. I was on Gabapentin and it did help me for awhile. I eventually weaned myself off. Again, Aspercreme and Lidocaine with at least 4% has worked best for me.

Thank you for  your help

I tried that, helped for a few days , no longer does it help

Purchased 2 other creams that didnt work either

I take evening primose, turmenric, try to boast my

immune system.

I'm going to a new pain dr this coming Saturday.

My present dr doesnt show me any compassion,

hard to talk ti and money hungry.

Hope we all get better soon

I had to get rid of any cotton that touches the area. I switched to the synthetic microfibers instead.  I have had PHN now for 2 years from the center of my chest under my right arm and around to the center of my back. The best bra I have found so far is the Champion medium support seamfree racerback with smoothtec band sports bra. The material is soft and stays put instead of rubbing the sensitive skin. I put on a Lidocaine 2.5%/Prilocaine 2.5% cream over the area every 4 hours. I too have tried the Lidocaine 4% patches, but removing those things was a killer! I also take Gabpentin 600 every 6 hours.

Reading the label on the cream, they methioned covering the area with Tegederm (kind of a air tight plastic dressing), so I may try that to see if it makes it last longer.

I will also try Aspercream, as that seems to help others.

Hi Paul,

Funny you talked about coloring books. I have found thst activity helpful it does take my mind away from the PHN pain.

Just read your post from a year ago. Hope things are better for you now. I have to share something with you since you talked about financial constraints. I found a website that provides a TON of patient resources. It is Pain News Network org

Take a look. 🤓