Depression with PHN?

By the way, my PHN is in the left side of my face.  The mandibular nerve is the most affected.  As of this writing I have a noticeable swelling on my lower jaw.  It's like living with an abscessed tooth.

Hi Soquilii,

So sorry to hear of the difficult things you're dealing with.  Very tough stuff.  PHN included:  It's a very difficult-to-manage pain syndrome.  In my experience, and many others on this website, docs have limited ability to manage it with oral meds and physical procedures.  Generally, people here have said that over the counter gels and creams seem to work best.  These include lidocaine gels and salicylate creams [Aspercreme and others].  If you're interested in exploring some of these types of things that other PHN patients use, and maybe using one or more to improve management of PHN, there's a thread on this site called something like "Things That Work."  Most of the people who are finding such help are folks, like myself, that have gotten past the stage of looking for a "cure," or complete control.  I've not found a cure to be possible.  So, I find things that work partially, and use them together, and try to focus more on how improved the condition is rather than how difficult it is. 

Depression:  You mention this a lot.  Not surprising, as I got very depressed in the first few years of PHN, and many of us do have this problem.  I'm very glad you have ruled out "the quick fix," which I gather means suicide.  Not only would that affect your daughter financially, but whether people know it or admit it or not, it is an extreme burden to put on everyone who cares about you.  I imagine your daughter does. 

Financial problems don't necessarily prevent us from seeking therapy.  If you're in the US and are on Medicare, it's worth finding a therapist who accepts Medicare.  There are some.  Also, community mental health centers are more affordable than private practice therapists, again worth checking out.  Most people who go to therapy get better and feel better within a few sessions.  I certainly did. 

I can go on about depression treatment more if you want, but I don't want to overwhelm people by writing too much in one sitting here.  Please let me know if you want more info, or just want to share more about what's going on. 

don't have any real new suggestions. I can certainly understand your feelings of frustration.

My story:  In short, I am a retired psychologist.  I specialized in pain management prior to getting shingles and then PHN in 1990.  I have worked in medical settings from 1989 on, including outpatient facilities, private practice, and a medical hospital.  Early on in my treatment I decided to try to avoid oral meds, just wanting to limit side effects.  However, I have seen lots of people helped by neurontin [a form of GABA].  I was a subject in a study on use of ibuprofen gel.  It worked, but no better than Aspercreme, which is another anti-inflammatory.  I used Aspercreme and lidocaine gel for years, but now use only Aspercreme.  I've seen my symptoms decrease very gradually, but still sometimes have severe bouts of itching.  These, I've discovered, are always related to mild dehydration, and a large glass of water relieves that in about 30 min. 

I had problems with depression early on, but now manage that well with a combination of Wellbutrin 300mg XL, and cognitive behavior therapy [CBT].  I can honestly say that my PHN is now an annoyance rather than a problem that controls my life.  I do everything I want, lots of physical activity, and just work through the pain. 

A big key to managing pain better is not expecting a "cure," but instead working toward finding and using a number of partially effective methods.  Another big key:  Don't allow yourself to think thoughts that are really negative, because they make the pain and the mood worse.  Thinking thoughts that are 100% true and helpful to you is best.  That is the basis of CBT. 

OH:  Nortriptylene is an older antidepressant.  It is more used for sleep now than depression.  Some docs use it for pain, but I don't think it's very useful for that.  It is very sedating, so I can see why you now have more energy.  In my experience, it has not often been useful for depression.  The newer meds are better. 

I do find Aspercream helpful for temporary relief on my eyebrow, forehead and scalp. The hardest and most challenging part of this problem is hoping and anticipating a cure which may or may not come. 

Also, during the time I had shingles and about 4 weeks later after my shingles I was experiencing severe headaches. Which I thought was part of the shingles "pain" b/c never having shingles I did not know what to expect.

Turns out I had 4 brain bleeds. And then had emergency craniotomy

During this terrible experience I was working full time and in a management position covering sales for the Western Region. I was in my  mid 50's. I kept thinking I was going to get back to work every other week. Well long story short I was laid off during my recovery or lack of recovery.

Thank goodness I have long term health care insurance.

I have gone to a mental health therapist and it was helpful. She did use cognitive therapy.

I go to yoga and walk everyday. I also get to the gym a few times a week and I find gardening is a great way to relax my mind.

Any stress triggers my itching and burning. I am trying my best to stay positive, eat healthy and move more. This Year and a half has been full of ups and downs. I am starting to feel this will be my new "normal". 

i hope 2017 will offer more healing.

Congrats on your positive attitude .  That's what I love about this forum.  Thanks for telling what has helped you.  It helps me too!

Elsa,

Yes!  I agree with Ruth:  Congrats on the positive attitude and your ability to seek and find things that work.  It's really important to return to activities again, even when we have this long-term pain.  If we don't, we become pain invalids, and that's a really sad state.  Your yoga, walking, gym work, and gardening show that you're managing pretty well and staying active. 

In the years I worked with folks with chronic pain, I found that CBT worked the best and fastest with most people, which is really good because it then costs the patient less and doesn't result in the patient becoming dependent on a lifetime of therapy.  I also found, oddly, that people who focus a lot on hoping for a "cure" do much worse.  With pain conditions that are unlikely to be cured, it only makes us sadder when it doesn't happen.  So I don't even think of the possibility of a cure, I just do my best at management, and that works.  If a cure ever comes, great!  I'll jump right in for it.  But I don't think that will happen, so I don't waste time and experience disappointment with the thought. 

Elsa,

You talk about stress triggering itching and burning.  I don't know if it will help or not, but please try drinking more water.  I'll be interested to hear the results if you do this consistently for a week or so, whether you see a decrease in itching and burning.  I certainly do.  It took me more than two decades to discover this, Ha! 

Hi Charlie,

i will I'll try and increase my water in take and see if it makes a difference.

And Thank you for the helpful advice.

Caseysue, I just noticed you were going to try Chamois Butt'r that Charlie had suggested. Did that help with the friction at all? I found the only thing I can use in the armpit is deoderant, All the pain creams I have tried seem to leave a sticky residue that makes that area hurt worse.