I've been anxious for almost 1 month, I don't think my anti-depressants are working

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Hello, I'm Tim. I'm new here!

In mid-May I was diagnosed with ileo-colonic Crohn's disease with mild to moderate inflammation. I was immediately prescribed 500mg of Salazopyrin, and I was instructed to take four tablets twice a day. Side note, I suffer with a Generalised Anxiety Disorder and a stammer. I was prescribed 10mg of Escitalopram of which I begun to take in early April, this was increased to 20mg during the initial start of May because I felt more anxious. It was really helping ease the anxiety and making me feel a lot less anxious in social situations, which was great and I started to really feel like my old self. The 20mg seemed to be working well, because I felt a lot less anxious so therefore my stammer was massively reduced. After my colonoscopy in mid-May where I was diagnosed with Crohns the hospital were quick to understandably put me on steroids in hope to reduce the inflammation of the colon. I had already made them aware of my mental health to which I was told the steroids would not affect. However, not long after I started to feel on edge, I begun to question myself because I was told by the hospital I wouldn't feel these feelings of anxiety I became self-conscious, I felt jittery and I was beginning to avoid people and situations. I called my Doctor, I was advised to come off them because they were affecting my mental health so badly. In a week or so I started to feel better again. I then attended a appointment at the hospital, where I was clear I mustn't have medication which will bring on anxiety. I was put on Budesonide because it has little side affects. I gave it 2 weeks, the anxiety started again. This time I felt so on edge that I had to come home from work, because it was too much to bare. I have been signed off for 2 weeks. I am weening myself off the Budesonide but that is going to take 2 weeks, I am supposed to go back to at the end of this week. I am still taking my Escitalopgram but it feels like its not even working at the moment which I gather is because steroids decrease your serotonin levels is it, which the anti-depressants are aim to increase. I feel so lethargic. I have a follow up appointment on the 9th of July where they want to review and discuss starting me on Azathioprine. Has anybody else been through a similar situation? Will the anti-depressants start working again once I come off the steroids? Has this interrupted my anti-depressant cycle? Is there another drug I can take in the meantime? What is Azathioprine like? I have an appointment with my GP tomorrow. I am my wits ends, I felt like I was making progress with anxiety before this Crohns diagonis and dose and dose of steroids. Can anybody offer some reassurance please? 

All your support would be very much appreciated.

Thank you,

Tim

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  • Posted

    Hi TIm

    Sounds like you're having an awful time. And the steroid treatment should never have been given as your mental health issues were bound to be affected. 

    It is the cheapest route to treatment, however there are brilliant biologic treatments available now and I think you should ask for them. Infliximab, Adalibumab and Vedolizumab.......they are far more effective and should have less impact on your overall mental health. 

    I wish you all the very best. And please please do as much research as you can. You need to learn how to trust your own body and intuition and do what feels best for you. The doctors are definitely not always right!!

    Take care

    Hannah 

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    • Posted

      Thank you Hannah for your reply!

      You are right - I am having an absolutely horrible time, you are right. I was such in a good place before taking these steroids. I just want to feel like I did again!

      Thanks again.

      Tim

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    • Posted

      Hey Tim

      You will get back to that good place again.  The steroids really do mess with your head...... they definitely do with mine so I only use them in absolute emergencies and only with a plan to move onto better treatment. My go to treatment of choice to avoid steroids has always been a purely liquid diet (MODULEN IBD) for 8weeks minimum with the guidance and support of a dietitian. Perhaps ask for this as an alternative if your bowel needs a rest and time to heal and calm down.  It's not an easy option but will definitely help in redesigning lifestyle choices with food and help you discover trigger foods with your Crohn's.   

      As you reduce your steroids your mood will plummet and your Crohn's symptoms will increase. It is totally normal.  So you really need to trust that you will get through this and to the other side

      Whatever tricks and aides and support you can give yourself to get through this the better. 

      Be kind to yourself.  

      It will get better. 

      Hannah

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  • Posted

    Hi Tim, my goodness you have your fair share of problems and I am so sorry to hear them.  All I can say is I took Azathioprine for 4 years.  My Consultant didn't want me taking them for longer than 5 years because of the damage they can do.  When I was first diagnosed, I was put on Steriods weened off them after 9 months and put on Azathioprine and Pentasa.  Was on Aza for 4 years and weened off them and now only take Pentasa but have been told I will have to take for the rest of my life or until they stop working and then I they will have to find something else for me.  Azathioprine was fine for me but not for everyone.  That is something you find with this illness is that what suits one person doesn't suit all.  My brother suffers the same and he is on totally different medications.  I have not  got the added problems you have so medication for you will probably be harder to sort.  You must go with what the Professionals say and keep asking questions and emphasising to them the problems you have.  Don't just tell them once thinking it will follow through on all appointments.  I find that problems must be mentioned at every appointment !!!.  Good luck to you and I hope you get some answers and results soon.

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  • Posted

    Hi sorry your having such a hard time but there is no easy fix with this chrons. It is in my experience a long drawn out process.

    Initially when first diagnose people are all ways put on steroids and buscapoan to settle the inflammation down. Once it gets slowly controlled then you will go through a stage of finding the right medication. It's hard as most of the drugs used to control chrons has some sort of side effects.

    On a personal level I went on azapophaine total complete reaction that made me very sick. Followed by methotrexate which at first with injection giving weekly seemed ok at first but three months into treatment and then on tablet form became no responsive and again not well..

    Then went down the biologic route. 9 months on infimax then body rejected that I'm a strange one .... then finally 4 years into this I am on velizamab and touch wood have been well for two years.

    I'm sure with the care of your lbd team and doctor you will get some relief and take control of your chronns good luck think positive lots of good treatments out there..

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