The depression question

Posted , 7 users are following.

I just wanted to say that chronic pain and fatigue can set off a real depression that cannot be overcome with just positive thinking. Some people - maybe those who already struggle with occasional depression - can be helped tremendously with anti-depressant medications. I would suggest at least talking with your family doctor. Just as your knee needs pain meds temporarily, your brain may need some help - temporarily. I’m not pushing medication for all recovery blues, but I do believe some can’t just think their way happy.... like me.

https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/pain-and-depression/faq-20057823

0 likes, 15 replies

Report / Delete

15 Replies

  • Posted

    Hi Alimarie,

    Your link is very helpful, as I'm one of those people who can't think themselves happy, I can do it for about a day and then reality hits back at me. I would love to be one of those positive people, but too much has happened in my life .....the TKR being the most recent dilemma, I thought I'd be walking miles every day by now but it has set me back in more ways then just walking.....where is that Mayo clinic, I've seen adverts for it before. ROSE

    Report / Delete Reply
    • Posted

      Mayo started in Rochester, Minnesota, USA. But they have several hospitals across the US now. They are known for their expertise and research in many areas. 

      I, too, thought I’d be walking well by this time. (10 weeks post TKR). I’m still limping considerably so I use a crutch. At work, I use a mobility scooter if I have to travel far across my large building - on concrete floors.

      Even in these times, there is still a perception that depression is weakness of mind. But for some, it’s a real and treatable medical condition. And getting that stabilized will help with the knee recovery, I believe.

      Report / Delete Reply
  • Posted

    You are so right. I had my rtkr over a year ago, I am still experiencing some pain and insomnia.
    Report / Delete Reply
  • Posted

    I respectfully disagree.  One big problem with this approach is withdrawal.  SSRIs and SNRIs are extremely difficult to get off of once you start them.  The number of cases of people trying to withdraw from drugs like Cymbalta, Prozac, Effexor and the like and what they go through are staggering.  I have experienced that myself once or twice. 

    For a TKR, the pain is not chronic but temporary.  The depression may seem very real but it's not...

    https://patient.info/forums/discuss/tkr-and-post-operative-depression-604195

    I had the same depression when I had my hip replaced nine years ago.  After three days, I called my MD cousin.  It's a medically DOCUMENTED condition called Post-Operative Depression caused by the subconscious mourning the loss of an original body part.  Once you realize this, you arm yourself with a weapon to fight this absolutely normal depressive effect of the surgery.  When I started to feel it post-TKR, I kicked it out the door because I knew exactly what it was.

    Then you apply other techniques, especially exercise to rebuild your muscles AND generate endorphins to counteract the depression.  Also getting your mind off the depression and onto productive activities is also key...

    https://patient.info/forums/discuss/the-power-of-rest-some-great-strategies-to-try-on-a-tkr-617892

    Remember, this is a very temporary pain/fatigue/depression cycle...it is NOT chronic.  There are ways to get past this without the anti-depressants.  Remember, it literally takes weeks to titrate up to an effective medication level with those drugs.  By the time they really kick in, you're likely past the worst of your pain and moving on.  I'm "Not-a-Doc" but I have had a lot of experience in this area personally and with family.  I also have many personal resources in the medical and pharmaceutical fields, including a friend at J&J with PH.D.s in pharmacy, chemistry and pharacokinetics.  Plus, following my wife's brain aneurysm 8 years ago, we ran through every anti-depressant known to man.  

    Given all these factors, especially the temporary nature of the problem coupled with the severe withdrawal symptoms associated with these drugs, I would respectfully recommend against this path.  Then again, everyone gets to make their own choices.  Just know what's ahead if you go in this direction.

    Report / Delete Reply
    • Posted

      Meditation does help! The pharmaceuticals for depression are rough for sure and the withdrawal us slow and hell! CBD oil, passion flower, dopamine, valerian.....a good naturopath did help me. I took non narcotic sleeping pills to try to get some sleep but they were useless. After 3 or 4 months I was much better. Today, at 5 months I need to exercise more but I sure feel way better. I get a furalane s**t in my other knee and can say I feel better and move better than before surgery. It was very hard...but they right..it is worth it . I appreciate all your posts especially since I found myself looking for my real knee those first couple months - thanks for explaining that better than I could! Regards from Toronto.

      Report / Delete Reply
    • Posted

      Agree to disagree. :^) I take a small dose of Wellbutrin every fall for seasonal affective disorder. As soon as the days get longer and lighter, I easily transition off the medication.  And I respectfully disagree with your statement that the depression is not real. I’m not saying everyone needs medication, but it is not a weakness to at least speak with your doctor about options- particularly if you’ve struggled with clinical depression prior to TKR.  (And I do agree that many of the drugs you mentioned have awful side effects. I can’t and won’t take those.) Truce?
      Report / Delete Reply
    • Posted

      Excellent comments...Wellbutrin is in a class of it's own. Clinical depression can be extremely dangerous. I have had both kinds of depression...and the knee threw me into a nasty situational depression, even lost a long time friendship from it. We are all different and need to access help in dangerous and serious times. Thanks for your post - I actually use a special light every day to help combat my slide in the Fall .

      Report / Delete Reply
    • Posted

      Clarification...  All depression is very, very real to the person experiencing it...no doubt about that.  The question becomes one of causality.  In your SAD situation, the cause (change of seasons) is known, with or without science explaining the underlying reason for the effect. SAD is absolutely real and the meds help.  Perfect.

      Post-Operative Depression is also a known, medical condition.  When I was crying for three days after my hip replacement, my MD cousin asked: "You mean your doc never told you to expect this?  He should have told you since it is so common."  So, now we know the underlying causality of POD: You're now missing a piece of original manufacurer's equipment.  Sure, it seems very real...I went through it with my hip.  However, once you are aware of what's causing the depression, you can mitigate the effects of it without resorting to SSRIs and SNRIs. 

      It's the same as going to a shrink about depression or a phobia.  Once you find out what's really behind your subconscious reaction to a specific stimuli, you can avoid it or confront it and deal with it.  In this case, be your own therapist.  You know that POD is a real post-op condition and that, according to the docs, it passes pretty quickly.  Knowledge is a powerful weapon against this thing.  I felt it coming on when I had my TKR and dismissed it...no effect on me because I knew what it was and dealt with it.

      Clinical depression, especially Treatment Resistant Depression (TRD), is something completely different from POD.  I agree that an already depressed person might have a tougher time with POD than one who wasn't in that state already.  My wife suffered from TRD for 7 1/2 years following brain aneurysm surgery until she became completely paralyzed by it to a very dangerous point.  For that, we had to seek out a very rare sub-species of humanity...the neuropsychiatrist.  Luckily, we have them at a special hospital in Dallas.  For my wife, they recommended Electroconvulsive Therapy (ECT).  Like the old "shock therapy" but very much updated and safer.  They run a brief current through the brain under anesthesia.  After almost 8 years of hell, I got my wife back...her brain chemistry magically restored to normal.

      Yeah, I have some experience with this stuff.  POD is very common, almost normal, when a body part is replaced.  Know what it is, wrestle it to the ground and kick its a$$ out the door.  If you need help by talking to your doc or a therapist, do it.  Just stay away from those drugs.  This is a very temporary condition.  You don't use a sledgehammer to squash a fly.

      Truce.....

      Report / Delete Reply
    • Posted

      I'm with Chico - Literally millions of people taking regular medication for 'psychological problems', many of whom will struggle to get off and most of whom don't need to be on in the first place....The pharms companies wont mind however, as they depend on us being ill for profits and your GP who prescribed them for you, will be taken to the launch of the next 'super-drug' in Fiji, or somewhere similar... 

      I've had some incredibly low days. And I mean very low ! I'm 16 months post-TKR and have a full revision planned for the new year, which doesn't make me happy, but there is no way I'm going to risk addiction to anti depressants..

      One day your leg will improve, then you have another problem to deal with..

      SMILE now and see how it 'feels'.... If it feels better, do it again and again.........

       

      Report / Delete Reply
    • Posted

      Peter - While I must believe you have the best of intentions, telling a truly depressed person - for whatever reason they are depressed - to smile, actually makes them (me) feel worse. It’s like saying to a diabetic, “Just think positively and your insulin levels will be normal.”

      We never know the life experiences, conditions, situations  someone is dealing with. . . Just as everyone recommends that we cannot compare our own knee recovery timelines to others’ recovery experiences, we cannot use a one-size-fits-all fix for the very real blues that accompany prolonged recoveries and pain. For some, those blues are just sadness over the situation, but for others- the pain can trigger true depression that cannot be wished away. I don’t think anyone chooses to feel depressed.??

      My own mother does not understand dealing with chronic pain (which I have extensive personal experience with - not just this knee), and she can reduce me to tears by telling me to “just get over it” when all I really hope for is a hug and a statement like “I’m so sorry you’re hurting.” 

      Report / Delete Reply
    • Posted

      Martha - I truly don’t think anyone intends to be hurtful (hopefully), but like my mother - their own experiences are different, so they come at things from a different perspective. 
      Report / Delete Reply
    • Posted

      BTW, thank you for explaining about the Mayo hospitals....I live in Ireland and we have a county called Mayo.....I thought this Mayo clinic might be in Ireland....silly me, 😊

      Report / Delete Reply
  • Posted

    I take effector and have no intention of coming off them, and I make no apologies to anybody for being on them, I don't have clinical depression it was brought on by many awful situations, smile and positivity is a load of rubbish and so is talking counciling, if you have genuine sadness and hurt talking isn't going to change the situation, anyone who says ....get over it or...pull yourself together haven't a clue what they are talking about....Alimarie is 100% right...no body chooses to be depressed, Rose

    Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up