The "wonderful" world of pharmaceuticals...
So uh... Hi! I'm still here, in case you were wondering... I just haven't had a lot to say over the last couple weeks, primarily because of depression that's been so severe it was all I could do to get out of bed in the mornings.
Last Saturday I hit rock-bottom in terms of my ability to cope with life and the brain God graced me with. The day started out okay, but by mid-afternoon I had a nasty headache and felt pretty down. I cancelled the plans I had and settled in to have a quiet evening in with the dog.
And then I crashed. Literally: I sat down on the couch and didn't move for quite some time. I'm not sure how long, because I didn't have a clock handy, but I ended up staring blankly at the television - which was off - in a kind of dazed stupor for several hours. I couldn't even bring myself to turn on the TV and find something to watch that I was even remotely interested in. So I sat there until it seemed like an appropriate hour to go to bed.
Sunday I felt slightly better and by Monday I was chomping at the bit to get in to see my psychiatrist. He was able to see me for a quick appointment in the late afternoon and thankfully I had work to distract me until then. He bumped up one of the medications I'm on, said I should start seeing some improvement in a couple days and suggested we re-evaluate when I went to my scheduled appointment the following Saturday.
I haven't been this depressed in about 12 years - not since before I first started taking anti-depressants. I can't even really explain how bad I felt that Saturday or how completely isolated and paralyzed I was. I've never, ever before thought about going to a mental hospital but that night the idea crossed my mind, and it wasn't the worst idea I thought of.
The strange thing is, I thought I was really depressed before I switched from Avonex to Copaxone, but this feeling was altogether different from my usual experience with depression. Usually I feel blah and uninterested in life, but I'm generally able to function - albeit at a lower level than "normal." This feeling was absolutely debilitating and it scared me a little bit, hence my urgent need to see my doctor and figure out what was going on.
When I saw my doctor this weekend, we talked about how I was feeling and he asked all the usual evaluative types of questions. And then we talked a bit about the Copaxone. He looked it up in his big-ass book of medications (and by big-ass book, I mean thousands of those tissue-thin pages like you see in many Bibles) and when he found the correct section, read out the pertinent sections about the drug and its effects on mental health. Turns out there are a lot of things in Copaxone that make it a potential depressant, and "psychotic depression" and other mental disorders are listed as "infrequent" side effects in the prescribing information.
So it's not clear yet whether the Copaxone is entirely to blame, because in general I feel better than I did when I was on the Avonex. But I wonder if having the Copaxone in my system has made my anti-depressants less effective in some way? My shrink thinks it's likely that the Copaxone has some involvement in how bad I've been feeling but has suggested that I continue on that drug - since it seems much better for me than the Interferons - and he will treat the resulting depression by increasing (or switching, if necessary) my anti-depressants. I was on a fairly low dose of those to begin with so I'm not too concerned about that, but my LORD, what a pain all this is.
Here I thought that switching to the Copaxone was going to solve the physical and mental problems I had while on Avonex, and yet many of those problems have gotten worse. Well, not many. But the one area that's really gotten worse is the one I need the most: my sanity.
So I'm just sitting tight now, waiting for the increase in my Wellbutrin to get to full effect. I do feel better, but I'm not back to how I felt before I had my MS relapse 18 months ago. (And let's just not think about how I've spent the last 18 months of my life feeling so crappy I haven't wanted to do much of anything... ) I've skipped several parties this weekend and last week that I'd agreed to go to, because the idea of dealing with people and making small talk and being friendly was more than I could handle.
I'm still feeling on the edge in that regard. A bit, anyway. So I'm just trying to focus on the positive right now and remember that I'm doing what I need to do to take care of myself. I think I'm headed in the right direction for the moment, and now I'm back to blogging... so it's not all bad, right?
Comments
Good for you for quickly seeing your psychiatrist. I'm sure about all of the possible side-effects of Copaxone, but it's less effect on mental status as compared to the interferons is the main reason my doc and I chose it.
I have been on anti-depressants for 10 years and was only diagnosed with MS 2 years ago. Last spring I was also diagnosed with rheumatoid arthritis. The aggregrate result being lots of meds.
After becoming aware of the downward spiral that had taken hold, I saw my psychiatrist/psychopharmacologist who hypothesized that with all of the meds, that the anti-depressant was probably getting lost in my system.
So we decided to raise the dosage to a level which actually exceeded the specified upperlimit. If that didn't work, we were going to try adding a 2nd anti-depressant or simply switching to something else (which all of the appropriate transition time of course.)
Fortunately, raising the dose is what did the trick. In fact, I have been able to modestly lower the dose to within the generally prescribed limits.
Anyway, good for you and if the higher dosage doesn't work, don't be afraid to try something different.
Good luck.
Posted by: Lisa Emrich | December 17, 2007 10:40 PM
Oh my! How scary that must have been for you...I'm so sorry you are having this experience during THIS time of year.
I have no answers for you and no cheap responses, so I won't bore you with patronizing jargon (as is typical for someone who works in the mental health field!). Just coping can suck sometimes...but I'm glad to hear you continue to do just that.
Take care,
Linda D. in Seattle
Posted by: Linda D. | December 18, 2007 01:00 AM
ugh, as if the ms itself isn't bad enough i can't even imagine how much worse it is trying to juggle the side effects of multiple medications. i have enough trouble just dealing with the side effects of my betaseron (i'm now in the land of cellulitis, woo hoo!) but it it'd be so much worse to have side effects from mulitple medications PLUS side effects like depression that make everything else harder to deal with.
i'm sorry you've been having such a hard time. but it sounds like you doing a good job taking care of yourself and hopefully are on your way to figuring things out. i'm glad you're blogging!
Posted by: jen | December 18, 2007 07:20 AM
I'm so glad you were able to go in and get some help. Hang in there.
Posted by: Yogamum | December 18, 2007 09:03 AM
I was just thinking this morning that I missed hearing from you on yer blog and here you are being bold in your truth. Thanks for sharing your struggle with MS and the depression that it or the meds one takes for it can cause.
I too have known debilitating depression. It's such a murky feeling and difficult to shake even we know logically it's going to pass sooner or later.
Anyway I love you and am proud of you for dealing with it all.
~F
Posted by: FranSky | December 18, 2007 10:37 AM
Copaxone doesn't seem to be the side-effect free walk in the park I thought it would be. I've never taken any other DMD's, so I can't compare but it really crappy to feel crappy. I'm sorry that you are having a hard time right now. I am glad to know that this happens to other people, too. So it's not just me. I have yet to talk to anyone involved with Copaxone (Shared Solutions/CuraScript) who will admit to the Copaxone causing the side effects that I'm dealing with. Better to continue with the drug, probably. Easy, no.
Posted by: christyn | December 19, 2007 07:06 AM
Hang in there!! It's a tough thing! But just remember how special you are and how many people care about you! I'm here if you need anything!!!
:-)
Posted by: Cyndi | December 19, 2007 07:20 AM
Glad to hear you sought help as soon as you realised the seriousness of your depression. I have experienced it to that degree only once, and coincidently it was when I was on Copaxone.I have had depression before but never as low and as dark as at that time. It scared me and I saw a psych right away.
I never thought about it being the med. I was on rebiff after that and it seemed to make me anxious. Don'cha just love the med merry-go-round?
Posted by: Cathleen Larson | December 19, 2007 09:49 AM
Glad you were able to get in to see your doc & he was able to hopefully find a solution to the problem. Happy Holidays to you & Rennie, xx
Posted by: Sara | December 20, 2007 04:09 AM