Pain causing pain - considering Cymbalta.

Right now I'm dealing with my pain (lack of management) causing my depression to spiral deeper and the two keep feeding off of each other. On Sunday I couldn't get out of bed. My sleep has been completely disrupted, getting a few hours here and there, any time day or night, and feeling like a zombie the rest of the time. I will make an appointment with my Rheumatologist once I can get past how foggy I am right now. I'm going to ask if I need to add Cymbalta to my medications since I haven't been able to take Prozac in a while and not medicating my depression is starting to take it's toll on me again. The last time I was treating it was last summer while Tony cat was sick and I continued a couple months after he passed away, but eventually the dizzy spells and migraines from it became too much so I just stopped. I know I shouldn't have, that I should have asked a doc to switch me, but I'm so sick of appointments I've just been avoiding some because I feel like going to appointments would become a full time job right now if I did, I'm already out of the house for physical therapy twice a week right now, and that's taxing.

Anyway, from what I keep reading, Cymbalta is the anti-depressive of choice for those with chronic physical pain issues and depression too.

The majority of my pain is in my back these days. I think physical therapy is working well for my hips, but that my back is either getting worse or is more noticeable with the hips not being as much of an issue. The back pain is keeping me from sleep. I feel like someone kicked me in the back and now it's all achey and stiff. Or like I have a lead pipe around my spine. I'm suffering limited balance and limited range of motion and I'm find myself leaning on counters and using my cane more even though my hips are a bit better. (Bursitis anyway, still dealing with Osteoarthritis and labral tears there, that only changes with surgery.)

Because this makes sleeping impossible, the lack of reparative rest makes my head foggy, pain more intense, and depression worst. The following is something I found because I was wondering what, if any, information might be out there in regards to A.S./R.A. and depression. I found that, like a lot of other forms of depression women are effected more than men. Kind of interesting that they could monitor that considering males are diagnosed with A.S. more than women, but according to the Spondylitis Association of America those statistics are changing.

Here is what I read;

Wiley InterScience

Depression has been established as a common reaction to rheumatoid arthritis but has rarely been investigated among people with other forms of arthritis. The present study examined the prevalence and determinants of depressive symptoms in people with ankylosing spondylitis, focusing on gender differences and set in the context of widely held medical views concerning the psychosocial nature of ankylosing spondylitis patients. Results showed that approximately one third of the ankylosing spondylitis patients reported a high level of depressive symptoms and that women reported more depression than men. No evidence was found to support the stereotype of the typical ankylosing spondylitis patient as being less depressed than people with other forms of arthritis. Pain was found to be a major determinant of depression for women, but was of lesser importance for men.

Depression in Women - Spondylitis Association of America;

People with chronic diseases are more prone to develop major depression. In fact, a British study showed that 37% of people with spondylitis suffer at least one bout of depression during a lifetime. Fortunately, more than 80 percent of people with depression can be treated successfully with medication, psychotherapy or a combination of both.

Women experience depression at roughly twice the rate of men, although it is an illness that affects both sexes. Contrary to popular belief, depression is not a "normal part of being a woman" nor is it a "female weakness". Researchers continue to explore how issues unique to women may contribute to the increased rate of depression. Such issues include reproductive, hormonal, genetic or other biological factors; abuse and oppression; interpersonal factors; and certain psychological and personality characteristics.

About one in every eight women can expect to develop clinical depression during their lifetime. Depression occurs most frequently in women aged 25 to 44 (Note: when a women is most likely to begin feeling the symptoms of spondylitis), and depression in women is misdiagnosed approximately 30 to 50 percent of the time.

So all this being said, I'm trying to get out of my fog. Finish up my physical therapy in the next couple weeks, and make an appointment with my Rheumatologist to find out what my next step is with physical therapy, and to see about adding Cymbalta. Most likely I'll need a new script for physical therapy to this time work on my back. I also need to remember to get a new referral for an orthopedic surgeon. I had one in my purse, but I took it out when we went to California because I didn't want to loose it, and here I've gone and lost it! I've looked all over and just haven't been able to find it! A lot feels chaotic these days. So disorganized and frustrating. I'm hoping things will get better soon though.

I'm really just making this post to remind myself of all these things, to keep track of the information I've found and to remind me to share it at my next appointment. I'll be OK, I've pulled out of issues like this before.