Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Is depression linked with AS?

I really wish I had some good news right now and hopefully I will have some good news soon..

I have had depression on and off now for probably about a year and I just don't know why! I don't get it. Normally I wouldn't say anything but this time I have been feeling really low and hopeless. This is the first time that I have really taken it seriously and now I understand how hard it can be and it is definitely something to be taken seriously. At the moment, I am feeling pretty good physically, but mentally I'm struggling a lot. I've been watching my diet and my AS pain has dropped for a bit which is great and I am pleased about that!

I don't understand depression. I'm happy with myself and my looks most of the time so I don't see that as the problem. I live in a well off family. I have had a great upbringing. It doesn't make sense. I just can't trigger it. The only things that I think have influenced my mentality this time is problems with my friends and most significantly a girl.

Has anyone else had problems with depression? I just find myself sitting at home feeling bad.

This is as bad as it has been so I really felt like I had to say something to anyone and see if anyone can relate or has any advice?

Thanks a lot. Sorry again, but I just felt I had to share with someone. Good news to outweigh the negatives in the near future I hope.

There are some who say chronic illness (no matter how well controlled) can trigger depression.

My husband, who has prostate cancer, is now on an antidepressant. His cancer is post treatment and he is doing pretty well, but the chronic nature of it was bothersome. His primary doc was quick to point out that chronic 'anything' can cause depression. It may just be a combination of several 'anythings'. And being the holiday season, when people are supposed to be happy....it's just an added insult.

Don't feel bad about yourself. It's nothing you did or didn't do. If you are distressed, see your doc and see if a brief time with an antidepressant would be of help.

Hey Seb!!
I can't say for sure that it is linked. I suffer from depression but I have had some bad life experiences that I know caused it (loss of my mother). Some days though I don't feel like its grief...that's it's just for no reason.
Don't feel bad that you feel that way. I have learned just to accept that that's the way I feel and I do what I need to do to make it pass. Some days I dont want to get out of bed and if I have no commitments I don't!! People try make me feel bad for doing that but it only lasts a day or two and then I'm fine. I feel that's because I've done what I felt I needed to do and got it over with.
I find that going for a walk with my favourite songs playing in my ears helps. I go and sit somewhere beautiful and peaceful and it really lifts my spirits!
Don't ever feel bad about feeling bad. Everyone crashes sometimes.
If you ever feel like you need a chat or anything send me a message. I am more than happy to help or yeah just keep doing what you have done by posting on here. Everyone is so helpful and welcoming
Moo Moo

Yes AS and depression are linked.
- 'Gender, depression & ankylosing spondylitis' - http://www.ncbi.nlm.nih.gov/pubmed/8443258
- 'Disease & psychological status in ankylosing spondylitis' - http://www.ncbi.nlm.nih.gov/pubmed/16595514

This is most likely due to the pro-inflammatory cytokines that are part of AS.

"Several medical illnesses, which are characterised by chronic inflammatory responses, e.g. rheumatoid arthritis, have been reported to be accompanied by depression. In addition, administration of proinflammatory cytokines, e.g. in cancer or hepatitis C therapies, has been found to induce depressive symptomatology. Administration of proinflammatory cytokines in animals induces 'sickness behaviour', which is a pattern of behavioural alterations that is very similar to the behavioural symptoms of depression in humans." - (Cytokines and major depression - http://www.ncbi.nlm.nih.gov/pubmed/15694227).

This paper discusses how depression may have a pathophysiology that involves gut barrier dysfunction and exposure to bacterial endotoxins which is very similar to what some scientists consider to be part of the pathophysiology of AS - 'The gut-brain barrier in major depression: Intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression' - http://posterous.com/getfile/files.poste...rrier_paper.pdf

This is also a good podcast discussing the gut-brain axis that is well worth a listen - http://chriskresser.com/the-healthy-skeptic-podcast-episode-9

I think the key with AS related depression is to understand that it is likely to have a large physiological component and not just a psychological one. Unfortunately this doesn't make it any less awful to experience. It also doesn't mean that it can't be initiated or made worse by traumatic events or greatly improve when good things happen but it can help to know that if things are generally ok and you suddenly feel really bad for no apparent reason (especially during an AS flare up) then it is likely that the problem isn't you, or the weather, or the cricket score, but a part of the physiological inflammatory process of AS interfering with normal brain function.

we are all different. for me, my moods correlate very directly with my pain levels and/or what is happening in my life.

but clinical depression is physiological and doesn't have to correspond to anything. that's i think what sets it apart.

on the other hand, you mentioned something about a girl. when i was younger, my relationships definitely affected my moods. that i think is normal.

i guess only you can judge if this is within "normal" or something that you should see a doctor about.

though going back to the original question: pain can trigger depression and depression can trigger pain.

but if you are having issues with relationships, that is another thing to consider as well.

hope happier days are just around the corner

i find that the busier i am, the less i will notice and be affected by being down (about something). or i'll go out of my way to do things and be around people that i know make me happy to try to work myself out of my mood. but if one has clinical depression, then those sort of "tricks" won't work, anymore than wishing away any other sort of illness.

Hey Jroc,

What do you mean by Depression having a large physiological component effect? Do you mean that depression can affect the physicality of one with AS? Don't quite understand that part.

Seeing as you mentioned cricket.. Did you see the score?! First time we've beaten Australia in 20 odd years, that certainly brightened up my day a little!

Hey Sue,

I'm hoping that my current situation is affecting this phase because if so then it would make it a lot easier to manage.

I have just finished school and have been wondering wwat I am going to do with the rest of my life, something that I find very daunting. I miss school because it gave me a routine. I was able to go everyday and see my mates and I was generally pretty happy with my everything (aside the AS struggle of course).

Now I wake up in the morning and don't know what to do everyday. It doesn't help that I fell out with a few of my friends. And yes, issues with a girl has DEFINITELY affected me.

So I'm thinking that I need to get a job or something and really find myself a routine otherwise it really is a crippling, horrendous cycle.

Thanks for the help

hey seb,

sorry that wasn't clearer. what I was meaning by a physiological component is that inflammation in the body can cause depressive symptoms in the brain that can be independent of physical pain or psychological aspects.

for example if you take a normal happy person and inject them with inflammatory cytokines they often develop symptoms of depression. inflammatory cytokines were used to treat some diseases which required an increased immune response but often caused depression as a side effect. "Pro-inflammatory cytokines can induce depression in 70% of people treated with such agents."(http://evolutionarypsychiatry.blogspot.com/2011/12/beyond-chemical-imbalance-part-2.html)

so it is possible for someone with AS with high levels of inflammatory cytokines to feel depressed for no other reason than the inflammatory cytokines in the bloodstream (the physiological aspect) crossing the blood-brain barrier and causing depression in the brain.

as we don't live in a psychologically neutral vacuum it can be difficult to distinguish physiological depression from psychological factors. as sue points out you have to know yourself and be aware of your moods and what affects them so that you can be your own detective. it sounds like you have a bit of stuff going on in your life at the moment that is likely contributing to your current situation.

further complicating matters is that the the gut-brain axis is a two way street. gut health can affect mental health and vice versa. mental health aspects such as psychosocial stress, social isolation and reduced sleep have been shown to increase inflammation along with lifestyle factors such as low exercise and poor diet so it is very easy to get sucked into a viscous cycle of poor mental and physical health.

i'm in the same boat at the moment as I just finished uni and have absolutely no idea what to do with myself. remember that you don't have to figure out what to do with the rest of your life, you only have to figure out what to do next! if it turns out to be crap then you learn from the experience and move onto something else. as sue mentioned, getting out and about and doing stuff and interacting with people is often a good way to get out of a bad patch.

PS that cricket was awesome! i am ashamed to admit i gave up on them on 159/2 and went on the computer. when i went back they were 192/5 and i watched it for a bit then went outside and when i came back they were 199/9! i thought we had it in the bag at that stage and then it turned into a nail biter. great stuff.

Hey seb, I have a suggestion that I'm certain will help. If you are able to, go out for a nice long walk at least for an hour or any other kind of physical activity that you enjoy. I know it can be hard to motivate yourself when your feeling down but trust me it will be worth it! Break a sweat then have a long hot shower this will naturally boast your feel good hormones. Giving you a big hug right now! Good Luck!

i second that. exercise, especially outdoors, really does lift my spirits.