Coping with depression and chronic pain on top of COPD

Note: This column discusses depression, including thoughts of hopelessness and suicidal ideation. Resources for help are listed at the end of the column.

This column also describes the author’s own experiences with various medications, including Lexapro (escitalopram) and trazodone. Not everyone will have the same response to treatment. Consult your doctor before starting or stopping a therapy.

Those of us with chronic obstructive pulmonary disease (COPD) often have other health issues, or comorbidities. Many of these conditions have a common denominator: inflammation.

One of my comorbidities is arthritis, and when that condition worsened, I found I could no longer cope with everything that was going on.

Hip pain has bothered me from time to time, but for a while, topical pain medications and physical therapy exercises kept me mobile. Unfortunately, I had to stop taking anti-inflammatory medications because they caused my reflux to worsen. I still performed my physical therapy exercises, which consisted primarily of stretching. This worked rather well until last September, when I had pneumonia.

After my bout with pneumonia, I never got back to my normal level of activity due to the pain in my hips. But I exercised daily, as well as I could, and was doing OK — until March arrived. March is a challenging month for me because it’s when my late mother and my late son were born. No matter what techniques I tried, I couldn’t overcome the feeling of being stuck in a rut.

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Along with the pain, I was also having great difficulty falling asleep. I couldn’t get to sleep before 2 or 3 a.m. I tried meditation, sound therapy, and some over-the-counter remedies, but nothing seemed to help.

Then, last month, I found I was no longer able to complete my exercise routine. I had too much pain in my hips and had lost the will to carry on. At this point, I realized I was likely struggling with depression.

One night, as I prepared for bed, I found myself thinking, “You might as well die in your sleep because you’re not useful anymore.”

When I awoke the following day, I realized that I was not likely to escape the hole I was in on my own. I had stopped wanting to leave the house, so I checked with my health insurance provider and found that MD Live, a virtual healthcare service, was covered under my policy. I went to the website and scheduled an appointment with a psychiatrist.

During the appointment, I was diagnosed with major depressive disorder. The psychiatrist told me that I might be able to come out of this on my own, but my answers to his questions led him to believe that I would not. He also asked if I had tried talk therapy. I replied that I had, but had stopped because I’d tried all of the therapist’s suggestions and nothing seemed to help.

The psychiatrist prescribed me Lexapro (escitalopram), an antidepressant, and instructed me to schedule a follow-up appointment within three weeks. During that follow-up appointment, I told the doctor that my sleep issues had not gotten better, but my mood had undoubtedly improved. He then prescribed me trazodone.

Trazodone is an older antidepressant, but doctors may prescribe it as a sleeping aid due to its sedative effect. I’ve found the medication to be quite effective in improving my sleep.

The one symptom of COPD I could never find a solution for was fatigue. I experienced some level of fatigue every day, but stayed true to my motto of “keep on keepin’ on.” It is difficult to describe the relief and elation I feel now that I’m no longer tired during the day.

In retrospect, I’ve probably been suffering from depression for quite some time. The straw that broke the camel’s back, as the saying goes, was continuing arthritis pain and the onset of the difficult month of March.

I write this in hopes that someone who needs treatment will be encouraged to seek it.

If you are struggling with thoughts of suicide, please contact the Suicide Prevention Lifeline in the U.S. (988, or 988lifeline.org, available 24/7) or Samaritans in the U.K. (samaritans.org).

Note: COPD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of COPD News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to chronic obstructive pulmonary disease.