Crohn's and Depression

Battling Depression in Crohn's Disease
By Connie Brichford 
Medically reviewed by Lindsey Marcellin MD, MPH 

Crohn’s disease disease is a difficult condition to live with: Symptoms of Crohn’s include diarrhea, abdominal pain and cramping, ulcers, and reduced appetite and weight loss — all of which can sap your physical energy and make you feel down emotionally. There's no question that living with these symptoms affects your mental and emotional well-being.

In fact, many people with Crohn’s disease experience depression. “Depression and Crohn’s are very commonly seen together,” says Frank Sileo, PhD, a licensed psychologist practicing in New Jersey.

Crohn’s Disease: Why You Feel Depressed

There are a number of reasons why people with Crohn’s disease experience depression. Understanding the connection between the two conditions is the first step toward dealing effectively. Here's what people with Crohn's disease should know:

Chronic illnesses affect mental health. People suffering from both a chronic illness and depression may find that each makes the other problem worse. “Individuals with Crohn's disease are dealing with a chronic illness that is out of their control," says Dr. Sileo. "There is no cure, and it impacts work, social, academic, family, and other areas of one’s life.” The words “no cure” carry a heavy weight. And not too surprisingly, facing a situation of that magnitude can lead to a more pessimistic view on life. Prolonged periods of feeling hopeless, helpless, and pessimistic are all symptoms of depression.
The physical challenges of Crohn’s disease are hard to cope with. Sileo says that Crohn’s disease “breeds a sense of helplessness and confusion.” Crohn’s disease is particularly challenging because it is so unpredictable. “There is always the threat of symptoms flaring up,” he says. It can be extremely stressful to live a normal life with this kind of uncertainty always hanging over you.Crohn’s disease can affect your personal life. 
In addition to physical problems, you might find yourself making lifestyle changes — not because you want to, but because you feel you have no choice. People living with Crohn’s disease might find themselves canceling plans with friends when symptoms flare up, and end up spending more time alone. Or they might notice that their Crohn’s disease symptoms are preventing them from working as quickly as they once did, causing their job performance to suffer, which can lead to a loss of self-worth.
Some people with Crohn's disease also feel guilty about burdening family and loved ones with their problems and withdraw from them, leading to even more isolation.

Treating Depression Along With Crohn's Disease

The encouraging news is that depression is a treatable condition, but it is one that requires professional help, Sileo says. If you have Crohn's disease and think you might be exhibiting signs of depression, the following steps can help you to get back on the right path:

Talk to a professional. Your family physician can help you find a mental health counselor or a psychologist who can help you. The mental health professional will work with you to develop strategies to combat your symptoms of depression, such as setting realistic goals and identifying negative patterns of thinking.
Do something positive for YOU.
Many people find that starting a moderate exercise plan or learning meditation techniques can have positive results. You might also want to start a new hobby or visit a place you've always wanted to go to. Setting aside time to do the things that are pleasurable to you will remind you of the many positives in life.
For some people, taking antidepressants may be the solution. If your depression is not relieved by therapy and other lifestyle changes, your doctor may prescribe an antidepressant likesertraline (Zoloft) or fluoxetine(Prozac). Since medications are usually an important part of managing Crohn’s disease, make sure you discuss any antidepressants you're prescribed with your gastroenterologist as well. This will prevent negative interactions with your Crohn’s medications. A mental health practitioner who is not an MD may not know how a new drug will affect your Crohn’s medications, but your gastroenterologist will.

Treating depression in people with Crohn’s disease is especially important. “Depression wreaks havoc on our immune system," says Sileo. "Because Crohn’s is an immune-system disease, treatment of depression is very important to avoid overtaxing an already compromised immune system.”

SOURCE: Everydayhealth.com

Mood Disorders and Inflammation

Mood Disorders Linked to Inflammation

Written by Brian Krans
Published on June 12, 2013

A large-scale Danish study strengthens the hypothesis that mood disorders like depression are directly tied to inflammation.

Depression and other mood disorders could be the brain’s response to inflammation, according to a new nationwide study from Denmark released Wednesday. 

The study, published in the journal JAMA Psychiatry, is the largest of its kind and adds further evidence to the emerging theory that certain mental health conditions could be caused by inflammation.

Researchers found that patients with an autoimmune disease were 45 percent more likely to have a mood disorder, while any history of infection increased the risk of a mood disorder by 62 percent. About one-third of people diagnosed with a mood disorder had been hospitalized in the past for a serious infection. 

Inflammation is the body's protective response to an infection, while autoimmune disorders are inflammatory conditions caused by the body's overreaction to naturally occurring substances and tissues.

“The associations found in this study suggest that autoimmune diseases and infections are important...factors in the development of mood disorders in subgroups of the patients possibly because of the effects of inflammatory activity,” the researchers wrote.

The new study offers insight into the mechanism of common mood disorders, including depression and bipolar disorder, and may help guide treatment and prevention efforts.

Inflammation as a Potential Cause of Mood Disorders

The Danish researchers drew on a nationwide database of more than 3.56 million people born between 1945 and 1996. Of those people, about three percent—91,637 people—were admitted to a free state hospital for mood disorder treatment.

Researchers compared the incidence of infections like sepsis, hepatitis, and urinary tract infections, as well as autoimmune disorders like lupus, anemia, Celiac disease, and Crohn’s disease, with the incidence of bipolar disorder, depression, psychotic depression, and other mood disorders.

They found a strong correlation between infection, autoimmune disorders, and mood disorders, strengthening the hypothesis that depression is directly linked to inflammation.

Earlier this year, another team of Danish researchers published a study in JAMA Psychiatry showing that elevated levels of a C-reactive protein—which the body produces in response to inflammation—in the blood are associated with an “increased risk for psychological distress and depression in the general population.” 

In 2011, a study in the Journal of Neuroinflammation found that high levels of another byproduct of inflammation, quinolinic acid, are associated with chronic depression and suicidal tendencies. 

These discoveries may point us toward better treatments for chronic mental health conditions. 

“Anti-inflammatory agents have actually been suggested to improve mood symptoms in patients with inflammatory disorders and enhance responsiveness to antidepressants,” the latest study reported.

Treating Inflammation Naturally

Getting regular cardiovascular exercise, drinking plenty of water, and relieving stress are all proven ways to help reduce inflammation.

A diet rich in omega-3 fatty acids like olive oil and salmon, dark leafy greens, ginger, garlic, and green tea has also been shown to reduce inflammation and improve overall health.

Source: Healthline.com

My Eye Exam

I went for my eye exam today. Basically because of my immune disorder, i have dry eyes and inflammation, recurrent sinus infections, and blurry vision with near sighted, far sighted and an astigmatism.

She said my 29 year old vision is acting closer to 40. I needed bifocals and need to start wearing them 24/7 mostly. She said it will continue to get worse, especially the less i wear the glasses and the more strain i put on my eyes.

So yay ... thanks Crohn's, you've taken over another part of my body and health! Such a selfish disease! But i will fight you back even harder! #hopeforacure

Crohn's and Your Eyes

Ccfa.org Article

Eye Complications in IBD

Approximately 10% of people with inflammatory bowel disease experience eye problems. Most of these are treatable and do not pose any significant threat as far as loss of vision is concerned. Still, if you notice any type of eye irritation or inflammation, bring it to your doctor’s attention sooner rather than later.

TYPES OF EYE DISORDERS

UVEITIS

One of the most common eye complications in IBD is uveitis, defined as painful inflammation of the uvea—the middle layer of the eye wall. Individuals with uveitis may notice pain, blurred vision, sensitivity to light, and redness of the eye.

These symptoms may come on gradually or quite suddenly. To make a diagnosis of uveitis, an ophthalmologist (a doctor who specializes in diseases of the eye) uses a “slit lamp.” This is a special microscope that allows the doctor to look at the inside of the eye. Uveitis generally improves when the IBD is brought under control, but the ophthalmologist may prescribe special eye drops containing steroids to help reduce inflammation. If left untreated, uveitis may progress to glaucoma—a disease of the eye marked by increased pressure within the eyeball—and possible vision loss.

KERATOPATHY

This eye disorder is an abnormality of the cornea that develops in some people with Crohn’s disease. Again, an ophthalmologist uses a slit lamp to make the diagnosis by spotting white deposits at the edge of the cornea. Keratopathy does not cause any pain or lead to loss of vision, so usually it does not require treatment.

EPISCLERITIS

This condition is an inflammation of the outer coating of the white of the eye, called the episclera. When the tiny blood vessels of the episclera become inflamed, they dilate and the area becomes red. In addition, episcleritis also may produce pain and tenderness. Steroid eye drops and topical vasoconstrictors are commonly used to treat episcleritis, but the condition may resolve on its own as the patient’s inflammatory bowel disease starts to improve.

DRY EYES

A deficiency in vitamin A may result in dry eyes (also known as keratoconjunctivitis sicca or KCS). This condition, which is caused by decreased tear production or increased tear film evaporation, may then lead to eye infection and irritation such as itching and burning. If the infection becomes severe, antibiotics may be necessary. Another possible consequence may be night blindness. Artificial tears provide relief of symptoms. Vitamin A supplements, taken either orally or given as intramuscular injection, can correct the deficiency.

OTHER PROBLEMS

Inflammation may develop in other areas of the eye such as the retina and the optic nerve, although this occurs infrequently. Also, it is not only the IBD itself that may cause eye disorders; sometimes the medications used to treat the disease create their own set of problems. For example, long-term use of corticosteroids may lead to glaucoma and cataracts (clouding of the lens of the eye that impairs vision).

SUMMARY

Although not everyone with Crohn’s disease or ulcerative colitis will experience IBD-related eye conditions, a regular examination by an ophthalmologist is very important. Early detection of eye problems generally results in successful treatment and preservation of healthy vision. The Crohn’s & Colitis Foundation of America provides information for educational purposes only. We encourage you to review this educational material with your health care professional. The Foundation does not provide medical or other health care opinions or services. The inclusion of another organization’s resources or referral to another organization does not represent an endorsement of a particular individual, group, company or product.

Update on My Health

Lately I have been so so. The antibiotics seem to help. But I am cramping so bad. I barely can move but its life and I have to. I have been pushing through, getting to my appointments anyway! :)

I posted some pics of me lately. I did my hair and have been trying to get dressed more often. Getting out of your pjs helps your anxiety so much!! Same with going to the gym!  My body may be hurting or i may be throwing up after 20 minutes or I may do ok but I still go regardless because it helps me feel more confident and I need that!

Camera Endoscopy Finally

I finally went in to swallow the Pillcam. I got there at 7:15am and go back to turn in the device at 3:45pm.

I couldn't drink until 9:45am and then only clear COLORLESS liquid,  which all i had was water. I'm allowed a light snack now and then no food or water until after i turn it back on :/ ugh

Also I can't exercise but I have to stay moving, no sitting or laying around. I was definitely hoping for a nap but nope lol I have to stay moving to keep the pill going through me.

Just a few more hours!!

Vaccine: Possible Cure for Crohn's Disease

Hope has come for sufferers of a crippling bowel disease in the form of a new vaccine.

The news comes as fears are rising that Crohn’s disease is caused by a bug found in milk.

Human trials begin this summer on the innovative vaccine which researchers believe is a breakthrough in the battle to find a cure for the disease.

Scotland has one of the highest incidences of Crohn’s disease in the world with one in 200 people affected. The majority of these are young people and children.

Professor John Hermon-Taylor of King’s College, London is convinced a TB-like bacterium called MAP ((mycobacterium avian subspecies paratuberculosus) is the cause of the disease.

The bug causes a similar illness in cattle, sheep, pigs and primates, and he believes, once passed into the food chain, through milk or meat, causes most human cases of Crohn’s disease. The bacterium is now also being implicated in a similar inflammatory bowel disease, ulcerative colitis.

New research commissioned by the UK government has also revealed evidence that MAP may be the cause of Crohn’s.

In the report issued a few months ago by the Government’s Advisory Committee on Dangerous Pathogens, Dr Ingrid Olsen said: “Together with all the genetic susceptibility emerging over the last decade, it is very hard to reject the hypothesis of mycobacteria being involved in the development of CD.”

The report also reveals live MAP is much more prevalent in pasteurised milk supplies than previously thought.

According to Dr Irene Grant of the Institute for Global Food Security at Queen’s University in Belfast, 50 per cent of dairy herds in the UK are affected.

In the government report, she added: “Without effective control programmes, MAP infection has spread widely and unquestionably the potential for human exposure to MAP via milk, dairy products and potentially beef has risen too.

“There is evidence that the incidence of Crohn’s disease in various countries has been rising over recent years.”

The bug has also been found in high quantities in infant milk formula which the report says is of particular concern.

The latest evidence reveals the bacterium can survive pasteurisation at higher temperatures than previously thought.

Crohn’s disease and ulcerative colitis have rocketed in babies and children over the past few decades – rising by more than 80 per cent.

Gastroenterologists have described it as an “epidemic.”

The vaccine has already been successfully tested on animals and now human trials are due to take place in London in July.

A substantial number of cattle go on to develop an illness called Johne’s diseases, which, under a microscope, is almost identical to Crohn’s disease in humans.

Professor Taylor was the first doctor to make the link between Crohn’s and MAP.

Previously, the UK Government has said that transmission to humans of MAP from animals was not proven, despite evidence of it getting into the milk supply.

But a report in the World Journal of Gastroenterology in December 2015 disputes this after a study in India where MAP is endemic in livestock and the general environment.

More than 42,000 people were tested over a two-year period, including healthy individuals and MAP was detected in all categories of patients at different frequencies.

The report, “On deaf ears, Mycobacterium avium paratuberculosis in pathogenesis Crohn’s and other diseases” states: “The results clearly show, humans like other species, are equally susceptible to infection with MAP regardless of health status.

“This places whole populations at risk of infection, depending on the prevalence of MAP in the environment and food supply.”

The report indicates that MAP in humans works in a similar way as TB, where not all people who have the bug become ill. Those with MAP who do become ill, develop Crohn’s disease.

More info on the MAP vaccine which has been developed at the prestigious Jenner’s Institute at King’s College, London, can be found at crohnsmapvaccine.com

Professor Taylor said: “We believe there is compelling evidence pointing to MAP as the cause of Crohn’s disease. We are extremely confident that the vaccine will work.”

The professor says that MAP is highly resilient, and, milk apart, has also got into the water supply by being washed off fields where cattle graze.

Crohn’s disease leads to a chronic inflammation of the intestine, wrecking patients’ lives and sufferers are at high risk of bowel cancer.

At the moment, mainstream medication concentrates on treating the symptoms only and very often does not work. Three quarters of Crohn’s disease sufferers need major surgery.

The first phase of trials on healthy humans, costing £1.4million is being funded by HAV Vaccines Ltd. Funding is needed for the second phase.

Volunteers, mainly made up of Crohn’s patients and their families are also raising the £470,000 for a diagnostic blood test to run in conjunction with the vaccine trials. They have set up a fundraising Facebook page at www.justgiving.com/teams/crohnsmapvaccineheroes

Professor Hermon-Taylor says that the bacterium is resistant to standard anti-TB drugs and has learned to “hide” from the body’s immune defences by invading white blood cells. Its hidden presence unbalances the delicate physiology of the gut, making it leaky to other bacteria and food molecules, triggering inflammation.

In studies a majority of people with Crohn’s disease have tested positive for MAP and it has now also been isolated in some people with ulcerative colitis.

Source: .edinburghnews.scotsman

Sooo Sick and Miserable

I still haven't gotten better in weeks. I've been super nauseous, throwing up bad and switching between constipation and watery diarrhea. I have had a couple "ok" days in between but not much.

I went to see my doctor  (my actual dr and not a work in) yesterday. He put me on antibiotics even though my labs came back fine (always baffles me how they can when i feel like THIS). Hopefully it'll rid my body of some of the bacteria and I'll start feeling better.

He also finally got me scheduled for the camera endoscopy. So today is prep (yay....) and tomorrow at 7:15am I am going in to swallow the camera. I will wear a device for 8 hours and then return it. It will take a couple weeks for them to read the images but hopefully they'll be able to find out what is going on!

I think it's funny because people keep saying things about feeling bad because I am so sick. I just keep telling them, it's life for me! I can't let it get me down or I would always be down! I have learned to get used to it and I am just thankful that i don't have to worry about losing my job or trting to make it through this. It also makes me a lot more thankful for the good days or even the ok days! I feel like i have a lot more appreciation for life than most and I'm good with that. Of course, i get frustrated with all the tests and when I'm laying in bed in agony, i cry and want it to end, but at the end of the day i know I'll be ok! :)