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#518056 - 01/12/18 06:20 AM AS impact on Mood
Didier Offline

Registered: 01/12/12
Posts: 193
It seems like common sense that AS can affect your mental health and bring on bad moods, anxiety and depression. Who wouldn't feel depressed faced with the prospect of long-term disability, pain, and the other host of horrors that might surface as the disease progresses? Compounded by sleepless nights from pain and discomfort, etc.

What I've found though is that AS can profoundly affect your mood day-to-day, especially if you miss your medication one day. During a flare, if I take my celebrex in the morning one day, I can usually count on having a good day where I feel relatively happy and positive. If I miss a dose that day, I might not notice any symptoms physically but mentally will quickly feel myself drowning in despair, being unreasonably upset and angry with those around me, and feeling like I'm falling asleep unless I have copious amounts of caffeine. Enough to mess up family and work relationships on that day if not really careful of what I say and do.

I'm curious if this is others' experience? If you forget your meds one day, does it have a noticeable and immediate impact on your mental health? or if I should be seeking new treatment options from my rheumatologist? Maybe a psychologist?

Edited by Didier (01/12/18 06:21 AM)

#518061 - 01/13/18 11:50 AM Re: AS impact on Mood [Re: Didier]
Sue22 Offline

Registered: 01/13/08
Posts: 21331
Loc: Upstate NY
When I was in a lot of pain, all the time, it was hard to know what was causing what.

But as I saw a rheumy who finally dx'ed and treated me, and I felt a lot better between flares, it was so much easier to see cause and effect.

My first experience with "mood" was when I used methylpred for a flare...I called methylpred "my magic happy pills" because they didn't just get rid of the inflammation (and thus pain) but also made me so very happy and full of energy.

When I was eventually put on humira, I noticed the same sort of effect; not quite as dramatic as with methylpred, but the few days before I take humira, I start feeling a bit "blue", I start "falling into a bit of a funk", find I need more sleep, even before any pain starts...then the pain starts, and I realize its a flare and/or its time for more humira.

I read "depression is an allergic reaction to inflammation"...I don't like the words "allergic reaction" but for me, I know that the mild depression is separate from the pain because the constipation, need for more sleep, and blue mood come first, then comes the neck or SI joint inflammation and pain.

So I do think the autoinflammatory / autoimmune diseases cause depression. Not sure if its the inflammation or maybe its just the signals from the bad bacteria in the gut, but either way, its not due to the pain, its a separate symptom of the disease, for me at least.


Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)

#518071 - 01/14/18 12:17 AM Re: AS impact on Mood [Re: Didier]
Robin_H Offline

Registered: 09/13/15
Posts: 284
Loc: Central Canada
Normally if I am in a flare then I have cognitive issues (brain fog), am high in fatigue and so am not happy with pushing myself beyond the pain. But I can be in a good mood in the middle of a flare.

Since inflammation influences the nervous system then there certainly is a direct influence on mood. But as many know now, we are highly influenced by the neurotransmitters, hormones and toxins that our microbiome exude. We must do what we can to keep the good bugs happy.

It is possible to turn off physical pain and separate it from state of mind. It takes a life time of practice to master. The older monks have abnormally thick vagus nerves. When you can turn it on at will you can turn off pain and other negative physical phenomena. I was able to do that a bit at will over 25 years ago. I could rapidly lower my heart rate and stop pain. I had a student six years ago whom from a very early age would spend his summers in the mountains at a Shaolin temple to practice physical and mental self discipline. I have witnessed him calm his system within thirty seconds after a strenuous activity. I should not have stopped meditation.

Coffee is my "happy juice" now. I should go meditate when I get a coffee craving!!!

I hope this helps. It helps me.
HLA-B27 neg, vague AS symptoms in 20s and early 30s
1993:fibromyalgia (age 25)
2013.07:Scratched by a sick cat
2013.08:Reverse blockage in a SCUBA accident
2013.09:Strange sore throat then meningitis
2014:Chronic inflammation at the base of the skull
2014 to early 2015:excess NSAID use developed complete axial inflammation, included psoriasis
NSD helped well and but was not perfect
2018.07: weak +'ve tests for borrelia, babesia, bartonella and mycoplasma pneumonia using Armin Lab, ANA=equivocal

#518076 - 01/15/18 06:03 PM Re: AS impact on Mood [Re: Didier]
Kellybells Offline

Registered: 01/21/17
Posts: 131
Loc: Toronto, ON
Interesting post Didier.

I definitely notice a link between treatment and my mood. When I came to this site a year ago I was a wreck physically and emotionally. Then I learned about the NSD and tried it immediately while waiting for my test results. Within 2 weeks I not only experienced a huge improvement in my pain and stiffness, my mood and chronic anxiety also improved - an unexpected surprise in the dead of winter.

After a month or so I decided to test whether starch really was the culprit. I started eating foods I hadn't touched in years: bread, pizza, yogurt, pasta, etc. Within days my pain was back and, interestingly, so were the depression and anxiety. I had planned to go for 2 weeks but only lasted 1 after having an anxiety attack so bad and disorienting I couldn't go on. I cut out the starch and a few days later my mood was better again.

It was eye opening and left no doubt in my mind the two are related. I've since wondered about others here. I don't tolerate NSAIDs, so I can't speak to their effects. But I find it interesting that although we use different treatment approaches, both approaches target inflammation. Leads me to wonder if the inflammation itself is the issue, affecting our brains as well as our joints.
Suspected SpA. HLA B27, xray, u/sound, blood tests all -ve. Ancient history of plantar fasciitis, SI joint pain, knee arthritis. Recent history of tendinitis, neck pain, debilitating finger pain and stiffness (especially mornings). No diagnosis, no meds.

2010 - stopped eating dairy
2012 - stopped eating wheat
2014 - stopped eating all grains
Jan 2017 - discovered NSD - 98% improvement in symptoms, continually amazed by my results, wish I'd found kickAS sooner

#518298 - 02/25/18 01:50 PM Re: AS impact on Mood [Re: Didier]
Rachel1102 Offline

Registered: 02/22/18
Posts: 2
Loc: Texas
I find that depression is often a precursor to my flares. I'm not certain if the depression makes my flares come on, or if the depression is simply one of the early signs of a flare. No matter the reason, I've noticed a strong link between the two. I also experience a lot of anxiety around this time, because I am not as productive, and the guilt sets in.

I do best if I stay on an SSRI. I was on tramadol every day for about 12 years, and I think it really did a number on my brain. After speaking with a pain management doctor and a psychiatrist, I've decided that a low dose of an SSRI is the best way to help me from slipping into a deep depression.

Everyone has different ways of coping. Of course, exercise, activity, and most importantly.. leaning on my support system of friends and family... aka ASKING FOR HELP (why is that so hard to do?!)... makes a huge difference. Medication alone won't cut it. It simply helps me pick up the phone, or get out of the house, so I can keep moving.



#518366 - 03/06/18 11:11 PM Re: AS impact on Mood [Re: Didier]
eleanthe Offline

Registered: 10/28/17
Posts: 4
So true. We get so used to being in pain that we can lose track of pain levels and just cope with an increase in pain subconsciously. I have found myself getting testy for no reason many times and then I take stock and realize the pain has increased and i need a pain pill. I have had depression in the past but mostly from untreated pain. Cymbalta is a depression med but also was good for the pain. I find pain management meds more successful for me in preventing depression. Currently on a low dose of butrans patch. Allowed me to move back into my bed from the floor.


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