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Post by Admin on May 16, 2017 17:38:17 GMT -4
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Post by Sara Witten on May 16, 2017 17:47:14 GMT -4
This article was interesting, but also relatively unsurprising. However, I was unaware of a possible link to hypersensitivity to pain with depressed patients; I feel as if this could be an intriguing area for future research. However, one aspect of this problem that I wish the article had delved into is the link between depression, opioid use, and incidence of suicide. In speaking to patients, one of the most common “plans” for suicide that I hear is “I have all these pills…just sitting in front of me. And sometimes, I think how easy it would be to just take them all.” It would have been interesting to hear if there was a commonality across the board, or only in my experiences.
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Post by Mandeep Gill on May 17, 2017 7:24:00 GMT -4
I never knew people who faced depression were often more susceptible to pain and I also did not realize there was a link between depression and opiod abuse. In the article it was stated that most people who abuse opiates are the ones who were usually not prescribed the medication to be begin with and I agree with this since people who are rightfully prescribed medications know how they must use their treatment to enhance their medical conditions. I think it is important for people to try and picking up signs of depression in individuals they know because people with depression need a strong support structure and that I feel is vital to rid them of their ailments. I also think people who are prescribed opiates should take responsibility upon themselves to know not to willingly hand out their prescription to those who were not prescribed it since they may think to themselves that they are helping, but in reality they could just be starting a really big problem.
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Post by Cammie Allen on May 17, 2017 16:24:34 GMT -4
I think that this article suggests some interesting insights regarding patients requiring chronic pain management. It makes sense to me that depressed individuals are more likely to ruminate on pain and be more sensitive to it. I think this helps explain the link between certain syndromes/diseases involving pain as a symptom such as fibromyalgia or premenstrual syndrome. It brings up the underwhelming management of individuals with mental health needs in the USA. Perhaps by treating depression, we can help prevent patients from developing chronic pain or treat it if its already present. I think it's exciting and interesting that we are discovering new applications for SSRIs and TCAs to treat numerous diseases such as PMS and fibromyalgia. Also, I think it applies well specifically to our population in Atlanta in light of recent news articles about the heroin epidemic in the north Atlanta triangle.
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Post by Fernando Grabner on May 17, 2017 17:29:35 GMT -4
In my experience, you'd be hard-pressed to find a patient with depression who doesn't experience concomitant physical pain. One of the greatest misconceptions about mental health issues is the idea that "it's all in your head", i.e. it's psychological rather than physiological, when in reality, they're inter-connected. Treatments for patients with mood disorders should target all symptoms they have, and while self-medication isn't the correct answer, the facts that this article brings forward about the need people suffering with depression feel to turn to pain medications is a good reminder to present and future psychiatrists that current anti-depressants may still fall short for certain patients.
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Margaret Armour-Jones
Guest
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Post by Margaret Armour-Jones on May 17, 2017 17:29:59 GMT -4
This article discussing Opioid abuse in depressed patients seems quite logical to me. It is much more accepted for patients to ask their doctors for pain medication than to ask about psychiatric care. The stigma socially of having a psychiatric diagnosis makes patients reluctant to talk about their problems with anyone, and because they internalize these stigmas they refuse to seek help for themselves. Upon the first exposure to the euphoric feelings of opioids, the ability to be lifted out of their depression immediately grants them more immediate gratification that working hard in therapy or waiting weeks for psychiatric pharmacotherapy to help. I can imagine that compounding such a vulnerable mental state with the addictive properties of opioids would only logically lead to increased addition in depressed populations.
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Post by Avneet Ghumman on May 17, 2017 20:11:42 GMT -4
As stated in the article above, depression is highly untreated and under diagnosed, and with the new Republican health act, cases of depression related opiate abuse is most likely to increase. Many people are already hesitant to get help for psychiatric illnesses, and where we see compliance is often an issue, it seems as though things are only headed for the worse. Depression patients are at risk for higher abuse potential because being in a vulnerable state, self-medicating often gives them a short-lived satisfaction, but this causes patients to go from abusing medication to becoming dependent. It was noted that depressed patients are more sensitive to pain, and while some opioids can give anti-depressive effects, some can exacerbate depression. Often in the clinic, patients present with chronic depression and some have given up on the idea of ever getting back to “normal”. This pessimistic attitude can often hinder their judgment and if substances such as opiates can help make them feel better, most individuals don’t care about the self-harm they are inflicting.
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Post by Harneet Ghumman on May 17, 2017 21:22:48 GMT -4
Reading this article further emphasized how common it is for mental health patients to self-medicate and depressive patients are no different. In the article it stated that depressive patients are twice as more likely to use opioids than non-depressive patients and I agree. I believe that if we were to evaluate opioid dependent patients almost all would be comorbid with depression. Opioids can often give patients that high and mood-elevation that they seek and though only temporary these substances often prove to be addicting and worsen the depression. Unfortunately with the passing of the new Republican health care plan, mental health care will not be available for patients and we are bound to see an increase in patients self-medicating with substances such as opioids.
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Post by Mackenzie Keintz on May 18, 2017 14:40:33 GMT -4
The link between chronic opioid use and depression doesn't surprise me. What I did find interesting was the the risk of taking an opioid is not increased, but the risk for continuing them was. I would like more information on the increased pain sensitivity in depressed patients. These patients are also more likely to ask a doctor for an opioid because generally physical pain is less stigmatized than a mental health problem. Because the opioid acts both on the physical pain and acts as a self medication for their depression it is more likely to avoid healthcare for mental health. Depression is such an underdiagnosed condition that I wonder if the link will be stronger if more research is done.
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Post by Silky Kataria on May 18, 2017 14:41:54 GMT -4
Recently there has been more light revealing the correlation between chronic depression and opiod use. In this article it has been found that Americans, who take opiod and have an underlying diagnosis of depression, are more likely to be addicted or inappropriately use opioids. The reason they are using it is because it indirectly causes them to feel elevated in terms of their mood along with having a very soothing and sedating effect. However, the dilemma stands that chronic prescription opiod use can then exacerbate depession thereby only allowing a transient mood elevation and starting the cycle again. Thus, chronic depression paired with chronic opiod use is challenging to treat especially when chronic depression can often go undiagnosed.
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Post by Prerana Rodrigues on May 18, 2017 15:28:35 GMT -4
There are many areas of focus in this article but I found the link between pain, depression and opioid abuse to be very interesting. I was unaware that depression can not only exacerbate pain but make people more susceptible to it, thereby prolonging the recovery process.This directly feeds into the growing opioid abuse problem which leads to increased scrutiny by physicians and undertreatment. Furthermore, the overuse of opioid medications can also exacerbate the depression furthering this vicious cycle of dependence and need.
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Post by Lauren Aamoth on May 18, 2017 15:48:13 GMT -4
I found this article to be quite interesting considering the rise in use/abuse of opioids. My perspective of the article was that opioids essentially serve as a “quick fix” to feelings of sadness or hopelessness, rather than long term treatment initiated and supervised by a physician. I don’t, however, think that many patients consciously abuse opioids as an alternative treatment to depression. I believe that in many places throughout the world, mental health tolerated far well than in others. Many societies may perceive depression as weakness, which likely deters a large number of patients from being treated. Although abusing opioids isn’t necessarily the “social norm” either, it carries a different stigma that could potentially be a factor for some users. |
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Post by Glenda Magtanong on May 18, 2017 16:39:05 GMT -4
There is an unfortunate dynamic relationship between depression and opioid misuse/abuse. The article allows one to think further about people who are too afraid to admit that they are clinically depressed. Many Americans still avoid being labeled as a “psych patient” due to the stigma attached to it. Instead of seeing a mental health provider to treat their depression, they may be more comfortable in seeing their PCP. This may stem from a warped self-preservation mode so as to not be labeled a “psych patient”. To their PCPs, they may only complain of generalized malaise and persistent pain, purposefully holding off sharing their true depressive symptoms and episodes. This could very well initiate a vicious cycle of depression and opioid abuse and further add to the growing epidemic. There is indeed a need for further research on this interdependent relationship between depression and opioid abuse but it would also be interesting to add chronic pain disorders as well in the future studies as people with chronic pain disorders such as Fibromyalgia are more likely to be depressed and use opioids.1
1. Palladino CL, Flynn HA, Richardson C, Marcus SM, Johnson TR, Davis MM. Lengthened predelivery stay and antepartum complications in women with depressive symptoms during pregnancy. J Womens Health (Larchmt). 2011;20(6):953-962.
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Post by Susanne Ajao on May 19, 2017 8:35:51 GMT -4
This article is enlightening as it showed the relationship between chronic pain and depression, especially how it contributes to increased opioid use in the population. What stood out to me was the increased pain felt among depressed individuals as the result of heightened sensations. It seems this causes them to seek pain management with opiods which may temproarly deal with the pain but not the depression. Hence, more treatment is sort after. This is a horrid cycle. I do agree with the article that mental health care needs to be provided in areas which lack them (rural areas) and depression screening could also be done for paitients with chronic pain. It doesn't hurt and it could help deal with the opioid epidemic.
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Post by Megan Tracy on May 19, 2017 9:05:30 GMT -4
This article showcases another example of how mental health stigma can lead patients to use substances other than the proper medications to treat their symptoms. I believe that this problem is widely under-recognized in health care today. If we, as healthcare providers, can intercept these so-called "addiction" patients and give them the proper diagnose, I believe that we can begin to alleviate this epidemic. Depression can present itself in a variety of ways, and if we are properly educated to recognize these symptoms, we can prevent a large amount of substance abuse within this community. I was really moved by the comment "it’s easier to explain not being able to get out of bed because of a bad back than crushing sadness." This statement summarizes the stigma surrounding mental health and how it can propagate substance abuse.
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