jus' wondering if any of u have as much trouble as i do w/depression, crying....just ur emotional state going crazy. i describe RSD as affecting my pain center, my temperature center & my emotional center. i do take Lexapro 10mg.... along w/Deplin (to make Lexapro work better). i also take 1500mg of Neurontin. (& meds 4 epilepsy) let me hear from u!

Here's an article I wrote that should help you understand the emotional impact of rsd on us. Understanding and Coping with the Emotional Effects of Complex Regional Pain Syndrome

RSD affects all of our sympathetic nerve systems that regulate emotions, body temp, blood pressure, etc. It's why there are so many symptoms with rsd.

Hope this helps you!

Hugs,

Karen

Dear Nancy -

We have all gone through what you are describing, one way or another. There are two saving graces we have going here. First, the psychiatric community has identified two brother/sister disorders as being specifically due to a medical condition, on account of which we can use these DSM codes for treatment without attracting the future scrutiny (or stigma) of whomever might be inclined to say "oh, you were treated for depression . . . ." They are actually handy tools that our doctors should be employing regularly when we get an "Axis I" Dx. Those codes are as follows, omitting some technical instructions to be used be the practioner in their utilization:

Mood Disorder Due to a General Medical Condition (DSM IV 293.83)

This Mood Disorder is diagnosed when the clinician believes a specific general medical condition causes symptoms suggestive of a Manic, Mixed, Hypomanic, or Major Depressive episode.

Diagnostic criteria for 293.83 Mood Disorder Due to...[Indicate the General Medical Condition]

A. A prominent and persistent disturbance in mood predominates in the clinical picture and is characterized by either (or both) of the following:

(1) depressed mood or markedly diminished interest or pleasure in all, or almost all, activities
(2) elevated, expansive, or irritable mood

B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct physiological consequence of a general medical condition.

C. The disturbance is not better accounted for by another mental disorder (e.g., Adjustment Disorder With Depressed Mood in response to the stress of having a general medical condition).

D. The disturbance does not occur exclusively during the course of a delirium.

E. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

AND

Anxiety Disorder Due to General Medical Condition (DSM IV 293.84) [as of 10/01/96]

The diagnosis of this Anxiety Disorder is made when there is evidence that persistent anxiety symptoms, including Panic Attacks, obsessions, or compulsions have arisen out of a general medical condition.

Diagnostic criteria for 293.84 Anxiety Disorder Due to...[Indicate the General Medical Condition]

A. Prominent anxiety, Panic Attacks, or obsessions or compulsions predominate in the clinical picture.

B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct physiological consequence of a general medical condition.

C. The disturbance is not better accounted for by another mental disorder (e.g., Adjustment Disorder With Anxiety in which the stressor is a serious general medical condition).

D. The disturbance does not occur exclusively during the course of a Delirium.

E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

From Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association

Secondly, to turn from matters of form to substance, the essence of what is commonly understood as "Buddhist phsychology" is that pain may be is unavoidable, suffering is optional. What's meant by that is that suffering is what we experience when we are presented with an objectively painful situation, and then devote our energies to either pushing away that which is (like it or not) or being attached to the way we otherwise want them to be. It was around this principle that Jon Kabot Zin, PhD. working out of the University of Mass. Medical School in the 1980's set up a program largely targeted on pain patients experiencing depression, called Mindfulness Based Stress Reduction (MBSR). It now has teachers around the country, including a number of some good ones (here) in LA. From the national homepage, including a directory to currently active teachers, many of whom are licenced psychologists, go to http://www.umassmed.edu/content.aspx?id=41252.

I was referred to a teacher in 2002 following a single 2 hour consultation with a high end pain psychoanalyst, after the so-called "pain pschologist" at the hospital where I was being treated told me that the outbursts of anger of which I was complaining, "went with the territory" of chronic pain, and ther was nothing I could do about it. After an 8 week course that meant for one evening a week, with taped guided meditations and yoga exercises for a sense of overall body awaremess, to be practiced every day in between, I was quite literally a new man. After a year and a half of struggling to practice law since I had become sick, and not being able to let go because of my egoic attachment to my professional identity - even though I had long stopped being able to net more than a few dollars a month from the practice - I was able to finally let go of it with some measure of ease, and direct my energies where they could be better employed. If you're curious, drop me a PM and I will be happy to give you the names of some very good teachers in town.

Along the same lines, is Shinzen Young (my teacher since 2003) whose Breakthrough Pain book and CD are designed to help you see to pain experience with enough concentration, sensory clarity and equinimity that you are largely free of it, or at least you are not identifying with the pain experience. One way he does this is by first having you ancknowledge where the pain is stongest in your body - if unbearable - and then finad another spot in the body which only holds a feint echo of the pain, but in which you can comfotably come to an intimate understanding of it's dynamics. The metaphor I use is standing behing a waterfall: you get a little wet from the mist, but you are by now means pulled into the vortex below. Breakthrough Pain can be obtained through Amazon. And if you want to read more about the man before investing your $20 or so, Shinzen's primary webpage, including freely downloadable reading material and YouTube videos is at http://shinzen.org/.

I hope that I you may find something of use in all of this. And that you know that there are many communities of friends, including this one, who are only too happy to make your acquaintance and be of service in any way possible.

Mike (in LA)

Thanks you Karen for the excellent article you wrote. You wrote it in such an easily understood manner. I have a pychiatrist and he has excplained to me about the limbic system and the autonomic system. It helps to know why we have certain symptoms. Like the autonomic system is the organs in our body that are involuntary, like the heart,lungs, kidneys,That's why the sweating, circulation problems, temperature changes, And why are blood pressure goes high because of the sympathetic nervous system and then low because of the para sympathetic nervous system. As I have passed out because of low blood pressure, I'm careful not to bend over too long when washing my hair, etc.
Thank you again for the article. I always enjoy your posts. Your friend, loretta

You're welcome and thank you! I have a couple of crps and preg articles coming out soon. I hope someone will find them as helpful as others have found all the ones I've written on crps so far. There's so much to write about so I'll have topics for a long time yet! lol The next couple coming is crps and weight loss, then a physical therapy series.

Hugs,

Karen

Hi Nancy,

I have RSD in my left leg and both arms. I developed it when I was 12 years old and am now 14. Like you, I also have problems with my emotional state. I always used to be the 'happy go lucky' child before RSD but now, I am always very emotional.

I tend to flip out at the slightest things and have mood swings all the time! I also find myself crying a lot and just generally feeling down.

When my mum mentioned it to my doctor, he told her that it was common with RSD as it affects the Limbic part of your brain which affects mood etc, though he did say in my case it could be worse because of my age and hormones etc.

Do you see a Psychologist at all? They can be helpful sometimes in helping you work through your anger, mood etc. I have a Psychologist but she is 4 hours away from me unfortunately so I can't see her that often but I have her email address and she has helped me quite a bit. I still get very frustrated and pretty depressed but it isn't quite as bad as what it used to be thankfully.

I'm sorry you have to deal with this also!! I think it is a very common symptom of RSD and most sufferers suffer from it unfortunately. I hope you start feeling better soon and if you ever need anyone to talk to, please know that I am here for you!!

Alison

Some people react to high folate amounts with emotional lability.

Deplin has a pretty high dose per tablet. 7.5mg.
Also high dose folate may severely mask low B12 levels.

I'd get a B12 serum level done...if it is below 500 I'd get B12 to go along with that folate. This is very important, because if you are low in B12 you can sustain neuro damage. Did your doctor test your B12 levels? Do you know what they were?

WOW.... thks 2 all of u! i luv having so many RSD "buds" who actually understand & can give great support & advice! i will ask about my B12 levels (since i'm taking Deplin). To GalenaFaolan: about 2 read ur article! To fmichael: thks 4 info & will ck out Shinzen Young!
To ali12: my, ur so young! i DO c a psychologist once/wk! thk goodness! and my worker's comp nurse said that she had never heard of RSD spreading from arms 2 legs!! ha (jus' visited my ft dr on friday.... may have RSD in ft now - from my left wrist, arm, shoulder) thks 2 all of u 4 support! as i said before, i fell at wk in 4/08 - was a school district's technology coordinator! broke left wrist in 2 plcs - that's why my typing lks like texting! i haven't wked since then - but being pd. very blessed in many ways! hugs 2 all!

Nancy: Sorry to hear that you are having such a hard time. I have been fighting this for 10months now and I understand. I spend several nights on the couch crying and praying trying to sort things out. The pain was a big driving factor, especially since I am allergic to most oral pain meds. I had emotional reactions to some meds; you might check the side effects. I didn't realize that that was one of the side effects until I asked my pharmacist. God is good and helps me to deal and I will pray that all the advice and venues you are seeking will be very helpful to you in your quest along with the rest of us. Take care. Suz

Hi Nancy and Welcome,
Besides seeing my psychiatrist once a month, the last 5 years, I'm taking a lot of vitamins anti-oxidants etc. I've seen a female Dr. that does bio=identical hormones and does all the tests. I'm 61 I have full body 13 years. I have spells of crying still, it's rough to loose your health. I use meditation, prayer, reading, music, keeping in touch with friends, scented candles, hand and feet waxing, epson salt baths, essential oils, massage therapy, swimming keeps me mobile and feels good. visualization, bio-feedback,
Basically any kind of distraction, my soft furry cat, I'm grateful for being where I am, my health seems to be getting better, not worse. I have a brilliant Dr. I going to try hyper baric oxygen chamber in his new clinic.
Before you settle with WC you might talk to others that have gotten lifetime medical care, and put in certain treatments that are not normally covered by insurance, but work really well for RSD patients. Take care, loretta