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Suggest treatment for severe depression due to Chrons Disease

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Posted on Mon, 24 Mar 2014
Question: Hi. I was diagnosed with duodenal ulcer disease that was H.Pylori negative in1994 and treated with a proton pump inhibitor that still left me with symptoms that I was told were "functional". I also got a second opinion from another excellent gastroenterologist. I'd also had increasing fatigue for years and had been on antidepressants since 1990 that didn't seem to be of much help. I continued to get much sicker until an alternative practitioner recommended i get tested for CD. My ttg was off the charts and my biopsy showed severe villous atrophy. I looked at my biopsy report from 1994 and it described a "duodenitis" which I've read can occur with CD. I've continued to have problems with an increasingly treatment-resistant depression, anxiety and fatigue. I'd been working as a "GP Psychotherapist" part-time which was the only thing i was able to do and after a severe depressive episode last year i found i was left with cognitive deficits and personality changes that made it impossible to do my job. (I'm a 55 yo female with a partner but no kids). I am really angry and think that I should have been diagnosed with CD in 1994. Do you think that is reasonable? I feel i no longer have a reason to live and despite being on a strict GFD since 2003 the only improvements have been GI and I'm no longer as weak. Everything else is worse. Thank you for your opinion. Best, XXXXXXX (Ottawa, ON)
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Answered by Dr. Gourdas Choudhuri (32 hours later)
Brief Answer: I can understand how frustrating it feels to have Detailed Answer: Hi XXXXXXX I can understand how frustrating it feels to have suffered a missed diagnosis for several years. The awareness about CD is steadily increasing and it is not uncommon to have missed out on it if the symptoms were atypical. I hope the GFD is helping your physical problems. CD can be associated with low feelings and weakness that usually improve when you start GFD. In case you have noticed improvement in your physical symptoms but continue to feel low, it could be depression that might be unconnected with CD. After all there might be 2 problems that are troubling you, both requiring attention and help independently. I suggest that you continue on GFD but do consult your psychiatrist for management of depression.
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Gourdas Choudhuri

Gastroenterologist

Practicing since :1978

Answered : 22 Questions

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Suggest treatment for severe depression due to Chrons Disease

Brief Answer: I can understand how frustrating it feels to have Detailed Answer: Hi XXXXXXX I can understand how frustrating it feels to have suffered a missed diagnosis for several years. The awareness about CD is steadily increasing and it is not uncommon to have missed out on it if the symptoms were atypical. I hope the GFD is helping your physical problems. CD can be associated with low feelings and weakness that usually improve when you start GFD. In case you have noticed improvement in your physical symptoms but continue to feel low, it could be depression that might be unconnected with CD. After all there might be 2 problems that are troubling you, both requiring attention and help independently. I suggest that you continue on GFD but do consult your psychiatrist for management of depression.