Rheumatoid Arthritis and methotrexate – week 5!


I am about to take my fifth dose of methotrexate. And I have to admit, methotrexate is doing what it always does. I am depressed.

There is no part of me that wants to take the little yellow pills.

But if I don’t take them, I have nothing but pain waiting for me. Or, more accurately, worse pain. With very little hope of the pain ever receding.

Followers of this blog know that this is my fourth attempt at tolerating methotrexate. Each time I have experienced nausea, fatigue, hair loss, diarrhea, headache, stomach ache…but all of this is doable. It is the depression that stops me. I dread the depression.

Depression bleeds all the colour from the world. It removes all the pleasure from my life. It takes away my ability to feel much of anything. Except to feel sorry for myself, and anyone who knows me, knows I don’t waste a whole lot of time feeling sorry for myself. Sure, every now and again…but it’s not the way I usually operate.

Except when I take methotrexate.

I have tried several anti-depressants. They either do nothing or make things worse. I will not try any different drugs. I have tried that therapy option and it doesn’t work. Persisting with a slightly different chemical will not change things. Anti-depressants, like most medications, do not work for everyone.

So I will rely on other methods for dealing with depression.

I hand out this advice all the time. It’s truly incredible how many people suffer from depression, and how many people tell me about it.

I believe that depression usually occurs because of several factors, so managing it involves several factors also. You don’t just wake up one morning depressed. It takes time to get there, and it takes time to get back.

At its core, there is a basic problem, or set of problems. Because of the depression, a sufferer can’t even begin to address this problem. So you need to improve the depression to see what elements of your life need changing.

In my case, the main cause is illness. My disease has impacted on every aspect of my life – my marriage, my career, my kids, my friendships, my financial future. But at its core, the main problem is Rheumatoid Arthritis. Specifically, the severe, daily pain and disability of Rheumatoid Arthritis.

I don’t believe methotrexate causes my depression, I believe it just enhances it. Unmasks it. Affects my mood enough to expose the underlying depression. I have often described is as like having permanent PMS.   Some days are worse than others. I have been depressed before, and I won that battle. I will win this one too…piece by piece.

Dealing with depression is a process.

I have basic rules that I follow.

And to have some hope in my life, I am going to have to ride out the depression, follow my own advice, and deal with these feelings, step by step. Because I do believe I am feeling some benefits from methotrexate as well.

So I need to keep my eyes on the prize…less arthritis pain and a more normal life. That’s worth fighting for.


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