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I am 32 years old and was diagnosed with Crohns 9 years ago.  I had a colon resection about 6 months after being diagnosed.  I had approximately a quarter of my colon removed.

Since then, I haven't had much gut pain...just frequent bathroom visits (8-10 a day) and fatigue.

My main concern is the fatigue and the general position this condition has put on my mental/emotional well-being.

The fatigue brings on depression (because I'm too tired to do anything) and the bathroom visits bring on anxiety (I don't venture too far from home or I start to panic).

Ive decided to be more pro-active in treating my problems.  Ive consulted my family doctor and hes put me on Wellbutrin for depression and buspirone for anxiety.  I also take klonopin at night to help me sleep.

I told my doctor of my constant fatigue and how I would have to drink 3-4 cups of coffee to get motivated in the morning.  To my surprise, he put me on Ritalin.

Now, I know the depression and anxiety medicines can take up to 3-4 weeks to take effect.

However, the Ritalin has taken effect right away.  It focuses me and gives me the boost to function and get my work done.

I know Ritalin is a stimulant (much like coffee).  Soon after I take it, I feel like I'm on Prednisone (the fatigue is gone and I get a lot done).  But, after a few hours, it wears off and I'm back to being mentally tired.

Am I actually mentally tired or is the medicine revving me up so much that when it wears off, Im back to normal levels? 

It just seems like I have about 4 hours out of my day where I don't feel tired and can get things done...otherwise, I am ready to just sit and do nothing (and I hate that feeling).

I have a follow up with my doctor in a week, but I wanted to see if anyone had similar experiences with any of the medications I've mentioned.

Thanks for reading!

 Reply posted for SemiColon.

hi,

I just read your post and was wondering if you could provide an update.  I notice that I too get soooo very tired, then get depressed and even more stressed out because I can't get anything done.  I've always had a hard time focusing, so I thought I might try Ritalin.  I am embarrased to ask for this type of medication but will suck it up and ask if it means that life will be better.  Any input is greatly appreciated. 

 Reply posted for SemiColon.

Greetings SemiColon,

It's good to hear that your experience with Ritalin (methylphenidate) has smoothed out. As for feeling some self-reproach about needing to take it to function, don't!

I come to stimulants by way of ADHD, and the stigma they still carry continues to astonish me. Many of the strong feelings are rooted in their use in children, which is understandable, if often misguided. But you shouldn't feel bad for using them if they help you function, anymore than you should feel bad about taking Remicade.

The only suggestion I'd make is to involve a qualified psychiatrist in the process. General practitioners are invaluable, but they don't have the experience with the psycho-pharmacopoeia that psychiatrists do. And with any psychiatric med, it's rarely the first one that works the best. You mention four different psych meds, and that warrants a psychiatrist's guidance to make sure they're working as they should. The cocktail that works best for you can take a while to discover. For example, there are anti-depressants which can help considerably with anxiety (e.g., Zoloft/sertraline), and some anti-depressants are more "activating" than others, helping with the lethargy,

As for the stimulants, you're taking a "short-acting" form of stimulant. Nearly all stimulants come in extended-release formulations now, often extending (and smoothing-out) the effects over 8-12 hours and avoiding the "crash" phenomenon. Furthermore, Ritalin can worsen GI symptoms for some, while others like Adderall and Focalin seem to be much easier on our already-abused guts. And yes, adding coffee to the mix tends to complicate things and aggravate the crash. It also makes it harder to figure out if you're on the right dose.

I hope your progress continues. It gives me hope for my own recent UC diagnosis (that came 30 years late, but better late than never).

Cheers.

 Reply posted for SemiColon.

I can really relate. I was diagnosed with UC a few years ago, and also have had these cycles of extreme fatigue, joint and body aches and depression. I've found that when I am under stress that it triggers flares and of course the vicious cycle of flares causing more stress. I usually drink 3-4 cups of coffee each morning to get myself moving, but have not tried any other drugs so far. I actually thought I might be low in B12 or something, so got tested for that, and it ended up being high. I can also relate on how the fatigue just makes you get down on yourself as you just can't get things done the way you need or want to.

I'm fortunate to get a bit of relief as my symptoms seem to subside in the Spring/Summer, but unfortunately start back up in the Fall/Winter. I've been resistant to try any other drugs except prednisone (which as we all know causes more emotional problems for most, even if it helps the physical symptoms), as I am very worried about lymphoma risks (although I know it is a very small risk). I joined a local support group awhile back, and have found that, along with these message boards, it helps lift me out of my depression a bit. I felt so alone with this disease, and just wasn't getting any emotional support from my family. Hang in there and I hope you start feeling better a bit each day. Sending good thoughts your way...

 Reply posted for MaryAnn.

Mary Ann,

I've been on Ritalin for about two weeks (I go in for my follow-up appointment today) and I believe that the side effects greatly outweigh the benefit of the drug.  You get short spurts of energy and are completely focused (kind of like coffee), but then crash (ten times worse than coffee).  I also think it makes you more tired and depressed once the drug wears off.

I see where my doctor was going by prescribing it, but I don't think that it's correct for my fatigue. 

Just wanted to give you some insight on my experience with the drug.

Cheers,

SC

 Reply posted for SemiColon.

 Hi,

           Mary Ann here again. I did not know that you could take ritalin to giver you more energy. I tought ritalin was more of a drug for children in school who can't concentrate. Maybe I need to ask my doctor for this drug. I have to drink a lot of coffee when I first get up too.

 Reply posted for SemiColon.

Hi,

           My name is MaryAnn. I'm 45 and have had crohn's for over 20 years, so I have dealt with it most all of my life. I am at this late stage in my life going to school for my Bachelors degree in education online. I have depression and have since I was about 10 or 12. Later, in life I was diagnosed with generalized Anxiety disorder. My doctor also thinks I have irritable bowl syndrome. I take mercaptopurine, cipro, lexapro and clorizapam. I get tired easy too. I also notice that when I have much stress in my life, crohns rears it's ugly head. I feel like crohns takes over my life. I don't make friends easily because I'm afraid they will judge me for my illness. I'm always paranoid about thinking I might smell, or have gas, so it is hard. I try to eat right and excercise, but sometimes it does not matter what I eat it still acts up. We had a party for my Mom this past weekend and my nephew soposedly just joking said something I really took to heart. I was telling him that I got ate up when I go outside by mosquitoes. He said, you probly get doo doo bugs on you. Well that really bothered me. My sister said he was just joking, but it hurt my feelings really badly. Do any of you all ever feel like this or do you think I'm too sensitive? Thank you for reading by the way. 

 Reply posted for SemiColon.

Update on my update.

I've been doing a lot of research about depression, fatigue, anxiety, etc over the past week.

I'm amazed that after living with this condition for the past 10 years that I'm finally really coming to understand the cycle of things.  I've always thought there was a division between how I was before being diagnosed and after, but couldn't figure it out.

Here's how it seems to go with me:  Extreme stress/Anxiety leads to a flare.  That flare leads to being extremely tired/fatigued.  That fatigue (both mentally and physically) causes depression.

The stress/anxiety can be brought on by a variety of things (worrying about bathroom visits / worrying about finances / worrying about work) and it takes off from there.

As mentioned before I tried drinking a lot of coffee to eliminate the fatigue.  I believed (in my mind) it worked fine...even though I went to the bathroom a lot and eventually crashed around mid-day.  I had tons of energy in the morning and could concentrate on getting things done later on.  But, this was just a short-term solution...as the effects would wear off and the fatigue remained.

As I mentioned, I'm working with my doctor to manage my stress/anxiety (the trigger) which, hopefully, will lead to a more productive life...living with Crohn's.

If there are others who share similar experiences, I'd love to hear from you and how you are managing your situation.

Cheers,

SC

 Reply posted for SemiColon.

Just a quick follow up:

I have been on Remicade for the past 4 years and it has helped with my fatigue.  I just go through periods where I just really get bogged down.

RE:  Ritalin - I was concerned about these severe crashes that made my fatigue worse, so I did some research yesterday (albeit on the internet, but I digress).  I couldn't understand why I felt good the first few days on it, but then horrible the last three.  Then, I realized that I was over-stimulating myself.  I would get up, take Ritalin in the morning and drink a few cups of coffee.  Taking the Wellbutrin with the Ritalin is suppose to help curb the crashing effects.

When I took Ritalin and drank coffee, I understood why they called it "Kiddie Cocaine"...I had an over abundance of energy and then came down really hard....causing extreme fatigue.

Today, I'm trying to do things differently.  I took my medicine when I got up, but avoided the caffeine and will drink more water throughout the day.

Yesterday at this time, it felt like I was on Speed or something.  Today, I fell alert and calm...and no fatigue...yet.

It's early in the day and the bottom could drop out, but I'm really trying to find what works and manage my medications properly.

I really hate that I have to resort to a medication to give me an energy boost, but otherwise I am just really lethargic and can't get my work done.

Thanks for reading and I hope to keep my progress updated.  Please feel free to add your comments.

Cheers,

SemiColon