Question: Can depression actually mimic signs of ataxia?

Thanks for your heartfelt response. I can walk, talk and write but everything is different now. Slower and more labored. I also feel as if my issues are physical but I am constantly being told that the physical is one thing and the psychological, another. Still confused. My husband, shrink and even neuros think I should get a job and stop obsessing about it. Hard when you think you are going to fall any minute. Thanks for your in-put.

Marie Turner said:

I feel sad at my lost skills and little hope for the future.I have the same dilemma as you Neta.

Which came first the chicken or the egg.I have had a history of depression but have all the classic signs of Cerebellar Ataxia.Who would not feel depressed when you cannot walk,talk or write.

I feel better if I say it is a brain disease.With me it is just physical,not affecting the cognitive skiills.Depression is horrible and like Ataxia only another afflicted in the same way can understand.I can understand your questioning.I am in the same boat.I am not depressed but my thoughts are a bit negative as a result of having Ataxia.Not the other way around as your shrink seems to think.Let me know the outcome.I have been on meds for years and the Ataxia is worse.

Cerebellar ataxia is accompanied by depression. This is almost a rule set in stone.

The depression can be ameliorated by anti depressants. Physical therapy such as Frenkel Exercises also help with the depression.

Psychiatrists dispense medication. Psychologists use talking therapy and aren't allowed to dispense drugs.

neta said:

Thanks for your responses. I think I should elaborate. He acknowledges that I have ataxia however his point is that I have overlayed it with a layer of depression and anxiety. I dont know the difference between psychiatry and psychology, to be honest. The shrink (a psychiatrist) has told me that for example studies,, famous ones, show that cardiac patients can die from depression and not a future heart event by not taking medication, eating right or exercising.He sees a functioning, walking, talking, travelling person (me) who thinks/acts like she has one foot in the grave, as he puts it.

I am taking drugs (medication) as well as doing talk therapy though I don't see the effects of either to be honest. The most effective thing so far is the walk to and from the shrink, who is a psychiatrist. I guess I must be depressed though I thought depression involved people staring at the ceiling apahetically or contemplating suicide or acting vacant. But I guess youcan be depressed (and thus imagine, you have say, cancer or something). Wow, I always thought such people were really nuts!

Brian1952 said:

Cerebellar ataxia is accompanied by depression. This is almost a rule set in stone.

The depression can be ameliorated by anti depressants. Physical therapy such as Frenkel Exercises also help with the depression.

Neta, depression can manifest itself in many ways. It is different for everyone. A depressed person can be sad, angry, irritable, tired, show lack of interest etc…

Like you, I do not feel I can be trusted alone with my 3 year old grandson. I would not be able to catch him if he fell or, if he ran to the street, I could not run after him to stop him. Also, just like you, I would not hold a baby in my arms unless I was sitting down and with someone near me. I loved to volunteer in my grandson’s daycare, but this is out of t he question now. I miss this a lot and am very sad about it. But it is what it is.
My 90 year old mother is healthier than me. I missed her birthday last June because I did not feel I was strong enough to travel to France where she lives, from ( i live in the US). So she will be coming to see me, accompanied by my two sisters, next month. I feel very bad about this. But it is what it is.

I used to be a very high strung, energetic woman and within seconds, the stroke which resulted in ataxia knocked me down to the floor and changed everything… I had always led a very healthy life, never smoked nor drank, was very athletic. I look at people who evidently are not taking care of themselves and yetwalk around normally, and wonder why this happened to me. My doctors, friends, therapists all give me the same answer, if I had not been in such good shape, I would not be here.
That is good enough for me. I have accepted my fate and live by my new motto: It is what it is. I try to find humor in everyday life. No, not easy, but what else can I do.

Neta, you might not feel the difference with or without your anti-depressant, but may be you would be worst without it. Also, there are so many different kinds of medications, you may not be on the right one. It can take several tries before the right one is found. Check with your psychiatrist.
Also, you could try another psychologist. I know. How do you find the right one? Trials an errors… No fun…

Tough life! It’s a jungle out there… :slight_smile:
Hang in there Neta. My best to you. I really believe that acceptance is what helps me get through this and of course the support of family and friends.
Take care.

Thanks "Cicina"
for your candor. I have very little support in part because I prefer to mask my ataxia and can still get away with this most of the time. Funny, my mother, from whom I think I have inherited all this crap, is also (almost) 90 and my father is 91 I am their youngest child.. Both parents and sibs, are healthier than me although they don't know/think so yet. My mom cannot travel either for various reasons, but Dad can! His mother lived to 95 and hardly had a wrinkle. She was quite fat (unlike me) and ate cake and all kinds of fattening foods. Forget about exercise! She thought salad was for horses and cooked her vegetables (BirdEye) to death!! I am reluctant to start changing meds or drs. now. Maybe I would be worse off. I had no stroke but it is thought my ataxia comes from some auto-immune issue. The other grandparents are all older than me and are much more useful. It kills me, as do all these people (including my husband) who eat and drink whatever they want and walk as fit as fiddles.
Cicina said:

Neta, depression can manifest itself in many ways. It is different for everyone. A depressed person can be sad, angry, irritable, tired, show lack of interest etc...

Like you, I do not feel I can be trusted alone with my 3 year old grandson. I would not be able to catch him if he fell or, if he ran to the street, I could not run after him to stop him. Also, just like you, I would not hold a baby in my arms unless I was sitting down and with someone near me. I loved to volunteer in my grandson's daycare, but this is out of t he question now. I miss this a lot and am very sad about it. But it is what it is.
My 90 year old mother is healthier than me. I missed her birthday last June because I did not feel I was strong enough to travel to France where she lives, from ( i live in the US). So she will be coming to see me, accompanied by my two sisters, next month. I feel very bad about this. But it is what it is.

I used to be a very high strung, energetic woman and within seconds, the stroke which resulted in ataxia knocked me down to the floor and changed everything.... I had always led a very healthy life, never smoked nor drank, was very athletic. I look at people who evidently are not taking care of themselves and yetwalk around normally, and wonder why this happened to me. My doctors, friends, therapists all give me the same answer, if I had not been in such good shape, I would not be here.
That is good enough for me. I have accepted my fate and live by my new motto: It is what it is. I try to find humor in everyday life. No, not easy, but what else can I do.

Neta, you might not feel the difference with or without your anti-depressant, but may be you would be worst without it. Also, there are so many different kinds of medications, you may not be on the right one. It can take several tries before the right one is found. Check with your psychiatrist.
Also, you could try another psychologist. I know. How do you find the right one? Trials an errors... No fun...

Tough life! It's a jungle out there.... :-)
Hang in there Neta. My best to you. I really believe that acceptance is what helps me get through this and of course the support of family and friends.
Take care.

You know Neta, may be the solution is Eat, Drink and be Merry :slight_smile: Seems to work for a lot of people.

Seriously, I put it all on fate. Happy fate, sad fate…we have no choice. Some die young, some die old. Some are sick all their life, some are never sick.
We are also wired differently. You can tell this from birth. Some babies are happy from the minute they see the light of day, some are grumpy.
It is not easy to change one’s attitude or ways of thinking. All my life, I tried to make a difference and change little things. Did not always succeed, but I tried at the price of a lot of frustration.

This stroke ( of bad luck) has changed me and now, I say “Whatever” to anything I do not agree with. Just tired of fighting I guess. But I am not giving up on myself yet. I keep trying to stay physically strong. And this is what you must do. I am really sorry that your family is not behind you all the way. But try to draw strength from all the people on this site. They understand you. Theyare here with you, holding your hand and trying to pull you up.
Try to find at least one person you can talk to and who would be objective. Sometimes, we need a “kick in the pants” to get going. I need one once in a while to put things into perspective.
To be honest, I hate it when people tell me it could be worst! Worst than feeling dizzy all day long? Worst than trying not to fall all day long?
Then I think of a friend who had esophagus cancer and who has not eaten any solid food in 5 years and is in constant pain and on high doses of pain medicine. Then I understand why it could be worst!

Okay, enough about philosophy and grandmotherly advice for now. I am sure you can debate all my arguments and theories, but that’s okay. It is in my nature to debate. That is the way I was wired. So it is not really my fault… :slight_smile:

Be good and take care!

Thanks again for your candor. I feel so normal when I am not standing, I feel like this is just a bad dream, But then when I get up, I remember what am up against, My GP also saId, "So you have ataxia, get over it," Easier said than done. It doesn't do me any good to know that someomeelse has it worse. I also dislike unwanted sympathy. This is definately the worst thing that has ever happened to me. I also say "whatever" alot. I care less about things, I do eat, live but am not so merry, I think what bothers me most is the idea of getting worse. That's creepy. I have shared this with a few close friends but no one seems to know what I am talking about or is prepared tto believe.My husand thinks that tough lovw is the answer. i am being treated with infusions of IVIg for autoimmunity issues but this doesnt seem to be a magic bullet. Thanks for being supportive. Its funny, because my shrink told me not to hang out at this site because it might give me bad ideas. I am not sure I agree with him. N

You don't say how old you are. But it is pretty apparent that your shrink doesn't know squat about ataxia. If the shrink is really implying that you are making yourself worse because you are depressed, you should fire him or her for incompetence and insensitivity. There is a difference between clinical depression and response to loss. But even if you have clinical depression which is caused by chemical changes in the brain, it is not going to make your ataxia worse. I have taken anti-depressants several times in my life and they do help the symptoms. . The other thing is that there is no shame in being depressed. It is not a mental illness, it is a chemical condition in the brain. Have you tried the depression medication? It takes several weeks to even notice a difference.

All the stuff on the internet about ataxia is very confusing. My mother and my aunt, and now another relative have it, and I am very much at risk as well. But they never identified what exactly my mother and my aunt had. Have they identified your ataxia as one of the inherited ataxia's? I know I would have a tendency to want to pull the covers over my head and sleep if I found out I have it too. I worry all the time myself about that. Actually knowing gives you an opportunity to do everything you can for yourself, physical therapy, exercise, and making your mood better, even if it means taking anti depressants. But find a shrink with whom you feel at ease and a neurologist who keeps up on ataxia.

One of these days they will find a way to stop the progress, even reverse it.

Charlie, (the name of my favorite cousin),

My shrink says he knows what ataxia is, and claims he even has a speciality in treating people with various physical ailments. I think I go to him because he is an activity and because he gives me some encouragement, such as, he says," you seem unchanged, maybe even a drop improved" or "you sound fine to me". He takes his cues on my physical health from my neuros.

I don't have an inherited ataxia but based on my blood work, it seems to be auto-immmune induced. I can understand your fears aboutthe future. Assume though, you will not get it. Yes, the Internet seems to give confusing info. Now I read the section on the "Frenkel exercises" and that's a whole new avenue.

Incidentally, on the same search, I found some document from the UK, about the conclusions of certain therapies. Most seem to require more study, including the so-called weighted vests as well as weights in general. Basically, if you woke up with this illness, 200 years ago, the treatment would be the same as today. No one seems to know anything new and the cerebellum is a highly unexplored part of the brain. There is a Nobel Prize waiting for someone. N


Charlie said:

You don't say how old you are. But it is pretty apparent that your shrink doesn't know squat about ataxia. If the shrink is really implying that you are making yourself worse because you are depressed, you should fire him or her for incompetence and insensitivity. There is a difference between clinical depression and response to loss. But even if you have clinical depression which is caused by chemical changes in the brain, it is not going to make your ataxia worse. I have taken anti-depressants several times in my life and they do help the symptoms. . The other thing is that there is no shame in being depressed. It is not a mental illness, it is a chemical condition in the brain. Have you tried the depression medication? It takes several weeks to even notice a difference.

All the stuff on the internet about ataxia is very confusing. My mother and my aunt, and now another relative have it, and I am very much at risk as well. But they never identified what exactly my mother and my aunt had. Have they identified your ataxia as one of the inherited ataxia's? I know I would have a tendency to want to pull the covers over my head and sleep if I found out I have it too. I worry all the time myself about that. Actually knowing gives you an opportunity to do everything you can for yourself, physical therapy, exercise, and making your mood better, even if it means taking anti depressants. But find a shrink with whom you feel at ease and a neurologist who keeps up on ataxia.

One of these days they will find a way to stop the progress, even reverse it.

I too have found that my anti-depressant Prozac (fluoxetine) helps my cerebellar ataxia.

Sometimes it is better to be as matter-of-fact about these matters as possible.

Being matter-of-fact about depression seems like a contradiction in terms, but do your best.

Depression or "dysthymia" as the shrinks call it, is a disease which goes hand-in-hand with cerebellar ataxia.

I can't talk about spinal ataxia because I do not have it. I have cerebellar ataxia due to a stroke.

Love to all.

Dear Brian1952

What is so weird is that I don't feel depressed ie sad,hopeless, just symptomatic. I dont take Prozac rather Setraline. I don' tknow whether to tell myself when I feel shakey, as about to fall....., oh this is ataxia or this is depression kicking in. I also dont have spinal ataxia or had a stroke. Rather, my ataxia is believed to be from an auto-immune issue.
Brian1952 said:

I too have found that my anti-depressant Prozac (fluoxetine) helps my cerebellar ataxia.

Sometimes it is better to be as matter-of-fact about these matters as possible.

Being matter-of-fact about depression seems like a contradiction in terms, but do your best.

Depression or "dysthymia" as the shrinks call it, is a disease which goes hand-in-hand with cerebellar ataxia.

I can't talk about spinal ataxia because I do not have it. I have cerebellar ataxia due to a stroke.

Love to all.

Hello Neta,
I am certainly not an expert in ataxia, far from it, but for the last year an a half, I have read about it as much as possible and here is what I understand.
Whatever the cause of ataxia ,ataxia is ataxia and the different types have mostly the same symptoms. Not every one has all the symptoms, some progress rapidly, some slowly. Some appear at a young age, some in mid life, others later in life.
The non progressive ataxia is usually caused by a stroke or a brain injury, or a tumor … Etc.
There is no cure yet and it appears that the best thing to do is stay physically active to keep our strength.

These are the facts. We cannot change them and although it is easier said than done as you say, we are better off accepting them. I understand your attitude, how can we deal with the constant need to try not to fall, with feeling dizzy all the time, and being practically unable to do anything manually?
I try to keep my mind busy, with my computer, I exercise severall times a day, but I must be honest, I am happy when it is time to go to sleep at night and I know I will have a few hours of peace. I suppose many are in the same state of mind.

So, Neta, try not to obsess with finding answers to the why and how did this ataxia happen. No one can give us any.
I am sorry if I sound blunt, I am only trying to help. And if your Sertraline helps alleviate symptoms, by all means, take it.
And by the way, when you feel you might fall, don’t try to figure out if it is because of ataxia or depression, just try to concentrate on grabbing something to stay upwards.:slight_smile:
And I personally do not believe that depression makes you fall…
Take care!

Right, I had a shrink appt. today. His point: Though I was diagnosed in 2010, I am srill very unaccepting of the ataxia. Imagine, he says, a cancer, diabetes or cardiac patient refusng to accept their bout with mortality. He would call that refusal-to-accept, depression. And he would treat it as such He says I am depressed because, in fact, there are still many things I can do but I refuse, He gave, as an example, a man who edits a certan newpaper's culture page, and has ALS and is in a wheelchair. .My friend, who is a long-term, respected psychologist, says that anxiety and worry will enhance one's symptoms or even create them Of course, in my case, everything is more subtle.

I vacillate between "not caring" anymore and tiring of thinking about ataxia to worrying about it, and me, constantly. I do not yet have a cane or use any walking devices but I feel as though my day is coming. I, too, love to fall asleep and to reward myself more, I watch a movie before or a rerun of my favorite TV show.. I also try to exercise daily but sometimes I feel all this obsession w ataxia is counter-productive. I am still furious that I have this/developed this. It's not just the fear of falling, it's the fear being mute, falling and being unable to write anything. What an awful condition. Thanks for listening to me. N

Cicina said:

Hello Neta,
I am certainly not an expert in ataxia, far from it, but for the last year an a half, I have read about it as much as possible and here is what I understand.
Whatever the cause of ataxia ,ataxia is ataxia and the different types have mostly the same symptoms. Not every one has all the symptoms, some progress rapidly, some slowly. Some appear at a young age, some in mid life, others later in life.
The non progressive ataxia is usually caused by a stroke or a brain injury, or a tumor ... Etc.
There is no cure yet and it appears that the best thing to do is stay physically active to keep our strength.

These are the facts. We cannot change them and although it is easier said than done as you say, we are better off accepting them. I understand your attitude, how can we deal with the constant need to try not to fall, with feeling dizzy all the time, and being practically unable to do anything manually?
I try to keep my mind busy, with my computer, I exercise severall times a day, but I must be honest, I am happy when it is time to go to sleep at night and I know I will have a few hours of peace. I suppose many are in the same state of mind.

So, Neta, try not to obsess with finding answers to the why and how did this ataxia happen. No one can give us any.
I am sorry if I sound blunt, I am only trying to help. And if your Sertraline helps alleviate symptoms, by all means, take it.
And by the way, when you feel you might fall, don't try to figure out if it is because of ataxia or depression, just try to concentrate on grabbing something to stay upwards.:-)
And I personally do not believe that depression makes you fall...
Take care!

I would call your attitude towar ataxia denial, but your doctor is a psyciatrst, not me.
When we are struck by ie : a loss, facing a terrible illness, we go through a grieving process. We all react differently. We can be sad, angry, depressed, scared, sometimes all of the above or only one or two of these feelings and then there can be acceptance. We all do this at our own speed and in different order.
So do not feel bad. You are going at your own speed.

In one of your post, you mentioned trying to hide the way you felt. This could be the reason why your family is not supporting you as much as you would like. What you tell them does not match the way you physically feeler act. They too are in denial. It’s tough to face a spouse or parent’s illness. They need to face the truth. They might need to hear it from a professional ( your neuro or psychiatrist perhaps).

I understand your fear of being mute. I was lucky that my stroke did not affect my speech. This was a big fear of mine too…
Hang in there, Neta, and keep smiling !

I completely agree with Cicina. Ataxia is not pleasant, but no one can make it go away, so we all just have to find a way to deal with it. I think that obsessing over the whys and pinning all hopes on a cure is unhealthy - we have to try to live our life.

About the denial - I really know what you mean. I have FA, and grew up with ataxia. I never told a soul (outside my immediate family) about me having ataxia, and never discussed it, despite the fact that over the years it became more and more difficult to hide. I covered cuts and scrapes I got from being clumsy and I tried to laugh off the numerous spectacular falls I had (once, when I was 15, I slipped on mud and was covered head to foot in it. Then I had to go to the school office so I could ring my mum to pick me up. Everyone saw. Still makes me cringe!). I had an operation when I was 17, and since then I've used a wheelchair. Still I told no one, and acted like I was 'normal'. I'm sure no one was fooled though.

I've just graduated from university where I studied psychology. Due to the nature of the course I researched things like neurological disorders etc. I remember reading a textbook (well, skimming through it anyway) where they were describing the symptoms of ataxia. I think that's when it hit me: I have ataxia, and pretending that I don't is pointless (and exhausting!). The last few years have been quite dark and depressing, but I think that I'm better now (I'm on sites like this anyway, which is something I never would have done before). I think I'm happier now that I've accepted it, but I know I won't let it run my life: I have ataxia, I'm not an ataxian.

So I get the denial. I think everyone goes through it, whether it lasts a month or years. I think we accept it when we're ready to, or (like me) when we are tired of pretending. I think denial is a defense mechanism not depression in itself (but then again, I'm no shrink... ).

It is not so easy to accept if you have a diagnosis of Cerebellar Ataxia which can be a broad umbrella term.

It would be natural to wonder and even if there is no cure you would always be wondering.

I do not have a specific diagnosis and I think it is normal to want to find out more.Especially if it is a non genetic form.

I would like to know what I am accepting first.

I know this may not be possible given your location, but have you considered getting a second opinion without changing doctors? When I say second opinion, I mean a real expert at a center that specializes in ataxia. The ataxia websites are full of people who have been misdiagnosed. That having been said, to confirm the diagnosis may in some way help you to accept it as fact and move on. You might gain some insight from Elisabeth Kübler-Ross's book On Death and Dying where she talks about the five stages of grief. Those stages of grief are just as applicable to other losses as well, your husband's loss of his wife as he knew her, your loss of your health, your inability to be able to hold your grandchildren, to a divorce, to your loss of the husband who no longer is supportive of you.

Neta, charlie had a great idea. Try to get another opinion. The National Ataxia Foundation here in the US, has a list of ataxia specialists worldwide and here is the one they list for Israel. May be you know already?
Also, I know you live in Jerusalem. Is it possible and easy for you to travel to Tel Aviv?
When I was diagnosed with ataxia by my neurologist, I sought a second opinion by a movement disorders specialist and he confirmed the diagnosis, which, although I was hoping he would say I did not have it, helped me put at rest my fight for a definite answer and I was able to deal with my situation better.
As Charlie said, you do not have to change doctor. I stayed with my first neurologist.
The hardest part was to wait 4 months for my appointment as this is a rare specialty and this doctor is very busy.

Israel
Tanya Gurevich, M.D.
Tel-Aviv Medical Center
6 Weizmann St.
Tel-Aviv 64239
Israel
Phone: +972-3-6974912
Fax: +972-3-6974911
Email: ■■■■■■■■■■■■■■■■■■■■■■■■■■■■

Whatever you decide, good luck to you!

I wrote a whole long response and it just vanished. Cant tell if its my computer of if the site so I will be more consice:

First, thanks to all who have reached out to me. Thanks!

My neuro's dont react gravely to me, maybe they have seen worse. The shrink takes his cues from them. He says my speech seems normal, walking only slightly off, that I am psychologically unable to deal with my condition because of a prior obsession with looks and attractiveness. I say bullshit but maybe I am wrong. I mean he is a psychiatrist of about 55.

I am sure that I am in some kind of denial but maybe that's not so bad given the fact thatthere is no cure anyway. It is true, I have protected my parents because they are older folks, Holocaust survivors and I am their baby, so to speak.

My husband (a prof) got a Spring appt. at a USA university which has an ataxia center. I plan on attending but will contact Dr. Gurevich anyway. I am American but gave up my American health insurance many years ago. Israel has a universal health care which is quite good and advanced. But now with his (mu husband's) appt. hopefully American insurance will be available to me again. I hoe they cover this Thanks again and good luck to us all. N