Periodic Paralysis and Depression

One of our members asked about the possible connection between Periodic Paralysis and depression. This comes up occasionally, so I thought I would write a blog article about it.

My reply:

There are five possible answers or issues to consider about Periodic Paralysis and depression...... 

First:
We know that (low potassium) can/may create mental issues including depression (and possibly psychosis, hallucinations and delirium).

http://healthyeating.sfgate.com/psychological-effects-low...

http://www.livestrong.com/.../468486-brain-fog-and-a.../

Second:
There are mental issues which can accompany Andersen-Tawil Syndrome, a form of Periodic Paralysis:

"Disease characteristics.

Andersen-Tawil syndrome (referred to as ATS in this entry) is characterized by a triad of episodic flaccid muscle weakness (i.e., periodic paralysis), ventricular arrhythmias and prolonged QT interval, and anomalies such as low-set ears, ocular hypertelorism, small mandible, fifth-digit clinodactyly, syndactyly, short stature, and scoliosis. Affected individuals present in the first or second decade with either cardiac symptoms (palpitations and/or syncope) or weakness that occurs spontaneously following prolonged rest or following rest after exertion. Mild permanent weakness is common. Mild learning difficulties and a distinct neurocognitive phenotype (i.e., deficits in executive function and abstract reasoning) have been described.
www.ncbi.nlm.nih.gov/pubmed/20301441 "

"Executive Functioning (EF) Disorder

Relates to difficulty in self regulation, organizing, integration, or high order reasoning skills. "Executive Function disorder, is a disability of not being able to show what you know" Executive Function disorder is associated with many disabilities: Attention Deficit Hyperactivity Disorder (AD/HD), Learning Disabilities (LD), Tourette Syndrome (TS), Obsessive Compulsive Disorder (OCD), Autism, Depression, Bipolar, etc."

http://concordspedpac.org/ExecutiveFunctions.html

Third:
Co-morbidity: We can all have more than one medical issue co-existing with our Periodic Paralysis.

From our book:

The Periodic Paralysis Guide And Workbook:

Be The Best You Can Be Naturally (pages 35 and 36)

"Co-Existing Conditions

The term ‘co-existing conditions’ also known as ‘co-morbidity’ means having more than one medical condition, illness or disease at the same time. Last year we prepared and executed a comprehensive four-part informal survey of the members of our Periodic Paralysis Network Support Group and received a great deal of important and surprising information. We discovered that most of our members had more than just the common symptoms of Periodic Paralysis. Many of them, whether they were diagnosed with a form of Periodic Paralysis or not, had at least one more other diagnosed condition. Most had several, and a few had as many as fifteen other diagnosed diseases, conditions or types of medical dysfunction. The following is the list of conditions reported:

Cyclic vomiting syndrome, high cholesterol, diabetes type 2, peripheral polyneuropathy, arachnoids cysts in the brain, loss of peripheral vision, poly cystic ovarian disease, migraines, osteoporosis (bone crush stage in spine and hips), spina bifida oculta, small brain ischemia, intolerance to most medications, paradoxical effect to most medications, hypoglycemia, intolerance to anesthesia, cataracts, costochondritis, gluten intolerance, fibrocystic disease, esophageal reflux, esophageal hernia, diverticulitis, hearing loss, lactic acidosis, metabolic acidosis, hypoxemia, (low blood oxygen), restless leg syndrome, stress fracture of the foot, neuroma (nerve tumor) in both feet, painful and tight calf muscles, fibroid tumor (uterus), ovarian cysts, chronic bladder infections, extremely dry skin, GERD, weak eye muscles, fasciculation, temporomandibular disorders, reflex sympathetic dystrophy, cervical and uterine cancer, uterine and ovarian cysts, vertigo, high clotting, blood clots, asthma, low set, hyper mobile joints, gastritis, syncope, muscle spasms, depression, obsessive compulsive disorder, memory loss (short term), chronic fatigue, edema, unnamed lumps in breasts, herpes simplex A (lips-cold sores), gastro paresis, myalgia, myositis, osteoarthritis, myoclonic jerks, dysphagia (trouble swallowing), lumbar spinal stenosis, many cysts, fatty tumors, hyperthyroid, clotting disorder, memory deficit, compressed pituitary, kidney cyst, allergies, goiter, hardening of the arteries in legs, trouble climbing stairs, low platelet count, mastectomy and hysterectomy, straight spine, vertigo, tinnitus, atrial septal defect, complete heart block, scoliosis, pitting edema, thyroid hormone resistance disease, seizures, cluster headaches, severe sleep apnea, rectocele, pulmonary hypertension, candida, acute pancreatitis, chronic pancreatitis, poorly distended bladder, Barrett’s esophagus, heart attack, gall bladder issues, carpal tunnel, exercise intolerance, kidney stones, degenerative disk disease, Ehlers-Danlos Syndrome, fibromyalgia, interstitial cystitis, Sjogrens Syndrome, LUPUS, Charcot-Marie Tooth.

Fourth:
Who would not be depressed when you are sick, ill, in pain, and/or too weak to do anything and not being believed?

Fifth: Any drugs being given for the depression, may/could be aggravating the issue if an individual has PP...

I hope this is helpful!!!

Until later...

Pain and Periodic Paralysis

Unfortunately, many doctors have the misconception, based on outdated and archaic information and data, that pain is a not a symptom and does not exist in patients who have Periodic Paralysis. This is a serious issue because these doctors refuse to recognize Periodic Paralysis and refuse to diagnose individuals who desperately need to be diagnosed because they experience pain.

Last year we created and carried out a series of four surveys attempting to gather as much information as possible in order to create a set of criteria that doctors could use to aid in diagnosing patients. Ninety-five percent of the participants indicated that they experience pain regardless of their diagnoses; Andersen-Tawil Syndrome, Hypokalemic Periodic Paralysis, Hyperkalemic Periodic Paralysis, Normokalemic Periodic Paralysis or Paramyotonia Congenita. It was the same whether they were diagnosed genetically, clinically or still seeking a diagnosis.

It was discovered that the pain can be experienced before, at the beginning, during or after episodes or it can be intermittent or chronic (all of the time). The pain was described in many ways such as achy, burning, sharp, constant, tenderness, sudden, cramping, rigidity, contractions, tightening, stiffness, charley horses, growing pains or spasms. It was reported as only involving one limb or body part, partial body, the trunk, several body parts or the entire body.

The pain results from several natural ways depending on the type of Periodic Paralysis or genetic mutation. In some cases it is from the swelling of the muscles when they fill up with fluid as the potassium shifts. Some of the pain is from the rigidity and contracting of the muscles. A third cause can be the shifting of sugar with the potassium. A fourth cause may be from low magnesium. Cold can create rigidity and pain for some. Metabolic acidosis, which can often develop in Periodic Paralysis, causes pain in the bones and chest pain.

A fifth cause and huge issue that can cause us great pain is as follows...
We must never push ourselves when in an episode or coming out of an episode because our muscles are very weak and the connective tissue (ligaments, tendons, cartilage, adipose) and other organs have to take up the work of our failing muscles, which is not their job. This puts great stress on them which can cause damage to them and creates great pain for many us.

Waiting until your body is ready to move, etc. is something that we should/must do...most of us are in paralysis during our sleep and many of us wake up still paralyzed or partially paralyzed, so not pushing ourselves in the morning (or any other time) is important. You will know you are in an episode or coming out of it if in the morning (or any other time) you are weak, having trouble breathing and/or speaking or keeping your eyes open, among other things.

You should also not be moved, if possible in an episode for the same reasons.
***Please Do Not Push Yourself, Or Try To Push Yourself Or Let Others Push You Or Move You When You Are Weak, Having Symptoms, Or In Partial Or Full Paralysis.***

Other conditions or diseases can co-exist causing permanent or intermittent pain such as Ehler-Danlos Syndrome (EDS), arthritis or fibromyalgia. These may be aggravated when an individual with Periodic Paralysis is in an episode or paralysis. Intermittent paralytic episodes can damage organs in the body, including the muscles. For some individuals the pain becomes permanent and may be misdiagnosed as fibromyalgia, or other medical issues like rheumatoid arthritis. Pain may also be caused from other unnatural means. The off-label medications typically prescribed for Periodic Paralysis or other drugs such as statins may create pain.

The best method to avoid the pain during the episodes is to avoid the episodes by avoiding the triggers and maintaining a balance in diet, rest, hydration and other natural methods.

Some people with Periodic Paralysis may be able to take medications to ease the pain but many  people cannot handle medications. It is advised that the pain be treated with natural means such as eating certain foods, herbal teas, heating pads, warm baths, ice packs, relaxation techniques and massages.  Many more ideas can be found on the Internet.

http://www.healthline.com/health/hyperkalemic-periodic-paralysis#Overview1

http://en.wikipedia.org/wiki/Thyrotoxic_periodic_paralysis

http://en.wikipedia.org/wiki/Hypokalemic_periodic_paralysis

http://www.med.nyu.edu/content?ChunkIID=96851

http://www.medscape.com/viewarticle/410649_3

http://www.socialstyrelsen.se/rarediseases/hyperkalemicperiodicparalysisa

http://www.healthline.com/health/hyperkalemic-periodic-paralysis#CausesandRiskFactors2

http://www.webmd.com/drugs/2/drug-6753/diamox-oral/details/list-sideeffects

http://emedicine.medscape.com/article/242975-clinical
http://beyondmeds.com/2012/10/03/natural-pain-relief/



Until later...