2. 



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Women are effected twice as often as men
The lifetime prevalence of depression is 14%
In general younger people are effected
more than those over 65
However, older people with chronic illness
like lupus have a high rate of depression.
Depression effects people of many
backgrounds; rich and poor, famous and
every day people.

3. At Eternity’s Gate:
Vincent Van
Gogh

4. Feeling sad or down for more than two
weeks
 Crying, feeling hopeless
 Poor sleep
 Loss of interest in doing normal activities
 Poor concentration
 Decreased appetite or weight loss
 Feeling tired and lacking energy


5. 




In the US, it is estimated as many as 1.5
million people have lupus.
1.8 to 7.6 people per 100,000 are diagnosed
with lupus each year.
Most cases are diagnosed between age 15
and 40.
Primarily women are affected (6-10 F:1 M)
African Americans (and possibly Latinos,
Asians and Native Americans) are affected
more than whites.

6. Lupus is an chronic disease.
 It is autoimmune disease, its cause is not
well known.
 Lupus patients frequently complain of
both memory problems and depression.
 There is currently research being done to
look into why this is the case.


7. 

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





Skin rash and photosensitivity
Joint pain and swelling
Tiredness
Fever
Shortness of breath
Hair loss
Sores in the mouth
Fatigue
Seizure, psychosis

8. 
This is a description of memory problems
which is reported by 21-80% of lupus
patients.
› Another way of describing this is memory
problems that come and go.
› Cause is not known; may be due to medications
or lupus itself. There is research in this area.

Symptoms include:
›
›
›
›
Difficulty remembering things
Problems making decisions
Difficulty finding words
Personality changes

9. 

Talk to your doctor about these symptoms
so that the appropriate tests are done to
see why you are having this problem.
Behavior modification:
› Make yourself lists of what needs to be done so
you do not forget
› Keep a calendar of your events and
appointments to remind yourself.
› Use family members and friends to remind you of
important events.

10. 





Pain from the joints
Weight gain from medications such as
prednisone
Medications make you feel sick or “crazy”
Change in how you look due to hair loss and
skin problems
Feeling unable to do what you want to do
such as work or care for children/family
members
Frustration that a family member does not
understand or thinks you are lying about your
condition

11. Having a chronic illness is a risk factor for
depression.
 Some of the lupus medications can
cause depression, such as prednisone.

› If depression is thought to be due to
prednisone one option to decrease the
dose.

12. Talk with your doctor about how you are
feeling.
 Ask your doctor if she thinks further tests
are needed to see if lupus is causing your
depression.
 Try to get psychiatric help with
counseling and medication as soon as
possible.
 If you feel suicidal go to the emergency
room.


13. 



Depression is common in patients with
lupus.
You can talk with your doctor if you are
feeling sad or down; there is good
treatment for depression.
Your doctor wants to help you feel your
best. Don’t be embarrassed to talk with
your doctor about your feelings if you are
feeling down.
You can also ask your doctor to talk with
your family if this would help them to better
understand your condition and concerns.

14. Talk therapy with a mental health
provider.
 Improving sleep
 Medications such as:

›
›
›
›
Prozac
Zoloft
Lexapro
Cymbalta

15. Keep your lupus in control by taking your
medications and seeing your
rheumatologist for regular check ups
and blood work.
 Lifestyle modifications:

›
›
›
›
Eat healthy
Exercise
Get enough sleep
Try to decrease stress in your life

16. Can lupus affect the brain? Yes.
 What are symptoms?

› Depression
› Coma
› Psychosis (hearing things or seeing things
that are not there)
› Seizure
› Stroke

17. Yes, but the tests are not always
definitive.
 MRI will show brain lesions.
 Two blood tests have been studied and
are thought to possibly be associated
with neuropsychiatric lupus: Antiribosomal P antibodies and NMDA
receptors.
 However, it possible to have negative
tests and have neuropsychiatric lupus.


20. Yes.
 Medications are strong and include:

› High dose prednisone
› Cytoxan
› Azathioprine

21. 



Depression and memory problems
(sometimes referred to as lupus fog) are
common in patients with lupus.
Reasons for depression in lupus patients are
multifactorial and may be due partly due to
the symptoms of lupus, as well as the
disease itself.
Lupus also can effect the brain itself.
The cause of memory problems is not well
understood and is undergoing further study.

22. There will be better days ahead.
 Just because you have lupus does not
mean that you will develop depression
or problems with your brain.
 Patients with lupus are leading happy
and successful lives now.
 With advances in research the future will
be even brighter.


23. There is a lot being done to study lupus
currently and to improve treatment.
 A listing of current trials can be found at:
http://clinicaltrials.gov
 Currently there are studies being done to
learn more using particularly using brain
imaging (MRI) and neuropsychiatric
testing.


24. Yasmin Santiago and the SLE Lupus
Foundation.
 Urban Health Plan.
 My colleagues at Montefiore including
Dr. Irene Blanco and Dr. Barbara
Mendez.
 My colleagues at Hospital for Special
Surgery including Dr. Michael Lockshin
and Doruk Erkan.
