Jason, your neighbor is responding normally to taking prednisone and
having a major systemic illness.

Virtually everyone who is on prednisone (above 5 mg/day) has
irritability, sleeplessness, mood swings, and a host of other problems.
  Lupus along is bad enough. Additionally, use of prednisone often
requires other medications and methods to counter the side effects of
the prednisone, and those add their own side effects to the ones due to
prednisone.

Perhaps your friend is not being treated appropriately for her lupus.
She should get a second opinion from a major medical center that
specializes in lupus and related autoimmune diseases.

There has been some advances in lupus treatment:  Rituximab, and perhaps
  Humira or perhaps Enbrel.  For severe cases, a high risk solution can
be stem cell transplant.

Here's some info on prednisone use long term for dosages about 5 mg/day:

     *  Many body changes occur when one is on prednisone for any
        extended time.

           o Some changes are temporary; some are permanent.

           o Typical and common body changes that aren't very serious in
            themselves or can be treated effectively are:

                 + acne, appetite increase, arthralgia, cataracts,
                  constipation, Cushing's syndrome (swollen face,
                  upper back hump), fluid retention, euphoria,
                  hyperactivity, impaired wound healing, insomnia,
                  muscle pain (myalgia), myopathies (muscle wasting
                  and weakness), Petechiae (minute hemorrhages into
                  the skin), psychological dependence, shakiness,
                  skin atrophy, yeast infection (thrush), weight gain.

                 + Some can be countered by medications, exercise,
                  and life style changes.

           o Some bodily changes that are more serious and require
            medical attentions are:
                 + Adrenal insufficiency, avascular necrosis (death
                  of tissue, often bone, due to capillary damage),
                  depletion (of calcium, magnesium,  nitrogen,
                  potassium, protein), increase eye pressure
                  (predisposes to glaucoma), peptic ulcers,
                  steroid-induced diabetes, steroid-induced
                  osteoporosis, stunted growth in children,
                  tooth erosion.

What your friend needs from you and others is the understanding that she
no longer has complete control of her mental state nor her life, and
that she needs tolerance and support, not criticism and isolation.  Her
energy levels are probably limited to the point where every little daily
activity is an intolerable burden.

This is when she needs a true friend, not just those who wanted her
friendship when she was well.

Your friend almost certainly needs an anti-depressant and a sleep aid
and I hope she's on those now.  Those on prednisone need to take a
multivitamin/mineral supplement, calcium supplement (1200-1500 mg/day),
extra vitamin D (400-800 units/day) and perhaps magnesium supplement,
and also a biphosphonate such as Fosamax to help prevent bone loss or
parathyroid hormone if biphosphonates can't be tolerated.

The above information I believe to be correct, however, I have NO
medical training and so nothing I say should be taken to be medical
advice, nor as necessarily correct, nor as applicable to any specific
persons.

For information on adrenal malfunctioning, see
http://www.drlam.com/A3R_brief_in_doc_format/adrenal_fatigue.cfm#10

Best wishes for your relationship with your friend.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Hello,
Thanks for your post. I suspected that prednisone was the cause of the
side effects (such as mood swings). Her weight is about 300 pounds and she
is NOT taking any vit., minerals or herbs. It's impossible for me to
discuss medical issues with her since it causes a mood swing to kick in. I
will continue to offer my support and encouragement. I read an excellent
book related to
adrenal problems and one of the cases discussed in the book made me realize
that my neighbor may have Addison's Disease or Cushing's Disease.
"Adrenal Fatique" by James L. Wilson, N.D., D.C., Ph.D

Thanks again,
Jason
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Jason- no, Lupus cannot cause Bipolar Disorder.  Bipolar I and II disorders
are genetically passed in families.  It can skip generations, but almost
everyone can track it back.  A Bipolar Manic episode will have symptoms of:
little to no sleep- this can last for days; heightened creativity;
grandiosity; much stamina/energy;  excess spending/sex/eating, etc. (These
cycles could last for days or hours)  This manic episode will be followed by
a period of depression, hence the "bipolar" or "extreme polar" mood swings.
Now, if she did happen to have Bipolar Disorder, it could be being effected
by whatever meds- either herbal or prescription- that she is taking for
Lupus.  And, if she is having a relapse, of either, I would think it could
have the potential to make her extra testy- but no, she could not get
bipolar disorder from lupus. Crystal Gray

~~~~~~~~~~~~~~~~~~~~~~~~~~

Crystal,
Thanks. Someone else told me that my friend that lives next door is
probably having mood swings as a result of taking a medication. I seem to
recall that the medication was Prednisone.
Jason
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