Over 50% of individuals with MS will experience depression at some point in their life after an MS diagnosis.
To date, what exactly triggers the onset of MS remains unknown. In some individuals, attacks of neurologic symptoms come and go, while in others, the attacks never get better. Nevertheless, in all individuals with MS, damage to the nerves can make it difficult for the nerve impulses to travel throughout the body. This results in symptoms such as muscle weakness and stiffness, dizziness, vision problems, sexual dysfunction, and cognitive problems. Further damage to the brain tissue may lead to memory loss, difficulty concentrating, and depression.
Depression is one of the most common symptoms of MS. The term applies to various emotional states of well being, from feeling sad for several hours to experiencing clinical depression that may last for several months. Over 50% of individuals with MS will experience depression sometime in their life after an MS diagnosis. The odds are more likely if an individual is more susceptible to depression before their diagnosis.
Depression and grief are not the same
Seeing as how any individual coping with too much stress or a difficult situation may become depressed, it is easy to understand how the long-term physical symptoms of MS can bring about changes in mood, such as sadness and feelings of hopelessness. MS is an unpredictable disease and experiencing losses, such as the ability to walk or the ability to engage in certain leisure activities, may prompt mourning for these losses. However, grief is generally time-limited and resolves on its own in time. This is why the process of mourning may merely resemble depression. “When treating depression, the focus is often on helping people reduce feelings of hopelessness, worthlessness and, for some, thoughts of suicide. Grief is not typically associated with these feelings, so the focus of therapy is likely to be different” said Hughes.
Other times, MS itself may cause depression. The disease can destroy the protective coating around the nerves that helps the brain to send signals that affect mood. As MS progresses, problems with self-control may become more frequent. Depression may also be a side effect of some of the medications used to treat MS, such as steroids and interferon.
One approach through which individuals with MS can keep track of cognitive changes is to undergo cognitive evaluation. This test is generally performed by a rehabilitation psychologist or neurophysiologist. “It is often a good idea to get this test done at the first signs of difficulties, as it can provide a baseline for future comparison. This evaluation can also help determine if treatment, such as cognitive behavioral therapy or cognitive rehabilitation, would be beneficial for improving fatigue, mood, and/or cognitive symptoms” said Abbey Hughes, clinical psychologist.
The ‘worst’ invisible symptom in MS
With so many invisible symptoms in MS, it can be rather difficult to pick the ‘worst’. Yet, depression is definitely one of the most severe symptoms of MS. It is very real and deep.
When an individual is depressed, they may feel sad, irritable, disheartened or lacking in energy. Some of the most common symptoms of depression include the following:
- Extreme fatigue
- Difficulty concentrating
- Uncontrollable crying
- Unexplainable aches and pains
- Digestive problems
- Change in appetite that causes weight gain or loss
- Low sex drive
Left untreated, depression can reduce quality of life, as well as aggravate other symptoms, such as pain and fatigue. In its most severe form, clinical depression is a major risk factor for suicide. In fact, the main reason why the risk of suicide is so high among individuals with MS is due to undiagnosed and untreated depression.
If you are experiencing any of these warning signs of suicide, contact a mental health professional or go to the emergency room immediately. These signs include:
- Always thinking about or talking about death
- Talking about taking your life
- Making comments about feeling helpless or worthless
- Suddenly switching from being very sad to being very calm or acting joyful
- Taking risks that could be fatal
- Losing interest in things that you used to care about or that once made you happy
- Experiencing symptoms of depression, such as difficulty falling asleep and eating, that are only worsening
Changing your mindset
The first step in getting the right treatment is acknowledging that you are depressed. If your sadness is making your life worse, such as causing strains in your relationships or at work, you should consider consulting with a mental health professional. He or she can help you to get to the root of the problem, as well as to make sure that the medications you are taking or another health problem are not causing your symptoms. Antidepressant drugs may be an option; however, you will need to take them only as your doctor prescribes them. Usually, they work best when taken alongside psychotherapy or talk therapy.
Developing a positive mindset is vital when coping with MS. Think about your overall wellness and consider the following:
- Exercising on a daily basis
- Getting enough sleep
- Keeping a feelings journal to acknowledge your stressors
- Avoiding addictive substances, such as alcohol
- Staying in touch with your medical team
- Maintaining social connections by spending quality time with your family and friends
- Trying out relaxation techniques, such as meditation or yoga
- Joining a support group
- Purging negative emotions by feeling them physically and then allowing them to pass
- Looking for evidence that things will get better
- Avoiding limiting yourself
- Believing what you tell yourself
- Being kind to yourself
Although it may be quite difficult to adjust to an MS diagnosis, failing to understand and acknowledge the disease only adds to the stress. And stress can lead to depression. The more you know about MS and how it affects you, the more empowered you will feel. Talk through any problems you may have and work through any treatments you may need. You do not have to choose between your health and your achievements.
Even though maintaining a positive outlook with MS may not come easily, it does play a key role in how you respond to disease. “Being positive is not about being happy all the time. It doesn’t always look like a smile. It can look like you’re empowered, determined, strong and putting your beliefs in something that works at the moment” said Andrea Hanson, certified life coach.