MS and Depression
Recent studies show that up to 20 percent of people in the U.S. will have depression throughout their lifetime. Some will display symptoms as they make their adjustment into adolescence. Others will begin having symptoms after the birth of their first child. Still, others will not experience depression until into their 60s, after they have suffered the loss of multiple friends.
No matter when it arrives, depression is a cunning and dangerous foe. Part of the danger is the wide range of symptoms and presentations possible with depression. Some sufferers will only face mild symptoms in the form of inconsistent sleep habits, weight loss and having less energy. People with severe forms of depression face an entirely different beast.
Severe depression can chronically distort your way of thinking, your self-worth and the value you place on living. At its worst, depression can trigger psychosis where you may see, hear and feel things that are not there. You may become delusional and suspicious of others.
The Link Between Multiple Sclerosis and Depression
When you have multiple sclerosis (MS), there is an increased cause for concern in regards to depression. While studies show 20 percent of all people will experience depression, studies show that people with MS are two and a half times more likely to have depression – meaning as many as half of all people with MS will meet criteria to receive a diagnosis of depression.
If you have MS, it may be time to beginning thinking in terms of when depression comes rather than if depression comes.
What Causes Depression?
To devise the best treatment for your symptoms, working to understand and conceptualize the source or sources of your depression is extremely helpful. MS serves to add many variables into the mix, but experts believe that there are several clearly identifiable sources of depression in people with MS. Some are unique to MS sufferers while others are possibilities to anyone.
Sources of depression include:
- Reaction – When people are faced with new stresses and new challenges, it changes the way they view themselves and the world around them. Learning that you have MS can trigger a strong negative reaction as you plan for children, finances, housing, transportation, and other necessities. Perhaps, your relationships and supports have become strained from your diagnosis. This can cause situational depression to develop.
- Physical damage – You know that MS attacks your brain by stripping away the myelin that your neurons need to communicate more effectively. If your MS is targeting areas of your brain responsible for emotional regulation, personality or decision-making, the outcome may be depression.
- Side effect – Always gain education when it comes to the medications that you are putting into your body. Interferon medications and corticosteroids have been linked to depression by past studies. Although there may not be clear evidence that medications cause depression, have an open conversation with your doctor to weigh the risks and rewards.
- Fatigue – MS wears you out. When your body is run down and tired, your brain is not functioning to its fullest potential. Fatigue will bring on other depressive symptoms like lack of energy, lack of motivation, problems sleeping and even feelings of guilt and shame.
Grief and Sadness
Grief and sadness deserve special consideration in this discussion. Sadness is a common, expected and natural feeling. It is not pathological. Being sad means that you are human, not that you are depressed. Certainly, sadness is an aspect of depression but is not enough alone to receive the depression diagnosis.
Grief, like sadness, is also a typical part of life. Grief will present at numerous times throughout your lifespan. It can present after a death or after you receive a serious medical diagnosis, like MS. It can be challenging for even the most seasoned mental health clinician to discern between normal grief and depression.
Grief, loss, and depression share many similar symptoms including low mood, hopelessness, anger, lack of motivation and issues with sleeping and eating. The risk is in treating grief as depression because many believe that grief should not be treated with medication. Ideally, you move through the process of grief and loss at your own pace until you reach acceptance. Medication can block your process.
Multiple Sclerosis Depression Treatment: Finding Professional Help
Because people with MS are much more likely to develop depression, professional assistance is necessary. If your car was smoking, would you wait to get an evaluation from a mechanic thinking that it would probably get better on its own, or would you take it into the shop immediately? Treating your car better than your mental health is a mistake.
Mental health professionals are numerous in their classifications and experience, but people with MS and depression will benefit from several. They include:
- Prescriber – States vary in their rules and regulations, but you will benefit from seeing someone who can prescribe medication, especially one that has experience in treating depression in people with chronic illnesses. Psychiatrists are medical doctors and can prescribe throughout the country. Your state may allow nurse practitioners or psychologists to prescribe certain types of medications. Medications can be very beneficial for people with MS and depression. Be sure to explain your MS symptoms and depression symptoms thoroughly. Your comfort with your provider is paramount – if you don't feel comfortable or don't have confidence in the professional you're seeing, seek a second opinion.
- Therapist – Whether it is a social worker, counselor or something in between, a therapist will be an important piece of your treatment. A therapist can provide information on depression and how your symptoms are a result of it. They will discuss useful interventions that can make profound differences in your thoughts, feelings and behaviors.
- Case manager – Your need for this service will depend on your MS symptoms. Do you often forget about appointments? Do you have trouble remembering the information the doctor gave you? A case manager, many times, can accompany you to appointments to be sure that your treatment is moving forward as planned.
Self-Help Tips for Coping With MS and Depression
Addressing and improving depression requires a lifestyle change. You cannot spend only 45 minutes per week working on your depression and expect significant changes. You must continually and consistently learn, practice and perfect skills to manage your mood.
- Follow recommendations. Trust the professionals in your life, and follow their treatment recommendations. Find creative ways to be consistent with medications if your memory is poor. Be clear with your professionals about how closely you are following their recommendations. If you do not trust your doctor or feel that he or she is not looking out for your best interests, seek another opinion. Having a solid team is the only way to confront a serious problem like MS.
- Seek support. Support comes in many shapes and sizes. Family, friends, and coworkers are great options if you are lucky enough to have them available. What if you don’t have people in your life? You must actively seek them out. In person and online, people exist that can empathize with your situation and status. Of course, making new friends is not easy, but the reward is incredible. Once you have support in place, use them to talk through your feelings.
- Have fun. Spending too much time, energy and attention on your MS will leave you drained. Choose to find balance in your life by finding fun in all shapes and sizes. Create satisfying experiences by doing old favorite activities or discovering new ones. Have you tried yoga yet? What about skydiving? There is always something new waiting for you. And while you have fun, be sure to maintain your sense of humor.
- Give back. MS makes you focus too much on yourself and your problems. Volunteering your time and energies to others in need turns the table and puts you in a helper role. This position will give you a new purpose and meaning. Volunteering will be a welcome boost to your self-esteem and worth.
- Relax. Over time, little issues grow to become bigger and more stressful. If stress equals worse depression, decide to find new and better ways to relax. Keep in mind that a positive, active stress-reducing activity is always favorable over sitting to watch TV. Exercise is always a great choice. An hour at the spa, a walk on the beach or 20 minutes of a relaxation technique taught by your therapist may be enough to get through the week.
The Bottom Line...
If you have MS, be prepared to make room in your life for depression. Understanding the ways that MS triggers depression is important as you find new ways to fight it. Professional help is a must, but real success comes with changing your life and focus towards treating your symptoms. If you never give up, you can never lose.