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How does depression affect people with MS?

People living with MS can experience a wide range of emotions including anxiety, fear, anger, frustration, worry, grief, guilt and stress. Feeling emotional is normal when faced with a chronic illness, and there is no right or wrong way to deal with these feelings. However, it's important to understand the difference between feeling down and clinical depression.

While we still do not fully understand the nature of depression in MS, we do know that:

• Stress is a major factor in depression. The stress of dealing with a diagnosis of a chronic disease and the possibility of disability can bring on depression.
• The disease process of MS may cause depression. If MS damages areas of the brain that are involved in emotional expression and control, a variety of behavioral changes can result, including depression.
• Depression may also be associated with MS-related changes that occur in the immune or neuroendocrine systems.
• Depression can also be a side effect of some medications.

How do I know if I'm having a major depressive episode?

People with MS often go through a period of grieving. They may grieve the losses they experience due to MS, such as walking or working. This mourning may look like depression. However, grief eventually goes away on its own.

Clinical depression is a serious condition that can last from at least two weeks to several months. It produces flare-ups known as "episodes."

Symptoms of depression appear to be more common in people living with MS. Symptoms of depression may also be associated with some MS treatments. If you experience symptoms of depression or have thoughts of death or suicide, contact your doctor immediately.

Symptoms of a major depressive episode:

• Sadness
• Loss of interest or pleasure in everyday activities
• Loss of or increase in appetite
• Insomnia or sleeping too much
• Agitation or slowing in behavior
• Fatigue (feeling of tiredness)
• Feelings of worthlessness or guilt
• Problems with thinking or concentration
• Ongoing thoughts of death or suicide

Dealing with depression

Depression does not mean that you are "weak." You should not feel ashamed about being depressed or feel the need to hide it. You cannot control or prevent depression, but it is very treatable.

Depression can be diagnosed only by a health care professional. Therapy or medication may be needed. A health care professional can treat the condition and prevent an even deeper depression that is harder to treat. It may be necessary to try different medications and different doses before an effective medication, or combination of medications, is found. If you suspect you are suffering from depression, please talk with your health care professional. He or she can get you the help you need.

Dealing with the ups and downs that come with living with MS

There are many strategies you can incorporate into your life to help manage your emotions. Here are some ideas:

• Talk openly about your feelings so those close to you can learn how best to support you.
• Allow for two-way communication. Regular family meetings are a good outlet for communication.
• Reach out to a loved one if you need help.
• Spend time with others.
• Get connected to others with MS.
• Get involved in the community.
• Find time to relax.
• Use exercise as an outlet (Always talk to a health care professional before beginning any exercise program.)
• Watch out for comfort eating which may provide a short-term lift but can provide empty calories that don't offer the nutritional value your body needs.
• Laugh as much as possible.
• Try to focus on the positive.

Talk to your health care professional about what strategies may help you manage your emotions.

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