Link Between MS and Depression

[Marco]

Multiple Sclerosis and Depression: Examining the Link and How You Can Help Your Patients

Multiple sclerosis (MS) is a potentially debilitating disease in which the immune system attacks the insulating layer surrounding the nerve fibers, causing communication breakdowns between the brain and body. Over time, this may result in permanent nerve damage.

The symptoms of MS are far-ranging — patients may experience numbness and weakness in the limbs, tremors, problems with coordination, fatigue, slurred speech, impaired vision, and dizziness, to name some. One symptom that’s not always talked about, however, is depression, despite its prevalence among patients with the chronic autoimmune disease.

Examining the Link Between MS and Depression


Experts agree depression is much more common in patients with MS than it is in the general population. The National Multiple Sclerosis Society says major depressive disorder (MDD) will affect more than 50% of patients with MS at some point.² Johns Hopkins University likewise estimates approximately half of patients with MS will experience depression that interferes with their daily functioning.³ A systematic review and meta-analysis of 58 articles sampling 87,756 MS patients identified depression 30.5% of the time.⁴

Investigators have sought to identify why this association exists and suggest that depression in MS is biologically mediated by processes relating to the immunopathogenesis of the condition. Specifically, it may be a result of increased proinflammatory cytokines, the activation of the hypothalamic-pituitary-adrenal axis, and a decline in neurotrophic factors that occur in MS. If these processes do play a role in the onset of MDD, treatment may have a positive effect not only on depression but also in slowing down the progression of MS. This makes treating depression a “neuropsychiatric imperative,” the investigators concluded.⁵

Strategies for Treating Depression in MS
MS is unique in each individual and depression is not a universal experience. Regardless, screening for MDD is imperative. In fact, the US Preventive Services Task Force (USPSTF) recommends depression screening for all adults.

• If a patient with MS does have depression, there are strategies you can share with them that might help alleviate their symptoms. Therapy—cognitive behavioral, analytical, and other forms—has shown to be effective at treating depression. In addition, the National Multiple Sclerosis Society offers a series of recommendations, including:
• Exercising daily
• Maintaining social networks and joining support groups Eliminating stressors when possible
• Incorporating breathing exercises and meditating
• Writing in a notebook
• Steering clear of alcohol and other addictive substances Staying in touch with their doctor.

Source: https://www.neurologyadvisor.com/top...your-patients/

[oceanpride]

Any person with MS who can honestly say they are not depressed … I would have to scratch my head. They might even be lying to themselves. It sure is a battle. Not to let it consume is the trick. Good luck to all.

[Seasha]

Strategies for Treating Depression in MS
MS is unique in each individual and depression is not a universal experience. Regardless, screening for MDD is imperative. In fact, the US Preventive Services Task Force (USPSTF) recommends depression screening for all adults.

• If a patient with MS does have depression, there are strategies you can share with them that might help alleviate their symptoms. Therapy—cognitive behavioral, analytical, and other forms—has shown to be effective at treating depression. In addition, the National Multiple Sclerosis Society offers a series of recommendations, including:
• Exercising daily
• Maintaining social networks and joining support groups Eliminating stressors when possible
• Incorporating breathing exercises and meditating
• Writing in a notebook
• Steering clear of alcohol and other addictive substances Staying in touch with their doctor.

I find it interesting/perplexing that they don't list anti-depressant/anti-anxiety medications as a strategy. My journey includes all these listed over the years and while they have helped to some degree, anti-depressant/anti-anxiety meds have played a much more significant role for me. Both at the onset of my diagnose and throughout the following years.

[palmtree]

Any person with MS who can honestly say they are not depressed … I would have to scratch my head. They might even be lying to themselves. It sure is a battle. Not to let it consume is the trick. Good luck to all.

So well said. I tend to shy away from discussing mental health with doctors because they don’t realize it’s part of the territory of having MS.

[Pistachio]

Any person with MS who can honestly say they are not depressed … I would have to scratch my head. They might even be lying to themselves. It sure is a battle. Not to let it consume is the trick. Good luck to all.

This made me pause. I don't think I'm depressed (yet!?). I tend to try to find the positive in situations. I'm more of an, "It is what is....suck it up and get going", type. I typically don't dwell because I feel it personally doesn't serve me. However, that being said, if I'm honest I'm less ambitious to do things. Sometimes even hubby asking if I want to go for a walk feels like a monumental task and I'm annoyed at even having been asked. Keep in mind, I'm mostly able-bodied. Tired, but able-bodied. I've never considered this might be depression. Maybe I'm wrong?

[oceanpride]

I’m sorry
I really shouldn’t have commented on this.
I do try to keep this sort of thing on the inside and I do count my blessings and I wouldn’t say that anywhere else.
That doesn’t mean it’s ok here.
I’m really here to get support and to try and give some. I didn’t mean to throw any gasoline on the fire.

[pennstater]

I’m sorry
I really shouldn’t have commented on this.
I do try to keep this sort of thing on the inside and I do count my blessings and I wouldn’t say that anywhere else.
That doesn’t mean it’s ok here.
I’m really here to get support and to try and give some. I didn’t mean to throw any gasoline on the fire.

I don't think you threw any gasoline on the fire. It is true the majority of MS patients experience depression at some point. Some of it may be situational, tied to the diagnosis, work, stress of a chronic illness and some may have a more constant state.

And whenever symptoms appear, it is wise to question is it depression or symptoms of MS or other conditions and life stressors.

And I am like pistachio - I could have written the same post. Your post made me think twice and question. I have experienced depression twice since diagnosis, both times labeled situational and resolved. Since the heat wave in August, I have been more tired, and yes, little more cranky with loved ones. Your post forced me to do a deep dive and look at my overall daily interactions.

At this point, I am thinking just fatigue related and I have not been able to resume exercise routine to help with that, due to 6 week bout of bronchitis. But your post was an important reminder to keep an eye on it and make sure to constantly reevaluate, and if heading down that path, I reach out ASAP to get help before it becomes full blown.

Also a good reminder to not be so cranky