Depression in MS
Uncovering Ways to Create Understanding and Solutions
One out of two people who have MS may experience depression during the course of their disease, yet it isn’t discussed much – not with their doctors, and not with family and loved ones.
“There’s a stigma around certain topics, depression is an area we’ve heard is of concern for many, but it’s discussed by few. We need to recognise that depression makes other symptoms of MS feel worse, and when it goes untreated, it can be life-threatening.” stated Cynthia Zagieboylo, CEO of the National MS Society (US).
Hard to Recognise
There are many shades of depression, from feeling a little “blue” to experiencing deep feelings of hopelessness and suicidal thoughts. It’s easy to miss a diagnosis of depression. Depression is not often a topic discussed during the course of a typical visit to the neurologist or other MS care provider.
A certain degree of depression is part of a natural reaction to a life-changing diagnosis of MS. Dr. Elisabeth Kübler-Ross famously outlined a cycle of natural reactions to loss that people tend to go through: denial, anger, bargaining, depression, and finally acceptance. But getting stuck in the depression mode is not natural.
Depression can impact everything else
Depression is like wearing dark sunglasses indoors so you can’t see what’s going on, it robs you of your own resources to cope. Depression is a significant impediment to people being able to manage their MS and engage in effective wellness strategies. Family members are also at risk of depression. If we can recognise depression and treat it early, we can make it easier for people to manage the challenges of MS.
Is MS Depression Different?
Depression occurs in MS at a higher frequency than in people with some other chronic disorders, and some believe it is the result of the MS disease process itself, rather than an emotional reaction to it. Researchers have identified specific areas of the brain that, when damaged, are linked to depression in people with MS. Others have found evidence that immune activity such as inflammation is associated with depression. It is still not known whether MS depression is the same as depression that others experience, but there is clear evidence that people with MS who experience depression can respond well to treatment.
Access to Care
Even when a mood problem is recognised, there are not always adequate sources of professional help available. This is a critical gap, and finding ways to grow the workforce of professionals who can treat MS depression is crucial. There are several types of professionals who are able to treat people who have depression, including psychiatrists, psychologists, social workers, and psychiatric nurse practitioners. But it’s critical for therapists to have solid knowledge about MS and its unique challenges. In particular, the unpredictable nature of MS can make it challenging for families to cope with daily logistics, let alone make plans for next month, next year, or the more distant future.
Raising awareness among healthcare providers, people with MS and family and friends will help remove the stigma from depression, and improve the chances that it will be spotted and treated.