Depression and Multiple Sclerosis

For many people, the emotional impact of multiple sclerosis is the most challenging aspect of the disease. A cascade of feelings can come and go, depending on whether or not you are having symptoms, how much your disease has progressed, and the up and down nature of day-to-day life apart from multiple sclerosis. Over time, chances are you may experience a wide range of negative emotions that can feel overwhelming: anger at the disease; anxiety about the future; guilt when you let others help; sadness and grief at the loss of certain abilities. All of these emotions are perfectly normal, but none of them is pleasant. The good news is that help is available. Before we discuss ways to get help, let's look at some of the most common emotional challenges for people with multiple sclerosis.

Depression and Multiple Sclerosis
Clinical depression is more common in people with multiple sclerosis than in the general population. Researchers are not sure if this higher rate of depression is due primarily to an emotional response to having the disease or is related to the physiology of the disease. Either way, depression should be taken very seriously. If you are feeling depressed, you should seek treatment as soon as possible.

Am I depressed?
Clinical depression is more than a passing sadness or a day or two of feeling down. The American Psychiatric Association has outlined the hallmarks of depression, which are listed below. If you experience any of these symptoms, you should talk to your healthcare provider or a counselor.

• Feeling sad or empty or being irritable or tearful for most of the day
• Loss of interest and pleasure in most activities
• Significant weight loss or gain or a decrease or increase in appetite
• Sleeping too much or an inability to sleep
• Physical restlessness or slowed movement
• Feeling personally worthless or having inappropriate feelings of guilt
• Inability to concentrate or make decisions
• Thoughts of death or suicide, or planning suicide

While fatigue or excessive tiredness is also a symptom of depression, many people with multiple sclerosis experience fatigue that is unrelated to depression.

Anxiety and Stress
The unpredictability of multiple sclerosis can lead to excessive worry, fear and anxiety that can be debilitating. You may find yourself worrying constantly about when your next flare-up will come, even when you're feeling good, or you may spend a lot of time contemplating future disability that may never happen. The length of time it can take to get a multiple sclerosis diagnosis is often itself a source of anxiety and fear.

A certain amount of worry is understandable when you have a chronic condition that is unpredictable. However, when fear, worry and stress become so great they prevent you from doing things you enjoy, keep you from getting a good night's sleep, or interfere with your relationships with others, it's time to get help.

Help is available
If you are experiencing depression, anxiety, stress or other emotional difficulties, you should tell a friend or family member right away and tell your healthcare provider as soon as possible. Your healthcare provider will be able to refer you to a counselor, social worker or therapist who can help you find the appropriate way to address your needs. Several different approaches to addressing the emotional challenges of multiple sclerosis are described below. Don't hesitate to try several, until you find the one that works best for you.

• Talk Therapy
  A trained, skilled counselor can provide guidance and support. Some counselors have experience working with people with multiple sclerosis and other chronic diseases.
• Medication
  Antidepressants and other medications can be very helpful in giving you the emotional relief you need to address life's challenges. They can also help you feel better, so you can enjoy life more.
• Coping Skills Therapy
  Some counselors and social workers teach effective coping skills that can be enormously helpful as you move forward with multiple sclerosis. These skills can help you take positive action when you feel depressed or stressed and give you a greater sense of control over your life.
• Other Approaches
  Eating a healthy diet and getting regular exercise can also go a long way toward helping you feel better emotionally. Doing yoga, practicing relaxation techniques and spending time doing things you enjoy can also relieve emotional distress.

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