The Emotional Effects of MS
Approximately 50% of people with MS experience a period of significant depression at least once in their lives; that’s two to three times the risk of depression seen in the general population.
It’s natural to experience a range of emotional responses when you’re living a life of unpredictability and change. Adjusting expectations and grieving losses inevitably involves feelings of sadness. There are many obvious external triggers for mood problems including pain, and the effects of MS on family, housing, work and finances. Neurological changes have been linked with an increased risk of depression in MS, and are implicated in other mood disorders that affect individuals with MS.
Depression is a persistently low mood, occurring most of the time and lasting for several weeks or more. This is sufficient to cause distress or affect social or work functioning. The low mood is usually accompanied by feelings of being sad or empty; worthless and guilty, or in some people, anger and irritableness. Major depression may be accompanied by suicidal thoughts or actions.
Bipolar disorder is a rare condition marked by alternating periods of depression and mania, or limited to just mania (hyper-activity, irrational thinking).
Mood abnormalities appear to be common in MS, and may take various forms, including:
- emotional instability (lability) involves frequent mood changes that appear to affect individuals with MS more commonly and perhaps more severely than the general population.
- pathological laughing and crying that occurs out of keeping with the situation; affects about 10% of people with MS; this can often be addressed with the help of your neurologist.
- euphoria is marked by an unrealistic sense of optimism which may be expressed at inappropriate times; affects 5% – 10% of people with MS.
Physical symptoms common to depression and to MS
- disturbed appetite
- sleep problems
- cognitive dysfunction
- fatigue
- pain
- loss of libido
Note: If these problems are due primarily to depression, appropriate treatment is likely to bring about an improvement.
Take steps to treat depression
- Address external triggers, eg, relationship stresses, housing/ financial problems
- Attend therapeutic counseling
- Take anti-depressant medication as prescribed
- Explore non-drug remedies such as CBT and exercise
Cognitive behavioural therapy (CBT) aims to identify and address distortions in the way that a person perceives themselves and the world. The treatment lasts for a fixed period to time, and you must make a commitment to work actively with the therapist to address your problems. Although costs of CBT may not be covered by public health insurance plans, it can be as effective as medication in people with mild to moderate depression. When the two are used in combination, there are added benefits.
Aerobic exercise can improve fatigue and enjoyment of life, along with mood problems such as depression and anxiety. This has been observed in several studies of aerobic and rehabilitation programs lasting from 12 to 15 weeks, and involving exercise sessions of less than 1 hour two to three times each week.