Depression and Multiple Sclerosis
Depression is common in the general population, but it is even more common in people with multiple sclerosis (MS). About 50 percent of people with MS will experience an episode of major depression at some point - a rate higher than in people with most other chronic diseases. Although major depression is a serious condition, effective treatment is available.
Why Depression Matters
Depression is a medical disorder that can range from mild to severe to life-threatening. It can affect your quality of life, your relationships, your work, and your overall health. People with depression are at higher risk for suicide, and the risk is even higher for those who have both MS and major depression. Depression is not something to ignore or try to push through on your own - it is a condition that requires attention and treatment.
The two hallmark symptoms of major depression are persistent sadness and a loss of interest in activities you usually enjoy. Other signs may include sleeping too much or too little, changes in appetite, feeling excessively guilty, difficulty concentrating, low energy, irritability, anger, feelings of hopelessness, or thoughts of hurting yourself or others.
It is worth noting that some symptoms of depression - such as fatigue and difficulty concentrating - can look very similar to symptoms of MS itself. Everyone feels down sometimes, but when these feelings last more than two weeks or start making it hard to enjoy life, it is time to talk to a health care provider.
What to Do If You Think You Are Depressed
Talk to a health care provider. This could be your primary care team, your neurologist, or a rehabilitation doctor. They can help diagnose and treat depression, or refer you to a behavioral health specialist such as a psychiatrist or psychologist for further assessment.
If you are having thoughts of suicide, get help right away: dial 988 for the Suicide and Crisis Lifeline. Veterans can press 1 to reach the Veterans Crisis Line.
How Depression Is Treated
Treatment for major depression often works best with a combination of approaches. Options include antidepressant medication, counseling, lifestyle changes, social support, and complementary therapies. There are many antidepressant medications available, and some have the added benefit of helping with pain, insomnia, or fatigue. For some people, treating depression also improves MS symptoms like fatigue, thinking difficulties, and memory problems.
Antidepressants are generally well tolerated, but they can take six to eight weeks to become fully effective - so do not get discouraged if you do not see results right away. Be sure to tell your provider about all medications and supplements you are taking, as well as any alcohol or drug use, since some substances can interfere with how antidepressants work.
If you have depression, talk with your MS care team. Depression can be treated successfully.
Based on an article by Christina Hughes, MD and Lynda Hillman, DNP, ARNP.
