Multiple Sclerosis Centers of Excellence
Questions and Answers About Depression
Christina Hughes, MD and Lynda Hillman, DNP, ARNP
Depression is common in the general population, but depression is even more common in people with MS. Approximately 50% of people with MS will experience an episode of major depression; a clinical diagnosis that requires at least two weeks with five or more depressive symptoms. Major depression is not only more common in people with MS than in the general population, it is also more common in people with MS than in people with other chronic diseases. Although major depression is a serious condition, remember that effective treatment is available.
Why should someone be concerned if they are depressed?
Depression is a serious condition, and if left untreated, can lead to chronic depression. Depression is a medical disorder that can be mild, severe, or even life threatening. Not only can it affect a person’s quality of life, it can interfere with relationships, jobs, and a person’s overall health. People with depression are at higher risk for suicide, and the suicide rate is even higher for those with both MS and major depression. Depression is not something to ignore or “just get over.” It is a disorder that requires close monitoring and treatment.
How can you tell if you have major depression?
The two main symptoms that may indicate major depression are persistent sadness and loss of interest in usually enjoyable activities. A person may also sleep too much or too little, eat too much or too little, feel excessively guilty, have decreased concentration, or decreased energy. Some might be irritable, angry, have feelings of hopelessness, or have thoughts of hurting themselves or others. Often, signs and symptoms of depression, like fatigue or difficulty with concentration, can mimic symptoms of MS. Everyone feels down or overwhelmed every once in a while, but when a person feels this way for more than two weeks or is starting to have difficulty enjoying life, it is time for a more complete evaluation by a heath care provider.
What should you do if you think you are depressed?
If you think you are depressed, talk to a health care provider. This could be your primary care team, neurologist, or rehabilitation doctor. These providers can help with diagnosing and treating depression, or they may refer you to a behavioral health specialist like a psychiatrist or psychologist for further assessment and treatment. If a person is having thoughts of suicide, immediate attention is required: dial 988 for the national suicide and crisis lifeline, and press 1 specifically for Veterans.
How is major depression treated?
Treatment options for major depression may include antidepressant medication, counseling, life-style modifications, and support, as well as complementary and alternative medicine. Effective treatment often includes a combination of these therapies. There are many antidepressant medications, and some have the added benefit of treating pain, insomnia, or fatigue. For some people, treating their depression also reduces some of their MS symptoms like fatigue, impaired cognition, and memory difficulties. Although, each person responds to medications uniquely, overall, antidepressants are well tolerated. Other substances can interfere with the effectiveness of antidepressants, and a health care provider should be informed about all medications and supplements you are taking, as well as alcohol and drug use before starting an antidepressant. Antidepressants can take as long as six to eight weeks to work, so do not become discouraged if results are not seen immediately.
If you have depression, talk with your MS care team. Depression can be treated successfully!