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Multiple sclerosis and depression

Depression is common in people with multiple sclerosis with around half of people with MS experiencing depression at some stage.

Experts don’t know whether depression is as a result of nerve damage from the disease, or because of the stress and anxiety of living with what can be a disabling and unpredictable condition.

Depression may also be a side effect of some drugs used to treat MS and its symptoms.

What are the symptoms of depression?

Everyone at one time or another has felt depressed, sad or down. Sometimes the feeling of sadness becomes intense, lasting for long periods of time and preventing a person from leading a normal life. This is depression, a mental illness that, if left untreated, can worsen, lasting for years and causing untold suffering, and possibly even resulting in suicide. It is important to recognise the signs of depression, which include:

  • Sadness
  • Loss of energy
  • Feelings of hopelessness or worthlessness
  • Loss of enjoyment from things that were once pleasurable
  • Difficulty concentrating
  • Uncontrollable crying
  • Difficulty making decisions
  • Irritability
  • Increased need for sleep
  • Inability to fall or stay asleep at night ( insomnia)
  • Unexplained aches and pains
  • Stomachache and digestive problems
  • Decreased sex drive
  • Sexual problems
  • Headache
  • A change in appetite causing weight loss or gain
  • Thoughts of death or suicide
  • Attempting suicide

When to seek help for depression with MS

You should seek help if:

  • Depression is negatively affecting your life - causing difficulties with relationships, work issues or family disputes - and there isn't a clear solution to these problems.
  • If you or someone you know is having suicidal thoughts or feelings.

Where should I go to get help for depression with MS?

Once you decide to seek medical help, start with your doctor. He or she can evaluate you to make sure that medication or another illness is not causing your symptoms.

Your doctor may prescribe treatment or refer you to a mental health care professional, who can perform a thorough assessment so that an effective course of treatment can be recommended.

How is depression in MS diagnosed?

A person will be assessed as being clinically depressed if they have at least 5 of these symptoms for at least two weeks:

  • Depressed mood, hopelessness and despair
  • Significantly reduced interest or pleasure in activities
  • Changes in appetite and noticeable weight change
  • Insomnia or excessive sleeping
  • Feelings of excessive restlessness or sluggishness
  • Fatigue, loss of energy
  • Feeling worthless, excessive or inappropriate guilt
  • Inability to think, concentrate or make decisions
  • Recurring thoughts of death or suicide

How is depression treated?

The first step in treating depression is recognising that you are depressed. The second step is getting help. These two steps may in fact be the hardest part of the entire treatment process. Once you seek help from a qualified healthcare provider, you will find that there are numerous treatment options to help you get back on track.

Several antidepressant drugs are available, but they must be used only under the supervision of a medical professional. Antidepressant drugs are most effective in treating depression in people with MS when used in conjunction with psychotherapy. Called "therapy" for short, the word psychotherapy actually involves a variety of treatment techniques. During psychotherapy a person with depression talks to a trained mental health care professional, who helps him or her identify and work through the factors that may be triggering the depression.

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