Mental Health and Multiple Sclerosis (MS): The Unseen Battle
Discover how multiple sclerosis (MS) impacts your brain and its connection to your mental well-being.
Mental Health and Multiple Sclerosis
If you have multiple sclerosis (MS), you may look completely fine to your loved ones and colleagues. But behind that seemingly healthy facade, you may be battling a range of physical and mental symptoms that greatly impact your daily life. Your vision may be so blurry that you can’t see your computer screen clearly, or you may have trouble socializing because one side of your body is numb or tingling. It’s a constant struggle that few people truly understand.
🤯 “Just imagine how distracting something like that is,” says Dr. Sharon Stoll, a neurologist who specializes in MS at Yale Medicine. It’s not just the physical challenges that MS brings, but also the toll it takes on your mental health. The disease process itself can lead to changes in your mood, causing depression, anxiety, and other emotional changes.
💔 Can MS Cause Depression?
According to research, up to 50% of people with MS may experience major depressive disorder at some point. That’s three times higher than the general public. While doctors previously believed that depression was a natural response to the stress of living with MS, there is now growing evidence that the disease actually changes the brain and immune system, directly impacting how you feel and act.
👩⚕️ Dr. Michelle Heil, a 40-year-old woman diagnosed with relapsing-remitting MS, has noticed an increase in depressive symptoms lately. Lack of motivation, little interest in leaving the house, difficulty paying attention, sleep problems, and feeling down or irritable are just some of the challenges she faces. To address these issues, she seeks professional help from her neurologist, psychiatrist, and therapist. She encourages others in the same situation to do the same, although she acknowledges that prioritizing mental health can be challenging when you have limited energy to spare for anything other than getting through the day.
🙅♀️ Unmanaged depression not only makes it harder to stick with MS treatment, but it also raises the risk of other health issues such as inflammation, immune system problems, blood vessel diseases, heart disease, and even suicidal thoughts. It is crucial to tell your doctor if you experience symptoms of depression and seek medical help immediately if you have thoughts of self-harm.
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😰 Can MS Cause Anxiety?
Living with MS can be compared to the stress and uncertainty of the COVID-19 pandemic. The unpredictable nature of the disease creates a constant sense of “unknown,” which can significantly contribute to anxiety symptoms. For instance, if you have lesions on your spinal cord, it may feel as if your skin isn’t really there, triggering anxiety and discomfort. Dr. Stoll humorously describes it as feeling like you’re at a cocktail party, desperately holding onto your stomach to make sure your insides aren’t falling out. It’s a challenging reality that requires coaching and support to navigate successfully.
👩⚕️ Michelle Heil experienced sudden and severe anxiety a few years before her MS diagnosis. The symptoms were so debilitating that she had to take medical leave from her job. Initially, she attributed the anxiety to stress, but looking back, she wonders if it was actually a symptom of MS, known as the “MS hug.” This sensation feels like being trapped in a tight bear hug, making it difficult to breathe and inducing panic. Understanding the root causes of anxiety in MS patients is complex, as it can be a result of both disease-related neurological changes and external life events. Consulting with a doctor can help differentiate between the two and find suitable treatment options.
😣 Can MS Trigger Other Emotional Changes?
In addition to depression and anxiety, MS can also lead to other emotional changes. Some individuals with MS may experience adjustment disorder, which makes it challenging to adapt to stressful life changes. Moreover, they are twice as likely to be diagnosed with bipolar disorder compared to the general population.
👩⚕️ Dr. Heil admits that she struggles with controlling her emotional reactions. When upset, she reaches a point where she can’t function or express herself verbally, and tears may flow uncontrollably. It feels as if her brain short-circuits, leaving her with an overwhelming flood of emotions and an incredibly short temper. Additionally, MS brain lesions can cause pseudobulbar affect (PBA), which involves inappropriate emotional responses like crying or laughing without reason. These symptoms can resemble depression, bipolar disorder, or mood swings, but PBA tends to occur suddenly rather than as a gradual change. While talk therapy may not be effective for PBA, medications can help manage its symptoms.
🆘 Where Can I Get Help for Depression and Anxiety?
If you’re dealing with depression or anxiety related to MS, it’s essential to seek help from medical professionals who understand the specific challenges you’re facing. Start by consulting with your regular doctor, who can rule out any other potential causes for your symptoms. However, your neurologist will have the expertise to provide optimal MS-related care.
Your doctor may recommend seeing a rehabilitation psychologist who specializes in MS, as they can offer valuable guidance and support. Therapists can provide coping strategies to help you accept your diagnosis and manage the challenges that come with it. Cognitive-behavioral therapy (CBT), a method that focuses on changing negative thought patterns and behaviors, can be particularly helpful in managing pain, fatigue, anxiety, and depression associated with MS.
In some cases, antidepressants may be prescribed to ease depressive symptoms. Interestingly, certain depression medications can also help manage nerve pain, headaches, or sleep problems. 💊 “As an MS specialist, I like medicines that are two for one,” says Dr. Stoll.
💪 Just like the annual brain scans and MS medication, Dr. Heil considers mental health treatment a critical aspect of her overall well-being. She emphasizes that managing MS requires a combination of strategies tailored to each individual’s specific needs. Unfortunately, there’s no handbook with a definitive list of guaranteed solutions to make life with MS easier. However, by prioritizing mental health and connecting with the right professionals, it’s possible to significantly improve your overall quality of life.
🤝 Let’s start a conversation! Have you or someone you know experienced mental health challenges related to MS? How did you navigate through them? Share your thoughts and experiences in the comments below. And if you found this article helpful, don’t forget to share it with your friends and family on social media. Together, we can spread awareness and support those affected by MS.
Q&A Content
Q: Can MS affect memory and cognitive function?
A: Yes, MS can impact memory, as well as other cognitive functions such as attention, problem-solving, and processing speed. These changes are often referred to as “cognitive fog” or “brain fog.” It’s important to discuss these symptoms with your healthcare provider to determine the best course of action for managing cognitive difficulties.
Q: Are there any lifestyle changes that can improve mental health in people with MS?
A: Absolutely! While medical interventions are crucial, certain lifestyle changes can also positively impact mental health in individuals with MS. Regular exercise, a balanced diet, adequate sleep, stress reduction techniques (such as mindfulness or meditation), and staying socially connected can all contribute to improved overall well-being.
Q: Are there any emerging treatments or therapies for mental health issues in MS?
A: Researchers are constantly exploring new treatments and therapies to address mental health issues in individuals with MS. Some promising areas of research include using virtual reality therapy for anxiety and depression, transcranial magnetic stimulation for mood disorders, and non-pharmacological interventions like yoga or art therapy. It’s an exciting time in the field, and staying informed about new developments can be beneficial in managing mental health challenges.
📚 References:
- International Review of Psychiatry: “Depression in multiple sclerosis.”
- National Multiple Sclerosis Society: “Emotional Changes,” “Depression.”
- Frontiers in Immunology: “Antidepressants on Multiple Sclerosis: A review of In Vitro and In Vivo Models.”
- Johns Hopkins Medicine: “Multiple Sclerosis and Mental Health: 3 Common Challenges.”
- Neurology: “Interface of Multiple Sclerosis, Depression, Vascular Disease, and Mortality.”
- Frontiers in Psychology: “Fatigue and Suicidal Ideation in People With Multiple Sclerosis: The Role of Social Support.”
- Neurology & Therapy: “Patient and Provider Insights into the Impact of Multiple Sclerosis on Mental Health: A Narrative Review.”
- Medicine: “Manic episode in patient with bipolar disorder and recent multiple sclerosis diagnosis.”
- The Journal of Neuropsychiatry and Clinical Neurosciences: “The Prevalence of Bipolar Disorders and Association With Quality of Life in a Cohort of Patients With Multiple Sclerosis.”
- Neurology Clinical Practice: “Pseudobulbar affect: Prevalence and association with symptoms in multiple sclerosis.”
- Pharmacy & Therapeutics: “Nuedexta for the Treatment of Pseudobulbar Affect.”
- International Journal of MS Care: “Cognitive Behavioral Therapy for the Management of Multiple Sclerosis–Related Pain.”
- Dialogues in Clinical Neuroscience: “Cognitive-behavioral therapy for anxiety disorders: an update on empirical evidence.”
- BMJ Journals: “Depression in multiple sclerosis: a review.”
