MS can be annoying, right? Feeling fatigued and irritable. Can’t do the things you usually want to do, but you want to be away from people anyway. Feeling guilty, worthless, helpless, apologetic. Just sad. MS is a drag. You don’t want to bring everyone else down.
Those feelings are also symptoms of depression.
“Depression is more common in people living with multiple sclerosis than in people with other chronic conditions. ”
At any given time, 35% of people living with MS are suffering from depression, according to the Journal of Neurological Science. It’s not all in your head.
Treating depression can make living with MS a little easier.
Depression is the primary factor determining a patient's quality of life, according to a meta-analysis of clinical studies published in the journal Dialogues in Clinical Neuroscience. Depression makes a greater impact than other variables, including physical disability, fatigue, and cognitive impairment.
The one thing you have to do when you see your neurologist? Be screened for depression. If they can’t help, they’ll guide you to help.
Dr Daniel Becker, of the International Neurorehabilitation Institute in Lutherville Maryland, attended a presentation on MS and depression at a joint meeting of ECTRIMS (the European Committee for Treatment and Research in Multiple Sclerosis) and ACTRIMS (the American Committee for Treatment and Research in Multiple Sclerosis).
The session on depression in MS left a real impression.
“When Dr Becker came back, we talked a lot about screening and treating patients for depression, and I was all for it! From working with stroke patients, I knew it would make a big difference,” said Sandra Eke Ferguson, Dr Becker’s nurse practitioner.
Before joining the International Neurorehabilitation Institute, Sandra worked with stroke patients facing the same kinds of challenges that MS patients faced. “They had always been the one taking care of everything and everyone, and now they needed help taking care of themselves.”
As in MS, the changes in patients’ abilities, relationships, and self-image seemed to affect their well-being even more than the physical damage from the stroke itself. And their sense of well-being seemed to strongly correlate with the success of their physical rehabilitation.
Once the stroke center began screening for and treating depression, patients thrived. Of course Sandra needed no convincing when Dr Becker considered addressing their patients’ depression as part of their multiple sclerosis treatment.
Now, every multiple sclerosis patient is screened for depression, and gets the treatment they need. Sandra says, “I like using Cognitive Behavioral Therapy (CBT) because it makes patients accountable for their responses and reactions.” She explained MS patients often feel powerless. CBT empowers patients to recognize, challenge, and change their negative thoughts.
The American Psychological Association says Cognitive Behavioral Therapy treatment usually involves changing thinking patterns. Strategies might include:
Learning to recognize distortions in thinking that are creating problems.
Learning to reevaluate those thoughts in light of reality.
Gaining a better understanding of the behavior and motivation of others.
Using problem-solving skills to cope with difficult situations.
Developing a greater sense of confidence.
Sandra recounted the story of a woman who came for a second opinion:
I confirmed this patient’s MS diagnosis, and I started to educate her about MS, but she stopped me. She’d already made up her mind. To go out west where assisted suicide is legal. She said she didn’t have anything to look forward to. She hated MS’s unpredictability, that she couldn’t plan from one day to the next, much less one year to the next. She couldn’t see a future.
I got her to agree to hold off for a just a while to see if Cognitive Behavioral Therapy could change the thinking that was hurting her.
She was really doubtful at first, but she stuck with it. Therapy really helped her, taught her to see things differently. She said she had been hijacked by negativity.
If you have MS, you may be depressed. Treatment can relieve some of the MS burden. Take the first step and get screened.
©Sherilyn George-Clinton
Images ©Eva Cohen