There are many symptoms of depression, including loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. If you are experiencing any or all of these symptoms please speak to someone.
For people with MS, depression is the single most important factor affecting quality of life – even more so than disability or fatigue.1
A major US consensus statement reported that depression was common in MS, and that it has a major negative impact on quality of life. Yet depression is both under-recognized and under-treated in people with MS;2 it is estimated that one in four people have undiagnosed symptoms of depression at any given time.3
If you are experiencing these symptoms, it is important to know that you are not alone.
It is known that depression is more common for people with MS than for people with other chronic illnesses. Overall, approximately half of all people with MS will suffer from depression at some point during the illness.
An Italian study found 46% of patients had major depressive disorder4
A Norwegian study found 59% of patients assessed had depression5
An Australian study found 67% of patients were depressed6
Depression and MS
You’ve probably noticed that how you feel physically affects how you feel emotionally – the mind-body connection is a cycle.
Depression increases inflammation in the body (the Th1 response), leading to a worsening of the physical illness, which can then lead to a worsening depression.
However, this cycle works the other way too. Feeling better physically can improve emotions, so preventing and managing depression is critical in managing MS.
Treatment for depression very much depends on how severe your symptoms are and your preferences.
Self-management through lifestyle changes
Many parts of the OMS program may help depression symptoms.
According to the HOLISM study,7 diet, omega 3 supplements, exercise, and meditation are all helpful in combating depression, as is vitamin D, which can help prevent or at least reduce it, while improving cognitive function. 9-12
Mindfulness and meditation
Mindfulness, or paying full attention to the present moment, can be very helpful in improving the cognitive symptoms of depression.
There are a range of other self-management techniques including (but not limited to): keeping a mood diary, ringing a helpline, practising self-care, getting enough sleep (if possible), connecting with others, avoiding alcohol, volunteering, starting a hobby or online support.
If your symptoms are more severe, speak to your physician about other treatment options available to you. NICE guidance about speaking to health professional
‘Alternative’ treatments - peer support, art therapy, complementary therapies etc
Talking treatments (for mild - moderate depression) with therapist or counsellor e.g. cognitive behavioural therapy
Medication (for moderate - severe depression). Please talk to your doctor about this option.
Ask for help
Talk to someone you trust as they might be able to offer you support and listen to you about what you are experiencing. This could be friends or family, within your workplace, an MS nurse, your GP or neurologist.
There are also lots of organisations, nonprofits and support groups who you can also reach out to for support. Try one that is MS or mental-health focused.
For more on the MS-depression connection, view Dr. Keryn Taylor’s talks about OMS research on depression below:
1. Benedict RH, Wahlig E, Bakshi R, et al. Predicting quality of life in multiple sclerosis: accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. J Neurol Sci 2005; 231:29-34
2.The Goldman Consensus statement on depression in multiple sclerosis. Mult Scler 2005; 11:328-337
3. McGuigan C, Hutchinson M. Unrecognised symptoms of depression in a community-based population with multiple sclerosis. J Neurol 2005
4. Galeazzi GM, Ferrari S, Giaroli G, et al. Psychiatric disorders and depression in multiple sclerosis outpatients: impact of disability and interferon beta therapy. Neurol Sci 2005; 26:255-262
5. Figved N, Klevan G, Myhr KM, et al. Neuropsychiatric symptoms in patients with multiple sclerosis. Acta Psychiatr Scand 2005; 112:463-468
6. Khan F, McPhail T, Brand C, et al. Multiple sclerosis: disability profile and quality of life in an Australian community cohort. Int J Rehabil Res 2006; 29:87-96
7. Even C, Friedman S, Dardennes R, et al. [Prevalence of depression in multiple sclerosis: a review and meta-analysis.]. Rev Neurol (Paris) 2004; 160:917-925
7.Taylor KT, Hadgkiss EJ, Jelinek GA, et al. Lifestyle and demographic factors and medications associated with depression risk in an international sample of people with multiple sclerosis. BMC Psychiatry; in press 2014
8. Lansdowne AT, Provost SC. Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology (Berl) 1998; 135:319-323
9. Gloth FM, 3rd, Alam W, Hollis B. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. J Nutr Health Aging 1999; 3:5-7
10. Stumpf WE, Privette TH. Light, vitamin D and psychiatry. Role of 1,25 dihydroxyvitamin D3 (soltriol) in etiology and therapy of seasonal affective disorder and other mental processes. Psychopharmacology (Berl) 1989; 97:285-294
11. Jorde R, Waterloo K, Saleh F, et al. Neuropsychological function in relation to serum parathyroid hormone and serum 25-hydroxyvitamin D levels The Tromso study. J Neurol 2005