A to Z of MS Depression
It is estimated that about half of all people with MS will experience an episode of depression at some stage.
It is important to distinguish clinical depression from low mood. Depression involves persistent sadness lasting more than two weeks, accompanied by other symptoms such as an altered sleep pattern, feelings of hopelessness, guilt and low self esteem, thoughts of death, reduced energy and the inability to concentrate and to take pleasure in anything.
There are two sorts of depression associated with MS - broadly, that caused by MS itself and that caused by living with MS.
As with other long-term conditions, the experience of living with MS can lead to depressive moods. The impact of symptoms on relationships with family and friends, changes in employment, changes in the ability to take part in some tasks or pastimes can all lead to depression. Some of the drugs prescribed for other MS symptoms can also have an effect on mood, such as corticosteroids used in the treatment of relapses.
Depression can also be caused by MS itself, though how this happens is unknown. The level of depression in MS is higher than in other neurological conditions, though again the reason for this is unclear.
Treatment
Treatment of depression takes two forms: drug therapy and psychotherapy, often used in combination.
Selective serotonin re-uptake inhibitors (SSRIs), for example fluoxetine (Prozac) or paroxetine (Seroxat), can be useful and imipramine and amitriptyline are also sometimes prescribed.
The psychotherapeutic approach may involve identifying the cause of depression, and trying to alter negative patterns of thinking and behaviour into more a positive approach.