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A to Z of MS

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A to Z of MS Depression

It is estimated that about half of all people with multiple sclerosis will experience an episode of depression at some stage.

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.

It is important to distinguish clinical depression, which is persistent, from episodes of low mood, which tend to resolve after a period of time.

Depression can occur as a result of living with MS and also as a symptom caused by MS itself.

Depression from living with multiple sclerosis

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. Fatigue, particularly is associated with low mood. Similarly, one of the consequences of depression can be increase in fatigue.

Some of the drugs prescribed for other MS symptoms, such as corticosteroids used in the treatment of relapses, can also have an effect on mood.

Depression as a symptom of multiple sclerosis

Depression can also be caused by multiple sclerosis 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 is usually very effective and 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.

A psychotherapist can help by identifying the causes of depression, and trying to alter negative patterns of thinking and behaviour into more a positive approach. Cognitive behavioural therapy (CBT) is a form of psychotherapy that is commonly used in the treatment of depression.


Self help groups

There are a number of charities offering support to people affected by depression, whatever its cause. All provide information and publications, support services and understanding for people affected by depression. Each also has a list of local support groups.

References

McGuigan C, Hutchinson M.
Unrecognised symptoms of depression in a community-based population with multiple sclerosis.
Journal of Neurology 2006;253(2):219-223.
abstract

Feinstein A.
Multiple sclerosis and depression.
Multiple Sclerosis Journal 2011;17(11):1276-1281.
abstract

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