MS and Depression: Tips for Mental Fitness

If you have multiple sclerosis (MS), you have a higher chance of depression. In fact, it’s one of the most common MS symptoms. Up to half of all people with the disease will have depression at some point.

That’s why it’s especially important to take note of your mood and take strides to care for your mind the way you care for your body.

The Connection

Having a chronic health condition can take a toll on your mood. That’s especially true if MS makes it tough for you to work or do things you enjoy.

You may grieve the changes and then move on. But sometimes, things like a flare- up or change in what you’re able to do may lead to depression. And the stress of having a chronic health problem can bring it on too.

Researchers think there are other connections between MS and depression. You may hear MS described as a neuro-inflammatory disease. That means it causes inflammation of your neurological system. That inflammation can help lead to depression.

MS can also damage areas of your brain that keep your emotions in check. Some medications prescribed to treat it, like corticosteroids and interferon drugs, can also trigger depression or make it worse.

Being disabled from MS doesn’t make you more likely to have depression. Depression can impact anyone with MS, and it may show up at any stage of your disease.

Signs of Depression

Everyone feels blue once in a while. But if you’ve often felt sad, depressed, or hopeless over the past 2 weeks or more, and you haven’t been interested in doing things you usually enjoy (like eating or spending time with loved ones), you may have depression.

Some other symptoms of depression can look a lot like signs of MS, like feeling especially tired or having trouble concentrating and making decisions. That’s why it’s important to see your doctor if you think you might be depressed. They’ll run some tests to make sure. They may even be able to tell if your symptoms are tied to MS, or to a mood disorder like depression.

What If I Have Depression?

Treating the depression will become part of your MS plan. Your doctor will watch for changes in your mood and help you come up with a treatment strategy that works for you.

That said, your treatment plan will look a lot like one for anyone else with depression. Your doctor may recommend talk therapy (also known as psychotherapy) or antidepressant medication. If the doctor prescribes these drugs, you may have to try different doses, medications, or combinations to figure out what works best for you.

Steps You Can Take to Feel Better

If you’re diagnosed with depression, it’s important to follow your treatment plan. But there’s a lot more you can do to manage your mood. These steps are good for anyone with MS, even if you aren’t depressed.

Exercise daily. Being active eases stress and has a positive impact on brain chemicals that play a role in depression. It can help ease MS symptoms too. Talk to your doctor about what type of exercise is best for you.

Squash stress. Yes, stress is a part of life. But when you have MS, the more you can do to ease stress, the better it is for your brain and your body. Breathing exercises, yoga, meditation, and spending time with others are good stress busters.

Stay connected. Having a good support network is important for everyone. But when you have MS, it’s crucial. Feeling lonely or isolated raises your chances of depression. Staying close with family and friends, however, can boost your mood. It also raises the odds that you’ll get extra help when you need it.

Let your health care team know how you're doing, too. If there’s a change in how things are going, your doctor should know.

Talk about it. You may not want to dwell on your condition, but sharing what you’re going through can help you feel better. Seeing a mental health professional, like a psychologist or social worker, is a great idea. But don’t stop there. Talk to friends and loved ones too. And think about joining a support group for people with MS. Being around folks dealing with the same illness can remind you that you’re not alone. It can also give you new ideas for dealing with MS-related issues.

Make rest and relaxation a priority. Listen to your body and say “no” when you need to. And make sure you’re getting enough sleep to give your brain and body a chance to recharge. If you’re spending a lot of time in bed and still feeling exhausted, let your doctor know. It may be time for a change in your treatment plan.

Doing these things can get harder just when you need it most, that is, when your MS symptoms worsen. Resistance training might be able to help. It stresses strategies that can help you get back on your feet. This includes some of the above like staying social and active, and taking time to relax when you need it. But it adds other mental strategies that can be especially helpful when symptoms worsen, such as:

1. Staying flexible: This can mean changing the way you think of normal. A good sense of humor and a positive outlook can help a lot when you’re dealing with some of the serious issues that MS can throw your way.
2. Planning ahead: There are serious practical challenges that can arise with MS. You can help lessen the challenges and the anxiety that goes along with them if you plan for them. For example, as you start to become less mobile, you can slowly work toward making your home easier to navigate by wheelchair.
3. Seeking meaning: This can mean involvement in your community through outreach, hobbies, or religious organizations. Or it may be time together with friends and family. Art, music, and literature can be great ways to connect with what is meaningful in your life.

Acceptance and commitment therapy (ACT) could also help. With the help of your therapist, you identify what is most valuable and then develop ways to pursue those things despite your MS symptoms.

Whatever approach you take, it’s important to seek help when you need it. About 15% of people with MS take their own lives. Your primary care doctor may be able to refer you to a rehabilitation psychologist that specializes in MS.

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