On the National MS Society’s website, there is a dedicated page for depression, and Dr. Deborah Miller, PhD, from Cleveland Mellen Center, was interviewed in a two-part video webcast, where she makes this statement,
“Depression is one of the most treatable symptoms of MS.”
For those living with multiple sclerosis, the journey includes a wide range of emotions, and depression is found in the MS population about 7.5 times more than in the general population.
Depression in the MS population
A definitive diagnosis of MS can take years from the onset of symptoms, through the battery of testing, and evaluating the results. After this process, there can be a feeling of relief of being diagnosed and being able to move forward with getting proper medical treatment.
However, the diagnosis can also lead to depression. The reality of having a chronic illness, and the negative impact on the quality of life, can be overwhelming. The feeling of loss, of one’s identity and capabilities, may lead one to experience stages of grief, mainly anger and denial towards being sick.
Depression can also be a result of the damage in the brain and changes in the immune system caused by MS. In this case, MS is the actual medical cause of this mental illness, rather than being a stressor.
As a treatable symptom, it is important to consider depression as part of the overall treatment plan.
Aside from general feelings of sadness and/or crying spells, depression can be seen in behavioral changes:
- lack of appetite
- lack of interest and/or motivation
- a general slowness in movement
- isolating from others
- sleeping too much or too little
Both MS and depression can cause fatigue, so sometimes depression may be overlooked. Your treatment team can help you sort out the difference. Your support network of family and friends may also notice symptoms that you don’t see, or before you see them.
Where to start
National MS Society offers local support groups, which can be found on their website or by calling (800) 344-4867. You can ask your local chapter about other resources, too.
Ask your neurologist or primary care doctor if they can recommend someone. Referrals from your support network can also help identify trusted providers. Insurance companies can provide lists of mental health providers in their network. Medicare provides information on their site as well.
Remember, treatment is available with or without insurance.
Who to see
Therapy can be provided by a licensed counselor, licensed social worker, or psychologist. They can be part of a treatment team or have their own private practice. The difference between these providers vary depending on their education, training, and specialty. Therapy can be short-term and focus on immediate needs and problem solving, or it can be longer term to explore deeper issues and build coping skills.
If you are considering medication, an evaluation by a psychiatrist or advanced practicing nurse can help you explore options. There are different types of medication to treat depression and other related symptoms such as anxiety. Some medications are taken daily, and some are taken only as needed. It may take time to find what is most effective, so it’s important to be patient.
A therapist and a prescriber who work together can collaborate on your treatment. It is recommended, but not necessary.
Where to go
County, city, or state-run facilities can provide free or low cost treatment. These programs can be at freestanding mental health clinics or inside hospitals, and can be found through local boards of social services.
Non-profit and/or community organizations can provide mental health services as their primary service, or as part of a cluster of services they offer. An internet search using the keywords “community” or “non-profit,” along with “mental health” or “behavioral health,” and your city or state, can pull up a list of places.
Private practice professionals and private facilities do not typically accept patients without insurance, but they can accept Medicaid, Medicare, private insurance, or private pay. In addition to the larger settings described above, these therapists and prescribers also work in private offices.
Other treatment options
Higher level of care is needed if depression severely impacts functioning or leads to thoughts of hurting oneself. There are half-day or full-day programs in many of the above organizations mentioned for a higher level of support. There are even inpatient stays, if necessary.
In a crisis situation and/or there is an immediate threat to safety, please call 911 or go to the nearest emergency room. To speak to someone anonymously, please call the National Hopeline Network at (800) 784-2433.
Do you suffer from depression? Do you use therapy, medication, exercise or other methods for managing it?
Shortly after earning her MSW degree from Columbia University and starting a career in psychiatric social work, KM was diagnosed with multiple sclerosis. She joined MS Bike Ride in spring 2014 and hopes to become an MS advocate someday. For now, she continues to explore ways to make use of her talent and skills. Whenever she can, she volunteers for NJ Hopeline and keeps a food blog, The Old Blue Eats. She lives in New Jersey with her husband, two children, and her nursemaids—cat, Mali, and dog, Moby.
Photos from Free Images.