Mood changes in multiple sclerosis: Understanding the causes and available treatments
People living with Multiple Sclerosis (MS) often face a range of mental health challenges, with depression being the most prevalent[1]. Approximately one in three individuals with MS experience depression, a condition characterised by feelings of sadness, irritability, loss of interest in activities, and changes in sleep and appetite[1].
Anxiety and emotional fluctuations are also common in MS patients. The unpredictable nature of the disease can lead to feelings of grief, worry, fear, irritability, guilt, and anger, which can surface during everyday activities[2][4]. Fatigue, a common symptom of MS, is closely linked to psychological conditions such as stress, anxiety, and depression[3].
Fortunately, there are several avenues for treatment and support.
Psychological therapies, such as cognitive behavioural therapy (CBT), have been shown to be moderately effective in reducing MS-related fatigue and can also help with depression and anxiety[5]. Antidepressants and other psychiatric medications may be prescribed to treat depression or anxiety symptoms[1].
Physical activity, including gentle exercises like yoga and Tai Chi, can improve mood and reduce symptoms of depression in people with MS[5]. Maintaining social connections and engaging with support groups can help alleviate feelings of isolation and depression. Rehabilitation counseling can address the emotional impacts of MS and uncertainties about the future[4].
A multidisciplinary approach combining medication, psychological interventions, physical rehabilitation, and social support appears to be the most effective strategy for improving the quality of life for people with MS, although the exact treatment plan may vary depending on individual needs[5].
It's essential to remember that everyone's experience with MS is unique, and the mental health challenges can be influenced by various factors, such as pain, fatigue, changes in mobility, concerns over symptom progression, access to treatment, worry about self-care, loneliness, and impact on working life[2][4].
If mental health issues are affecting a person's daily life and well-being, it's crucial to seek professional help. A doctor or health professional can work with an individual to develop a personalised activity program that suits their needs.
Some common antidepressant drugs prescribed for depression or anxiety in MS include duloxetine hydrochloride (Cymbalta), citalopram (Celexa), venlafaxine (Effexor), paroxetine (Paxil), fluoxetine (Prozac), bupropion (Wellbutrin), and sertraline (Zoloft)[1].
In some cases, people with MS may experience pseudobulbar affect, causing uncontrollable episodes of laughing or crying[6]. In such instances, medications like dextromethorphan and quinidine (Nuedexta) may be used[6].
Mindfulness meditation has been found to benefit some people with MS, potentially improving mental health, quality of life, and some aspects of physical health[7].
In conclusion, depression and anxiety are common mental health issues for people with MS, and treatment is typically multifaceted, involving therapy, medication, exercise, and social support to manage symptoms and improve wellbeing. It's crucial to seek professional help if mental health issues are impacting daily life, and a personalised treatment plan can be developed to address individual needs.
[1] Multiple Sclerosis Trust. (2021). Depression. Retrieved from https://www.mstrust.org.uk/a-z/depression [2] National Multiple Sclerosis Society. (2021). Mood and emotional changes. Retrieved from https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Common-MS-Symptoms/Emotional-Changes [3] National Multiple Sclerosis Society. (2021). Fatigue. Retrieved from https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Common-MS-Symptoms/Fatigue [4] National Multiple Sclerosis Society. (2021). Emotional well-being. Retrieved from https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure_Emotional-Well-Being.pdf [5] National Multiple Sclerosis Society. (2021). Treating depression and anxiety. Retrieved from https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure_Treating-Depression-and-Anxiety.pdf [6] National Multiple Sclerosis Society. (2021). Pseudobulbar affect. Retrieved from https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure_Pseudobulbar-Affect.pdf [7] National Multiple Sclerosis Society. (2021). Mindfulness meditation. Retrieved from https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure_Mindfulness-Meditation.pdf
- The mental health challenges faced by people with Multiple Sclerosis (MS) often extend beyond depression, encompassing anxiety and emotional fluctuations as well [2][4].
- Science and health-and-wellness interventions, such as psychological therapies like cognitive behavioral therapy (CBT), antidepressants, and mindfulness meditation, can play a significant role in treating mental health issues in MS treatment seekers [5][7].
- In creating a treatment plan for managing mental health in people with MS, a multidisciplinary approach combining medication, psychological interventions, physical rehabilitation, and social support is recommended to address individual needs effectively [5].
