We focus on multiple sclerosis and mental illnesses as we enter May’s Mental Health Awareness Month. In this blog, we cover why people with MS are at high risk of developing mood disorders while suggesting ways to mediate the associated anxiety and depression experienced by many MS patients.
Background: Multiple Sclerosis
Multiple sclerosis is an autoimmune disorder that attacks any part of the brain, leaving plaques where the coating of the nerves is stripped off. Because the plaques can vary in location, the manifestations of MS vary, with different symptoms of weakness, numbness, difficulty walking, and even psychiatric issues. In addition, people with MS have a higher risk for mood disorders than the general population.
MS and Mood Disorders
Mood disorders afflicting MS patients often include depression, anxiety, adjustment disorders, and bipolar disease. The numbers are striking:
- 30 to 50% of MS patients suffer from depression compared to 20% of the general population. (Source).
- Anxiety affects over one-third of MS patients, and adjustment disorders affect one-quarter of MS patients.
- Bipolar disorder affects 13% of MS patients, compared to fewer than 5% without MS, or a 2.6-fold difference.
- Although the rate of depression is higher in MS patients, depression in MS is under-diagnosed and under-treated. (Source).
- MS patients have an increased incidence and prevalence of psychiatric symptoms. (Source).
Unfortunately, these staggering statistics predispose MS patients to a greater risk of suicide, nearly twice that of the general population. In addition, MS’s deleterious effect on mental health is more significant than patients with similar degrees of disability from other chronic diseases.
Reasons for MS Patients’ Increased Risk of Mental Illness
So why are MS patients at such increased risk of neuropsychiatric illness? In part, this is due to the damage to the brain from the disease state itself. Other factors include genetics, treatment with high-dose steroids, the sense of loss that MS patients confront by receiving this life-altering diagnosis, and by accepting increasing physical challenges each time they experience a new flare. With each new symptom, this cycle of loss and grief begins anew. Ultimately, the cumulative effect can change self-image.
MS and Depression vs. Grief
Grief can be difficult to distinguish from major depression, both afflicting the MS population. With grief, the period of mourning is usually time limited. In depression, the symptoms can be unremitting, and may require professional intervention.
Effect of Mental Illness on MS Patients
The ramifications of mental illness are significant. The quality of life and even the disease course itself may be affected. For example, patients often become less involved in directing their care and pursuing physical exercise and other means of self-help needed to maintain their functional status. In addition, anxiety may, directly and indirectly, impact fatigue and depression levels, further augmenting the degree of suffering. (Source).
MS patients report that MS causes a unique stress of its own. They often report that their symptoms worsen during stress; conversely, symptoms improve when the external stress is gone. In addition, the unpredictability of new symptoms and the uncertainty about the future are additional stressors. Interestingly, none of the many research studies have been able to definitively conclude that stress affects the MS disease state. (Source).
Ways to Offer Positive Effects on MS Patients’ Mental Health
What are the treatment options for MS patients and the accompanying mental health challenges?
Cognitive behavioral therapy (CBT) and many of the antidepressants used in the general population can help. While individual treatments have not been validated, considerable work suggests that the psychological intervention of CBT may be effective in managing depression for MS patients. (Source).
Social support has long been identified as a buffer for stressful life events. However, little is known about how greater social support modulates depression, anxiety, and fatigue in patients with MS.
A 2019 research studied 112 patients with clinically definite MS to explore social support and its links to specific aspects of mental health. What became evident: social support from a network of family, friends, professionals, and other MS patients can have a significant positive effect on emotional health and likely on MS disability.
Other studies have demonstrated that the amount of social support from friends predicts anxiety symptoms. (Source). Further, social support positively influences morbidity, mortality, and quality of life (QOL) in general and chronic disease populations. Social support reduces morbidity and mortality. In addition, it improves the quality of life in the general population and patients with chronic illness by buffering the impact of stressful life events. (Source).
BeCare MS Link and Mental Health Monitoring
BeCare MS Link was developed to help MS patients take charge of their healthcare by enabling patients to monitor and measure their physical and mental status. The objective data produced by our app can help you report and communicate with your physician. In addition to performing 13 activities that measure your neurologic health, the app asks for your input on your mental health and mood every time you update your status. These results can be essential in guiding your care.
Download BeCare MS Link today:
On the Google Play Store here.
On The App Store here.
For MS patients dealing with everyday challenges, do you have tips you’d like to share that have helped you? Let us know in the comment field.