Depression, Inflammation, and Multiple Sclerosis
The Blues are Nothing More than a Lack of Red in Your Life -
Paint Your Walls Pink and You'll Never be Sad Again
Wouldn’t it be nice if that’s all it took to “be happy” once again - a fresh coat of paint?
In graduate school, I became uncharacteristically weepy, sleepy, and fatigued. It got to the point that I finally dragged my tired, teary tush into the Student Health Center on campus where the doctor on call diagnosed depression. He prescribed a short round of a popular antidepressant. The years that followed, my moods fluctuated with wider and deeper swings and revealed a major depressive disorder. Eventually, I began taking antidepressants full time and it seemed to help.
Fast forward to last spring during a thrilling week of IV Solumedrol for spastic and weak relapse. The infusion center was quiet so the nurse and I had some great discussions. One day she was asking me about when and how my MS symptoms began. I mentioned the optic neuritis and random times that I stepped out of bed and ended up on the floor and just shook it off.
She asked if there were anything else that started around the same time looking back at it now. I mentioned the onset of depression and she looked at me with that ‘all-knowing’ look. “In some patients, depression is the earliest symptom of MS,” she said.
Recent studies have found that inflammation is associated with some major depressive disorder patients. Blood tests of non-suicidal patients showed increased levels of interleukin-6 (IL-6), a protein associated with acute inflammation and fever. The levels of IL-6 correlated directly with depression severity.
At Johns Hopkins, researchers have determined that IL-6 is linked to demyelinating disorders such as multiple sclerosis. "IL-6 is a chemical messenger that cells of the immune system use to communicate with one another. One of the cell types injured by high levels of IL-6 includes oligodendrocytes, which help produce the protective myelin sheath coating around nerve cells."
With this information it becomes plausible that IL-6 as seen in one type of depressive disorder may also be associated with demyelination as seen in multiple sclerosis. Common emotional changes known to be caused by damage to the central nervous system include depression, mood swings, and pseudobulbar affect (uncontrollable and inappropriate laughing or crying).
Simply recognizing that emotional changes can be part of the disease process, as well as a reaction to it, makes it easier to understand, tolerate, and manage them. A mental health professional with expertise in MS can assist patients and their family members by teaching strategies to manage the effects, and if the changes are too extreme, medications are available.
So pass me some pink paint and let’s lift the mood in here - happiness all around!!