On Tuesday, Merely Me asked a few questions: Do you feel that your personality has changed due to having Multiple Sclerosis...?  Have friends or family told you that you seem different in temperament since your diagnosis?

My first response was similar to her own sentiments in that I would like to think I am the same as before MS.  So I put the question to someone close to me, my mother, who said, “I believe that you are more outgoing than before.”  I pondered - more outgoing... I suppose, but doesn’t age and experience have anything to do with that?

One of Merely Me’s quoted resources was written by Patricia Daily, L.C.S.W. who is the Director of Counseling and Support Services at The Rocky Mountain MS Center (RMMS).  The article “MS and Personality” first appeared in RMMS Center’s Quarterly Newsletter, INFORM, Volume IX, Number 1, Winter 1994.

Ms. Daily makes three statements early in her discussion:

1. Personality is the sum of the behavioral and attitudinal characteristics that give each one of us our individuality.
2. Our personalities are the result of the complex interaction between our native abilities, our experiences, our values and the mechanisms we have developed to help us make sense of our lives.
3. Personality is the habitual way we organize and present a coherent picture of who we are to ourselves and to others.

So personality is a very complex trait, one which may indeed change over time due to our interactions with the world.  But, that doesn’t explain one example given:

"For example, sometimes people find themselves crying when they aren't sad or laughing uncontrollably at something that is only mildly funny."

This is called Pseudobulbar Affect (PBA) or Pathological Laughing and Crying (PLC) which is prevalent in an estimated 10% of MS patients and is generally associated with the later stages (chronic progressive phase) of the disease. See Schiffer R, Pope L. Review of Pseudobulbar Affect Including a Novel and Potential Therapy. The Journal of Neuropsychiatry and Clinical Neurosciences. 2005 Nov; 17:447-454.  [Note: For a historical view of MS and affect, explore the secondary sources cited in this article.] 

However, it was the discussion in Merely’s Sharepost of the potential misdiagnosis of Bipolar Disorder (or other mood disorder) instead of Multiple Sclerosis which caught my attention.

How many patients are diagnosed with a Mood Disorder or Mental Illness before they are later found to have multiple sclerosis?

In my case, I was diagnosed with depression years before developing optic neuritis and eventually diagnosed with multiple sclerosis.  I find the following article abstract an exciting peak into the connection of cytokines (which help to regulate inflammation and immunity) and depressive symptoms.  See Gold SM and Irwin MR. Depression and immunity: inflammation and depressive symptoms in multiple sclerosis. Neurologic Clinics. 2006 Aug; 24(3):507-19.