Six years ago today I had an odd dream.  It was of my grandmother coming into my bedroom to talk.  I mumbled something (in the dream) about wanting to sleep a little longer and she laughed, saying that it was fine.

This was a Monday morning after Hurricane Isabel swept through the East Coast and Washington DC area.  I was home alone when the power went out on the previous Friday morning which would ruin the mound of food I had just stocked our new freezer with.  The power did not return until late Sunday evening.

I received a phone call later in the morning on Monday.  My grandmother had passed away that morning.  This turned out to be only the 2nd of too many devastating events which occurred during the most hellacious week I’ve ever experienced before or since.  Hurricane.  Death.  Funeral (in Oklahoma).  Family Violence.  Police.  Hospital.  Panic Attacks (mine).  Xanax.  Delayed, then Cancelled Flights.  Stuck in St.Louis.  Missed Flights leaving DC for Indiana.  Doctoral Oral Exams on following Monday.

After recovering, slightly, from all of the above, I knew I NEEDED HELP!!!  As a result of the hellacious week, I had many reasons to be depressed.  I found a therapist with whom I would develop a great working relationship, which certainly helped years later when I was being diagnosed with MS.

Causes of Depression

1. Disease Response

Experiencing a period of depression and uncertainty following the diagnosis of MS is not uncommon.  It takes time to adjust to a “new reality” and grieve the loss of what was, or the loss of a planned future.  I have observed that the first year post-diagnosis seems to be the most difficult one emotionally.  However, most patients do eventually adjust to altered circumstances, even the ones which come from new disabilities, loss of employment or loss of relationships.

To be honest, I must admit that I’ve experienced the same post-diagnosis depression during each exacerbation.  All of the uncertainties and fears come rushing back with each gain of unstable ground.  If staying in a place of “emotion-centered” thoughts and avoiding constructive problem-solving skills, I become depressed more easily during and following a relapse.  It takes time to come back around to acceptance.

Also, low self-esteem (due to poor body image, loss of abilities, activities, friends, etc ) can lead to feelings of worthlessness and guilt, which can certainly lead to depression.  But do not give up hope; there are strategies which can help.

2. Physiological Changes

Damage to the central nervous system can impact mood directly.  One theory is that lesions which cause damage to the right frontal and temporal lobes of the brain can cause depression.  These are areas of the brain which regulate emotion.