Mental health problems do not affect
three or four out of every five persons
but one out of one.
~ William C. Menninger (1899-1966)
May is Mental Health Month and Depression is the mental health problem I am talking about today. It is not unusual for someone who has Multiple Sclerosis to be depressed.
Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods. True clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended period of time.
Multiple sclerosis is a neurological condition that often progresses into disability. New symptoms and long-lasting symptoms all leave the MSer feeling helpless, hopeless and depressed. All of this is equivalent to the loss of a loved one or a life that cannot be recovered. It often involves the five-step grief process of denial, anger, bargaining, depression and acceptance. Many of us with MS go through that five-step process with every new symptom and, therefore, depression is sometimes a part of our lives. Sadly, some of us are stuck in the depression stage. MSers are said to be three times more likely to develop depression than the general population.
Characteristic of a chronic condition, MS symptoms are often serious and unpredictable. There is no way an MSer can predict when to expect a symptom, which symptom it might be, how serious it might be, how long it might last and whether it might come back. All of this sounds like a recipe for depression to me.
MS-Related Reasons for Depression
One link between multiple sclerosis and depression may be physiological. First, insulating myelin may be destroyed by the disease. This prevents nerves from transmitting signals affecting mood. In addition, a plaque may develop in the Limbic Cortex, the area of the brain that controls emotions. Then the disease may create chronic depression as a symptom which may come and go as unpredictably as any other MS symptom. This organic cause may strike at any time regardless of stress or any other symptom.
2. Isolation and Loneliness
A typical cause of depression is dealing with the uncertainty and stress of any MS symptom as it comes and goes at any time. Recurring symptoms such as fatigue, weakness, and pain may interfere with the ability to complete daily tasks and therefore to keep a job. Suddenly the environment changes, often not by choice. In addition, loss of a job interferes with personal lives because the coworkers are no longer available daily, and other friends are busy during working hours, too. This may cause isolation and even loneliness. To organize or attend social activities is difficult. Energy and effort are needed to socialize, especially when fatigue sets in. It is often difficult to make a commitment knowing a symptom may suddenly appear and interfere with a schedule.