What are the challenges of multiple sclerosis?

Multiple sclerosis (MS) affects everyone differently. If you or a loved one has MS, you are undoubtedly already familiar with symptoms like fatigue, numbness, and tingling. These and other bodily symptoms can be severe and debilitating. However, psychological issues and emotional shifts can be just as, if not more, incapacitating.

Depression

Depression is three times more common in MS patients than in the general population and can affect up to 50% of them. Up to 40% of support partners, such as carers and spouses, may experience depression at some point. Distress among caregivers may be exacerbated by household role shifts, financial strain, depression, and cognitive symptoms in the MS patient.

Depression is not only a reaction to MS; recent research has discovered that depression may also be a symptom. Early in relapsing-remitting MS, depression seems to be connected to inflammatory processes. Unhelpful thoughts, such as emotions of shame, worthlessness, or pessimism, become more prevalent later in the secondary-progressive phase. Therefore, it is believed that depression, in this case, was more reactive and was caused by irritation over lifestyle changes or a functional loss.

Addressing MS-related depression

It's important to seek treatment for depression and anxiety since they may aggravate suicidal thoughts. In most situations, it can be adequately controlled with a mix of antidepressants and cognitive behavioural therapy. This form of treatment focuses on understanding and changing ideas, attitudes, and actions that may lead to emotional suffering.

Anxiety

Anxiety is a condition that affects almost half of those with MS and depression. However, anxiety is an independent condition from depression. Anxiety is linked to decreased social contact, a greater risk of alcohol consumption, higher levels of pain, and it may even affect cognitive abilities like how quickly your brain absorbs information.

When it comes to dealing with multiple sclerosis, anxiety frequently stems from not knowing what the future holds. Flare-ups are unpredictable in relapsing-remitting MS. You never know if an exacerbation will occur, how severe the symptoms will be, or if the symptoms will worsen over time. It might be challenging not to worry, particularly if you have a lot of obligations that include taking care of your health, your family or children, and your profession.

How does the mind work

If you've ever dealt with anxiety, you know how challenging daily functioning can become. Some people cope with anxiety by ignoring the source of it. If you're anxious about being dizzy while driving, your first instinct may be to avoid getting behind the wheel. Or staying home could seem like a decent option if you're worried about having a bowel incident in front of people. These avoidance behaviours could cause you to miss a doctor's appointment, spend less time with friends, or refrain from engaging in activities you find enjoyable.

Addressing anxiety

Anxiety treatment comprises behavioural therapy and exposure exercises to help improve confidence and tolerance. The use of acceptance and commitment therapy is another alternative (ACT). Specific causes of anxiety can also be treated with talk therapy and medication.

Pseudobulbar affect

Pseudobulbar affect is a condition caused because of a gap between how you experience and express your emotions. If you have this condition, you may find yourself crying unexpectedly even if you are not sad or disturbed. Or you can begin giggling uncontrollably at something that isn't even that hilarious to you.

This occurs as a result of a breakdown in communication between the front and rear of the brain. This may occur in MS patients due to brain lesions that impair neurotransmitter activity. It could also be caused by general brain atrophy in the later stages of MS. Steroid use increases the likelihood of having a pseudobulbar effect, and lowering or discontinuing steroids may alleviate it.

Differentiating Pseudobulbar Syndrome from other conditions

Pseudobulbar affect can occasionally be mistaken for conditions including bipolar disorder, mood swings, and despair. Inappropriate emotional outbursts can also trigger embarrassment and anxiety.

Unlike depression or anxiety, this disease cannot be addressed with talk therapy or counselling, hence it is crucial to obtain a proper diagnosis. Pseudobulbar affect can be treated with antidepressants or a specifically designed medicine that targets a specific molecule in your neurological system.

Listen to your doctor

If you have MS and suspect that you are suffering from depression, anxiety, or pseudobulbar affect, consult your primary care physician. They can suggest a rehabilitation psychologist who specialises in MS or another helpful expert.

Watch for symptoms of depression and anxiety in your loved one as well as in yourself if you are a support partner for someone with MS. They might not always be visible and frequently appear as increased irritability, aggression, or social withdrawal.