I recently wrote about the importance of mental health awareness for people with multiple sclerosis (MS). Not long after that, a notification about MS and depression landed in my email box.
But it wasn’t specifically the bit about depression and MS that caught my eye. It was the differences between then and now: the contrast between how we used to do or think about or treat MS and what is practiced now (or is emerging) that interested me.
Depression and MS
The article, titled “The Deep and Multidimensional Connection Between Multiple Sclerosis and Depression,” is quite comprehensive, and although it was written for healthcare professionals, I’d recommend giving it a read if you’re interested in such things.
It covers some of the basics, like diagnosing depression by ticking at least five of these nine factors:
- Depressed mood
- Loss of interest or pleasure in almost all activities
- Significant (more than 5 percent in a month) unintentional weight loss or gain or decrease or increase in appetite
- Sleep disturbance (insomnia or hypersomnia)
- Psychomotor changes (agitation or retardation) severe enough to be observable by others
- Tiredness, fatigue, or low energy, or decreased efficiency with which routine tasks are completed
- A sense of worthlessness or excessive, inappropriate, or delusional guilt (not merely self-reproach or guilt about being sick)
- Impaired ability to think, concentrate, or make decisions — indicated by subjective report or observation by others
- Recurrent thoughts of death (not just fear of dying), suicidal ideation, or suicide attempts
It explains how cognitive behavioral therapy (CBT) can be quite beneficial to people with MS, but that adaptations must be considered to “address visual problems, cognitive deficits, and dysgraphia [writing difficulties] in its use of homework assignments.”
It also delves into pharmacological interventions for depression and MS, as well as the issue of suicide.
Suicide, Divorce Risk, and MS
There is well-regarded research showing that people diagnosed with MS between 1953 and 1996 had approximately twice the risk of dying by suicide than people without the disease — and in that time span, the risk didn’t change.
In the almost two decades since the study was published, this is the figure that has been used when speaking of suicide risk among people with multiple sclerosis.
Surely things have changed by now.
It reminded me of studies on divorce and MS, many of which show a higher likelihood for people with MS to eventually divorce than couples in which neither has a serious or chronic disease.
But there are some interesting differences among them: Research from 2009 shows women with MS being six times more likely than men to be divorced after diagnosis, while a study from 2018 shows an increased risk of divorce among men with the disease but not among women.
It would be nice to see more recent research on both of these topics, given the changes that have taken place in MS care and treatment over the past 10 or 15 years.
Overall, Things Are Better Today for People With MS
The point I’m making is that things are different now than they were a decade or two ago. They are almost exclusively better now for people with MS than they have been in the past. Even if you are still on one of the original disease-modifying medications for your MS, even if your disease has progressed faster and further than you’d have hoped, even if things feel pretty bad now … they are, overall, better than they would have been decades ago.
While I'd never diminish how we’re feeling about the way MS has affected us, the knowledge that it was once worse — fewer treatments, less understanding of the disease — sometimes kicks me in my mental backside.
MS symptoms are real, the depression that it can bring is real, far too many difficult aspects of the disease are real. But there are better treatments, better understanding, and more and better resources today for those of us with MS.
We’re working longer, we’re playing longer, and we may even be living longer, according to the Multiple Sclerosis Trust, than just a few decades ago. While it may not be perfect — in fact, it might be pretty bad — I find some comfort in knowing that we’re better off than we likely may have been before.
Wishing you and your family the best of health.
Cheers,
Trevis
