MS and Depression: Tips for Mental Fitness
By R. Morgan Griffin
WebMD Feature
Reviewed by Arefa Cassoobhoy, MD, MPH
When you have MS, your emotions are in play. While having MS raises your chances of having depression, knowing that fact -- and being aware -- can help you try to prevent it and get treatment. Protect yourself with healthy habits.
Get moving. When it comes to MS treatment, exercise is a two-for-one. Being active improves MS symptoms -- like fatigue and bladder problems -- and improves your mood, says Rosalind Kalb, PhD, vice president of clinical care at the National Multiple Sclerosis Society. "It's essential," she says.
Many people with MS say they feel better after walking, swimming, and biking. Before working out, talk to your doctor about what kind of exercise is good for you.
Relax. Kicking back in front of the TV likely isn’t enough. Try to relaxconsciously -- set aside time for it.
"I think it’s especially hard for people, especially women, to be in the moment," says Cindy Richman, senior director at the Multiple Sclerosis Association of America. "Yoga, meditation, mindfulness, and other approaches can help with that." Taking breaks works too, she says. “Read a few lines of a poem. Write in a journal. Go smell the flowers in your garden."
Get backup. You still have all the responsibilities you had before you got MS, but now you may not have the energy to tackle them all. That leads to stress.
Talk to your family and friends. Ask for help -- whether it's grocery shopping, picking up the kids after school, or making dinner. Talk to the people in your life before you're already feeling overwhelmed.
Taking care of yourself -- and preserving your resources -- isn't selfish. Lowering stress is good for your mental health, and that's good for your family.
Tackle issues one at a time. It's easy to get overwhelmed, especially when you’re having a challenging day. Stay in control by focusing on specific issues, and come up with solutions one at a time.
What would make your mornings easier? What household tasks are the most and the least important? Prioritize. "One success builds your confidence, and that leads you to the next," Kalb says.
Get a coach. Therapists -- like psychologists, social workers, and counselors -- aren't just for people who are in the middle of a mental health crisis. They can also be life coaches, Kalb says. "Therapy is a way to help you sort out your priorities, to find solutions to what's challenging you at home or at work."
You might see a therapist for a while, take a break, and then come back if a new issue crops up, Kalb says.
Treating Depression
If you think you might be depressed, don't rely on lifestyle changes alone.
Find the cause. Your doctor can help you find out what triggered your depression. The causes can vary.
It’s possible your depression has nothing to do with MS.
Having a chronic condition like MS can create stress, and that may bring on bouts of depression. But research has found people with severe MS symptoms are not necessarily more likely to be depressed than people with mild symptoms.
Sometimes medication can play a role. The steroids and other medications used to treat MS may trigger or worsen depression.
The MS itself can also affect certain areas of the brain that relate to mood.
Once you understand what led to your depression, you can get the right treatment.
Build a team. To treat depression, you'll do best with a team of people supporting you.
A psychiatrist can determine if medication would help you. Don’t expect an immediate change. Finding the right drug and dose for you can take some time.
Don’t stop therapy. While drugs can relieve symptoms, Kalb says, therapy can help with specific problems that might be contributing to your depression.
Depression is not something you need to hide. Identify friends and family that you feel comfortable talking with about how you’re feeling. Their support can really help. Your MS specialist can also be your ally.
Whatever you do, Kalb says, don't accept that depression will be a constant part of your life.
"They say, 'Well of course you're depressed, you have MS.' That's not true at all. Depression is never normal for anyone, including people with MS."
Get help. Don't settle. "It's not enough for treatment to make you feel a little bit better," Kalb says. "Treat your depression until it's gone."
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