Moody Blues - Most of Us Know Them
How’s your mood these days? Mine comes and goes, but mainly it’s better since I went back on an antidepressant. I weaned off of it over the winter months, thinking there was no way I needed to be taking this additional chemical, but it might be I was wrong. Depression doesn’t run in my family and I certainly don’t view myself as depressed, however I did find that without this pill, my motivation was slipping and my energy levels stayed pretty much at zero.
People with MS – about 80% of us or so – have mood disorders that are associated with this chronic disease. I’ve shared this fact more than once over the years since my own diagnosis, but for some reason I wanted to see if perhaps I could be one of those in the 20% who don’t have this side effect of Multiple Sclerosis. It appears I am not.
Despite all the commercials for the psychotherapy drugs we see playing on our televisions, our society has a difficult time acknowledging and treating mood disorders. It is rarely talked about – you hear lots of people discussing what cholesterol drug or high blood pressure pill they might be taking but how often do you hear conversation about their antidepressants? In my experiences, the answer is rarely, even within the MS community.
The American Academy of Neurology (AAN) recently issued a summary, EMOTIONAL DISORDERS IN PEOPLE WITH MULTIPLE SCLEROSIS, which reviews the basics types of mood disorders we might experience.
What causes this problem for those of us with MS? There are multiple factors in play – the first is genetics. If we have the genetic disposition toward depression, that puts a bullseye on us, making mood disorders a pretty sure shot to hit us. Fortunately, depression hasn’t been diagnosed in my family and doesn’t seem to be a factor for me.
The next factor is situational – shoot yes, we are going to have our moods affected just knowing we live with this constant companion that can’t be divorced. We are stuck with MS in our lives until a cure is found. Even then, there might not be answers on how to repair the damage to our central nervous system that has already been done. Having MS is a drag - it is a drain on health, finances, relationships, and jobs, and it affects most everything we do every day, in one way or another. Being in this situation it is only normal to have our mood affected. Life events, such as having a baby, earning a promotion, getting a divorce or losing a parent or loved one, all affect our moods. Having MS is a major life event that isn’t going away- we won’t see it graduate, celebrate with it at happy hour, or even able to bury it with the appropriate solemn goodbyes. Depressing, isn’t it?
Moods can also be seriously altered by our drug therapies and treatments – have you had a personal experience with high dose steroids for a relapse? That is one serious mood altering drug that creates manic moments, excitability and insomnia. Fortunately that one wears off, eventually. Depression is a known possible side effect of the interferon therapies (Betaseron, Avonex, Rebif) and if your mood changes while on one of these drugs, you definitely need to have the discussion with your doctor. The interferons may do a great job of controlling your MS, but if it decreases your overall quality of life and causes mood changes, you might be better off on another therapy.
Rounding out the prime suspects in the depression causing group are the physical changes of MS – the majority of us have brain lesions and it doesn’t take much imagination to understand how something eating at our brain might also affect our emotions. Emotional disorders can show up in many ways, including apathy, inappropriate emotions such as mistimed laughter or tears, or sudden changes in mood (lability). If the lesions are in the perfect spot, they can turn our mood and emotions on and off without warning.
Cognitive behavioral therapy, contemplative meditation, and even exercise have all been shown to help with depression but for many of us that isn’t enough. I would like to think that my mood has improved, thanks to the sunny skies we have experienced lately, but realistically I have to acknowledge that my upward mood movement is also accompanied by restarting the antidepressants. It’s a small, subtle shift, but nonetheless noticeable. If you find yourself depressed, I hope you know that you are not alone and you recognize there is help available. We just have to let our medical team know – talking about it is the first step.
Wishing you well,
How do you feel before getting an MRI done?