Depression in Multiple Sclerosis: What We Know, What We Need To Learn, and What We Can Do Today
This is an article of the National Multiple Sclerosis Society
Summary
People living with MS want to know how to manage mood changes – particularly depression – and develop strategies to achieve emotional wellness. They want to know what they can do to feel and function at their best and they want the support of knowledgeable healthcare professionals to help them achieve their goals. To better address these needs, the National MS Society brought together people with MS, healthcare professionals, researchers and Society staff to discuss key issues related to depression in MS, highlight the work that needs to be done in the areas of screening, diagnosis, treatment and suicide prevention, and develop a prioritized list of research recommendations. In addition, the group made specific recommendations regarding the information, programs and services individuals and families need in order to recognize and manage depression, and outlined next steps to move this important priority forward.
Contents Introduction .................................................................................................................. .2
Key Priorities in the Identification and Treatment of Depression in MS ........................................3
What We Can Do Now...................................................................................................................4
Recommended Next Steps............................................................................................................5
Key Research Priorities to Better Understand and Treat Depression in MS .................................6
Next Steps .....................................................................................................................................7
How People Can Access the Care and Support They Need Today...............................................7
Closing Thoughts........................................... 7
Introduction
The National MS Society is committed to identifying solutions to the challenges of living with MS through research initiatives and focused efforts to improve access to high-quality MS healthcare. In keeping with this strategic priority, the Society has convened meetings to explore the needs around difficult and complex symptoms. The meetings involve multiple stakeholders, including people with MS, care partners, healthcare professionals and researchers.
One of the most challenging symptoms people affected by MS (including those who have the disease and their family members) have identified is depression. They want to know how to recognize, understand and manage the mood changes that are so common with this disease. Addressing mood changes, along with using diet and exercise to help manage their MS, are the areas that people consistently identify as being high priorities in their efforts to achieve personal wellness while living with this disease.
However, individuals who experience severe mood changes, particularly significant or major depression, may be unable to engage actively or effectively in any self-care strategies, including MS management, emotional wellness strategies, physical exercise or healthy eating practices.
Therefore, effective depression management is necessary not only to help people feel better and improve their quality of life, but also to make it possible for them to embrace self-care and lifestyle changes to enhance their overall health and well-being.
In June, 2015, the National MS Society convened a group that included people with MS and support partners, healthcare professionals in the fields of neurology and mental health, researchers and Society staff, to address the following depression-related issues:
• High prevalence of significant depression among people living with MS and their support partners, compared to the general population
• High rate of suicide in MS compared to the general population • Complex, probably inter-related causes of depression in MS (changes in the immune system and in the brain, as well as psychosocial stressors) • Inadequate recognition, diagnosis and treatment of MS-related depression
• Lack of information about which types of treatment for depression work best for which individuals
• Impact of depression on: quality of life; self-care; ability to participate actively in MS treatment decisions and adhere to treatment plans; MS symptoms such as cognition, pain, fatigue
• Impact of MS-related depression on families
• Possible role of depression and other mood changes in central nervous system inflammation and the MS disease process
• Lack of well-designed studies to:
Identify the cause(s) of depression in MS
Help individualize treatment plans
• Insufficient numbers of mental health professional who are knowledgeable about MS to provide diagnosis and treatment
• Potential role of wellness behaviors, including exercise, stress management, mindfulness and other self-care strategies in managing depression in people with MS
Key Priorities in the Identification and Treatment of Depression in MS
