DEPRESSION

Depression is common in MS, but it is not just MS which is associated with increased tendency for depression. MS is a chronic illness, and every chronic illness is associated with increased tendency for depression.

Depression in MS is not a separate illness, and it is not an added illness(burden). It is just a complication or otherwise an association. 

Depression results from prolonged frustration with the illness itself or with certain symptoms such as pain, fatigue, or physical weakness. Depression in MS results from continuous struggle with the requirements of daily living. It is not an added illness, and it must not be seen as a “stigma” in any way.

Depression in MS can result from within the person(frustration), but it can be from the surroundings. People’s judgements, lack of understanding, un-reasonable expectations, or work requirements are all possible ingredients for depression in the affected person with MS. Family relationships can be blamed sometimes(spouse, children, parents, in-laws, relatives, etc).

We (neurologists) should know how to deal with MS depression. We need to understand and appreciate our patients suffering and frustrations. We need to give them good listening, and listen to their views with a lot of attention and respect. We are probably the best to be trusted by our patients, and that trust enables our patients to talk to us openly and frankly. Knowing the ingredients for depression would help us a lot to help our patients ease the pressure and build up confidence in their powers, abilities, and in themselves. We are the first trusted front for our patients… we need to helpful and understanding.

It must be said that depression in MS can be eased or sorted out by good explanation, good advises, and clear instructions for our patients and what to do to help themselves before we resort to medical treatment in this area.

In my view, depression in MS does not need a psychiatrist to sorted it out, but it needs a psychologist. A good psychologist(neuro-psychologist ideally !) will not use medications to help patients with MS and depression. They need to exert their skills, care, and kindness to help those patients. Psychologists do listen a lot, and do see more dimensions of life than us(neurologists), let alone ordinary people. Going to a psychologist is in reality visiting a nice and  cheerful friendly person who is fully committed to help you…. and – take it from me – they do !. 

Please, please, my dear MS patients, never see depression in MS as a stigma or another illness. Never see it as a “madness”, and please see it as a “temporary” incident, and it’ll go away…. may be forever !.

How can you get rid of your depression?

1. Admit it… accept it. Try not to deny it.
2. Take it easily with light hearted feeling from your neurologist.
3. Listen carefully to your neurologist and follow his/her advises.
4. Always say your view, and ask any questions in your mind.
5. Think back for a year or two, and replay past events to pick up any potential triggers, causes, or prolonged frustrations.
6. Always remember that depression hold under its wings anxiety, sensitivity, edginess, irritability, emotional variability(turbulence), insomnia, bad dreams at night, lack of motivations, lack of interest, fatigue, concentration problems, and memory deficits.
7. Always see it as a temporary visitor, who will leave you sooner than you expect.

How to build up self confidence?

1. The first step for you is to realise(recognise) that you don’t have much confidence in your abilities. Try to see the picture very clear with no any attempts to cover up(deny).
2. Try always to see the positive side of your life.
3. Try to see the good things those you own, do, or your friends commenting on.
4. Try to realise your weaknesses, but never see yourself through them.
5. Try to forget about previous failures, pitfalls, bad events in your life, and the old negative memories. 
6. Always remember that life is a moving train, which only moves forward, and that train trip is one way only. It’ll never return back. Your life must be part of the “life train”, and always see yourself a passenger in that train.
7. Try to always see your personality treasures, abilities, strengths, and try to appreciate and feel your good characters as well. 
8. You must always dig deep inside you to search for strengths, and those things you can do better.
9. Set up targets, and make serious plans to achieve them. Never forget to reward yourself “generously” when you achieve any set target or targets.
10. Try to follow successful people’s steps, and try to mimic them when possible, but please be realistic to avoid mishaps.
11. Try to read about successful people such as Sir Richard Branson, Steve Jobs, Mark Zuckerberg, etc. to find out how those people were thinking before they became famous.
12. Always believe in your brand and identity. Never give up, always maintain your pride, and never kneel to others. Be proud of yourself despite of your disabilities and limitations.