Depression in Multiple Sclerosis

What Depression Feels Like and What You Should Do If You Suspect You Have It


Depression and multiple sclerosis have a complicated relationship since one can aggravate the other. Also, depression has many of the same symptoms as MS, making it hard to tell which disorder is to blame.

What Does Depression Feel Like?

Some people don't realize that they are depressed, just that something is off. Here are some clues as to whether or not you are depressed and not just "feeling blue," which happens to everyone at some point in time.  

In order to be diagnosed with clinical depression, also known as major depressive disorder, your doctor will ask whether you have felt sad or lost interest in activities during the past two weeks.

In addition, your doctor will inquire about these symptoms below, of which at least five occur nearly every day. It's important to note that these symptoms are severe enough to upset your daily routine, seriously impair your work or interfere with your relationships.

  • Depressed mood: You are depressed, sad, tearful, or irritable most of the time. This can be noticed by you, but it's also important if others notice it.
  • Loss of Interest: You have a lost interest or pleasure in most of the things you previously liked to do.
  • Appetite Change: Your appetite is much less or much greater than usual. You have lost or gained weight without trying to diet or gain—usually a 5 percent or more weight change.
  • Sleep Problems: You have a lot of trouble sleeping or sleep too much every day.
  • Psychomotor Agitation or Retardation: You are agitated and restless or slowed down that other people notice.
  • Fatigue: You are tired and have no energy.
  • Feelings of Guilt: You feel worthless or excessively guilty about things you have done or not done.
  • Cognitive Problems: You have trouble concentrating, organizing your thoughts, or making decisions on a daily basis.
  • Suicidal Thoughts: You feel you would be better off dead or have thoughts about killing yourself.

How Severe Can Depression Get?

Untreated depression can lead to suicide. Studies show that people with MS are between two and 7.5 times as likely to commit suicide as the general population. If you are having thoughts of harming yourself or committing suicide or are concerned about someone else doing this, please call the National Crisis Hotline at 1-800-273-TALK or text "ANSWER" to 839863.

What Should I Do If I Think I'm Depressed?

If you have MS and feel sad or have no interest in things around you, you need to seek help. Start with your primary care doctor or neurologist or both. In addition, you can call your local MS Society Chapter for recommendations for a psychiatrist near your home or place of work.

The thing with depression is that it's not something that will just go away or get fixed on its own—just as you would seek treatment for a urinary tract infection or a pain in your stomach, depression needs professional guidance and therapy as well. Depression is not a sign of personal or emotional weakness—it's a real disease.

Be sure to tell your doctor that you have MS, as this may play a role in your diagnosis and what medication and/or type of therapy your doctor recommends. Sometimes managing the effects of having MS, like getting a wheelchair or cutting back on hours at work, can cause depression-like symptoms that are actually a normal part of grieving.

In addition, some medications used to treat MS-related symptoms or the disease-modifying therapies can cause or worsen symptoms of depression.

Don't worry about all of this, though. Your doctor can help tease this all out for you. All you need to do during your visit is relax and tell your story—be honest about how you feel and leave the diagnosis and treatment plan to your doctor. The good news is that you can feel better—depression, if you are diagnosed with it, is treatable. 

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Article Sources
  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).
  • Goldman Consensus Group. The Goldman Consensus statement on depression in multiple sclerosis. Mult Scler. 2005 Jun;11(3) 328-37.
  • National Multiple Sclerosis Society. (2016). Depression.