Multiple sclerosis and mood changes

People with multiple sclerosis (MS) may experience mood changes. These changes can take many forms. Understanding mental health symptoms of MS can help a person recognize these changes.
Both multiple sclerosis (MS) itself and related causes can lead to mood changes. MS can be unpredictable, and symptoms can occur without warning. This uncertainty can affect a person’s mental well-being.
multiple sclerosis
The National Multiple Sclerosis Society note that people with MS tend to focus on their physical symptoms, and they may neglect their mental health. Addressing MS’s impact on mental health is a crucial aspect of treatment.
National Multiple Sclerosis Society
mental health
Possible causes
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Here are some reasons why mood changes may affect a person with MS:
When a person receives a diagnosis of MS, this can affect their mood. The person may be grieving over the change in their life that comes with a diagnosis. They may fear the impact of the disease and worry that they will not be able to continue doing activities they enjoy.
grieving
A low mood does not necessarily mean a person has depression, but if the low mood continues, the individual may benefit from counseling.
depression
MS may increase the risk of depression. The American Academy of Neurology state that one-third to one-half of people with MS experience depression at some point.
depression
American Academy of Neurology
A person with depression may feel helpless and unable to engage with life or enjoy daily activities. It persists for several weeks and can last for months or even years.
However, a counselor or doctor may be able to recommend treatment that can help a person manage depression or stop it from becoming more severe.
Other factors can affect a person’s mood in the short term or long term, such as:
pain
pain
fatigue
changes in mobility and independence
concerns over symptom progression, including concerns about cognitive changes
access to treatment
worry about how they will look after themselves and their loved ones
the impact on their working life
loneliness
These factors can lead to short term or intermittent feelings of sadness or stress, or may contribute to a depressive disorder or an anxiety disorder.
stress
anxiety
Sometimes, mood changes can result directly from the neurological changes that occur with MS.
If MS affects the nerves or parts of the brain that control the emotions, a person may experience feelings such as:
sadness
fear
anxiety
anxiety
agitation
trouble sleeping
aggression
This can then lead to changes in behavior, such as withdrawal from others or irritability. If loved ones do not understand the reason for these changes, they may react in ways that make the situation worse.
Another phenomenon that can occur in people with neurological conditions such as MS is the pseudobulbar affect. This causes uncontrollable episodes of laughing or crying that are not in proportion to what the person is feeling.
pseudobulbar affect
The condition occurs in about 10% of people with MS, according to the National Multiple Sclerosis Society.
10%
Another less common symptom is euphoria or extreme and unrealistic happiness. It can affect people with advanced MS, and it reflects certain changes in the brain that occur as a result of the disease.
Treatments
As with other aspects of the disease, treatment for the emotional impact of MS may need a variety of approaches. A doctor should tailor the approach to the needs of the individual.
Depending on the underlying cause, a doctor may recommend antidepressants or drugs for anxiety or depression.
antidepressants
According to the National Multiple Sclerosis Society, a doctor may prescribe the following drugs:
following drugs
Nuedexta
duloxetine hydrochloride (Cymbalta)
citalopram (Celexa)
venlafaxine (Effexor)
paroxetine (Paxil)
fluoxetine
Prozac
bupropion (Wellbutrin)
sertraline
Zoloft
These drugs may affect each person differently, and side effects are possible.
People should work closely with a doctor to monitor any side effects and change medications if needed.
In cognitive behavioral therapy (CBT), people learn how to redirect harmful thought patterns into healthier ones, which may help change someone’s thinking.
CBT)
The American Academy of Neurology note that there is weak evidence to support using CBT in people with MS who have major depressive disorders. The evidence they cite relates to treatment sessions held by phone, however.
American Academy of Neurology
A doctor may recommend CBT alongside other therapies.
Reaching out to friends and family may help someone who is experiencing mood changes.
Helping loved ones understand what a person is experiencing may provide insight into ways they can help.
MS support groups can also offer help. Sharing experiences with others may reduce worry or make it easier for people to find peace of mind. People in groups may be able to share coping mechanisms they have used successfully.
Mindfulness is a type of therapy that stems from ancient meditative practices.
Mindfulness meditation involves paying attention to the present moment. There are now many mindfulness-based interventions for various medical conditions, including MS.
A 2014 review notes that mindfulness-based interventions may help some people with MS. It may benefit their mental health, quality of life, and some aspects of physical health.
review
Natural remedies may help people feel a sense of calm and general balance, which may translate to mood stability.
These may include the following:
gentle exercises, for example, yoga or Tai Chi
yoga
breathing exercises and taking deep breaths when feeling overwhelmed
joining a support group
following a healthy diet
when possible, following a regular sleep routine
A doctor or other health professional can help the individual work out an activity program that will suit their needs. Cycling and swimming may be beneficial for some.
Here, learn more about natural remedies for MS.
Here, learn more about natural remedies for MS.
Takeaway
As with other symptoms of MS, changes in mood can vary greatly in how they affect individuals.
Home and lifestyle remedies can help, as can learning as much as possible about MS and sharing this information with loved ones and colleagues.
If issues relating to mental health are affecting a person’s daily life and well-being, they may wish to speak with a doctor. Antidepressants and other drugs can often help manage symptoms.
If symptoms appear to stem from changes related to MS, a neurologist may be able to help find a solution.
Read this article in Spanish.
Read this article in Spanish