Beware of depression when having an MS relapse, says study

[ActiveMSers]

Multiple sclerosis relapses and depression

Moore P, Hirst C, Harding KE, Clarkson H, Pickersgill TP, Robertson NP; Journal of Psychosomatic Research 73 (4), 272-6 (Oct 2012)

OBJECTIVE The expression of clinically significant depression symptoms during and post multiple sclerosis (MS) relapse was investigated. The point prevalence of possible depression during a confirmed MS relapse and at 2 and 6 months post-relapse was examined and the influence of disability on the time course of depression symptoms post-relapse determined.

METHODS 132 sequential patients were recruited from an open access relapse clinic. Clinical data including disability (Expanded Disability Status Scale: EDSS) and depression symptoms (Hospital Anxiety and Depression Scale depression subscale: HADS-D) were recorded at 0, 2 and 6 months post-relapse.

RESULTS Prevalence of possible depression (HADS-D score of≥8) was 44.5% during relapse, reducing to 29.2% at 2 months and 34.4% at 6 months post-relapse. HADS-D scores were significantly lower at follow-up than during relapse. Possible depression at relapse was significantly related to a higher likelihood of possible depression at 2 month follow-up (OR 12.12) and improvement in EDSS was related to a lower likelihood (OR 0.51). EDSS at relapse (OR 1.47) and possible depression at relapse (OR 11.87) were significantly associated with possible depression 6 months post-relapse.

CONCLUSIONS High rates of possible depression were observed during relapse. Although depression scores reduced significantly post-relapse, rates of possible depression at follow-ups remained high. The results suggest that although improvements in disability may influence depression symptoms over the short-term, once depression symptoms are elevated at relapse then depression symptoms become persistent. Further studies are required on the relationship between relapses and depression and whether targeted psychological interventions are beneficial.

[Niko]

Ok this article is pretty old, but I'll comment anyway. Just speculating here, but I think maybe one of the best things to do in situations such as these is to be surrounded by a helpful social network. I feel a huge difference emotionally while in a relapse when I am with others who understand my situation and help me out (by doing things for me, or just by providing company) versus when I am alone. It is a terrifying experience alone. I don't care whether it's close family or a support group, but to at least have someone around is great.

As for the physiological aspect to it (ummm... as in how the brain itself reacts to a relapse...or something like that?), I don't quite know anything about that. I think for some people, parts of the brain which drives mood are more affected than other parts of the brain for other people. This probably also makes a difference, but maybe there is a way to strengthen the brain. Like reprogramming it, just as we try to do for learning different ways to memorize things, or retraining the body to move in different ways than it would normally think to do.

Just speculating...

[LivWell]

On days when I am not functioning all that well, it definitely helps me to be in an environment that is accepting. It also helps when I can interact with people who, even if they do not know how I feel, at least understand that I am struggling with symptoms.

Self compassion is another tactic I have been trying. It helps me quiet down those inner demands to perform when what I really need is rest.

[Niko]

LivWell, I love your note on "self-compassion"

I have been practicing that more and more, through meditation and yoga, but also more recently by massaging myself with warm almond oil every night (as in Ayurveda). Not only do I feel much more in tune with myself, but the days when I have had tremors and slight burning sensations in my limbs, and then massaged myself, the feelings went away. I can't explain that scientifically, I can only say what I experience for myself...