Increased Risk of Suicide
Suicide is one of the leading causes of death among MS patients. The primary predictors of suicidal intent in those with MS include:
- Severity of depression
- Abuse of alcohol
- Living alone
In addition, a family history of mental illness, higher perceived levels of social stress, and anxiety also contribute to suicidal intent. Although fewer men are diagnosed with depression, they are four times more likely to commit suicide than women.
In a study of individuals with MS who had suicidal intent, one-third had not received any psychological help and two-thirds (all suicidal and with major depression) had not received any anti-depression medication. This research clearly points to the importance of seeking treatment for depression. When treatment is sought, the risk of suicide drops considerably.
Family Relationships are Often Affected
Similar to the way in which MS affects the family, depression also has a strong impact on relationships. Family members will often say that they can handle the patient’s physical MS symptoms, but they cannot deal with his or her depression. Others may feel helpless as they watch a loved one succumb to the grips of depression. Sometimes family members believe that they are somehow the cause of their loved one’s unhappiness, but this is rarely the case, and this misperception puts an added strain on the relationship.
Since depression typically causes its victims to withdraw from others, family and friends can feel shunned or neglected. Similar to MS, the symptoms of depression are usually invisible, which can lead to misunderstandings. Unfortunately, when others cannot visibly see the cause of someone’s pain, they may not be as sympathetic – as they may be unaware of how much the other person is suffering.
Many people still believe that depression can be overcome by willpower or religious belief alone. They may have a “pull yourself up by your bootstraps” mentality, stemming from ignorance about the condition. These same people would never tell a cancer patient to just “try harder” or “snap out of it.” Education is the best way to combat these misconceptions.
Children are not immune to a family member’s depression. In fact, a recent Swiss study of children who have a parent with MS and depression found that these children are at a high risk of mental health problems themselves. These children were found to be two-to-three times as likely to experience anxiety or depression. Parents need to be aware of the impact that their own psychological state is having on their children, and to watch for symptoms in them as well.
The symptoms of depression in children are more difficult to recognize. They may exhibit problems at school and with friends. They may be irritable and aggressive, or conversely, they may withdraw and isolate themselves from others. Children experiencing depression may not want to eat; they may also have trouble sleeping and have bad dreams, which may contribute to memory or learning problems that can also develop. When depression is present in one or more family members, seeing a family counselor as a group can help to bring about an emotionally healthy outlook.
Treatment Compliance and Health May be Affected
Depression can compromise one’s willpower to follow his or her MS treatment plan. Even simple activities, such as getting out of bed in the morning, may become difficult. Bigger tasks, such as getting to a doctor’s appointment, may feel impossible.
Following a treatment plan for MS includes taking medication on a regular basis. Taking the correct dosage at the scheduled times, especially with respect to injections, requires determination, discipline, and motivation. All of these traits are compromised when a patient is depressed. Other wellness strategies, such as following an exercise program, eating well, participating in support groups, and staying involved with positive people, may also fall by the wayside during depressive episodes.
Additionally, studies show that depression has been linked to many physical ailments. These can include (but are not limited to) such symptoms as: a lowered immune response, which could make someone more susceptible to colds and flu; an increased sensation of pain; mental and physical fatigue; weight gain or loss (according to changes in appetite and behavior); and an increased sensitivity to noise.
Loss of Libido
One of the chief complaints among individuals experiencing depression is a lack of interest in physical relationships. When someone is feeling tired, withdrawn, or unlovable, he or she is much less likely to be interested in physical intimacy. Naturally, this has a negative impact on relationships. Loved ones will often feel rejected and unwanted when their partner withdraws from them sexually.
Since 25 to 50 percent of men and 50 percent of women with MS report having some type of sexual dysfunction, depression only makes matters worse. However, these sexual issues can often be resolved when the underlying depression is treated.
Some worry that antidepressants may decrease their sexual desire, however, medications have been improved over the years and this has become less of an issue. Anyone taking a medication and experiencing reduced libido should discuss the situation with a medical professional. He or she may be able to adjust the prescription to minimize or eliminate this potential side effect.
Less Participation in Social Activities
Depression often causes people to turn inward, withdrawing from family and friends, and declining to take part in social activities. The thought of picking up the phone to call a friend or to hold a conversation can seem overwhelming for someone who is depressed. As a result, individuals with depression will often discontinue social activities and commit ments. Friends may eventually become discouraged and stop calling to urge the depressed patient to join them.
Severely depressed people may feel that they have very little to give others, as they are often using all of their energy just to make it through the next few minutes. The net result is that support systems tend to crumble when they are needed the most. This is unfortunate, because connecting with others can often be of much benefit to the depressed patient.
Maintaining social contact is a necessity for both mental and physical health. According to the Centers for Disease Control and Prevention (CDC), a strong correlation exists between loving and supportive relationships, and the ability to cope with illness.
Losses in Employment
Although many mildly to moderately depressed patients are able to continue working, individuals who are severely depressed may have great difficulty going to the workplace, let alone being productive while there. In fact, The Journal of the American Medical Association estimates the annual cost of depression in the United States is $43 billion. Of that, $23 billion is lost through absenteeism or loss of productivity in the workplace. For the depressed individual with MS, the loss of employment and insurance benefits can have a devastating long-term impact.