- Researchers say lesions on the brain from multiple sclerosis (MS) may be a factor in people with the condition developing depression.
- Experts say at least 50 percent of people with MS will experience depression symptoms sometime in their life.
- They add that depression can also affect MS symptoms.
There could be a physical connection in the pathways in the brain that causes the high rate of depression in people with multiple sclerosis (MS).
That’s according to a new study published in the journal Nature Mental Health.
Researchers at Brigham and Women’s Hospital in Boston located and studied the area in the brain responsible for depression in relation to lesions on the brain from MS.
They said they found new connections between MS-related depression and brain lesions as well as damage to brain tissue from MS.
Details from the MS and depression study
The researchers looked at medical data from 281 people with MS.
Using a virtual laboratory, the researchers collected and analyzed MRI data in the study participants’ records.
They specifically looked at the connectome database to view the connectivity between MS lesion locations and brain circuitry for depression. A connectome database is a like a large-scale wiring diagram of the human brain.
The researchers said they found significant functional connectivity between MS lesion locations and a depression circuit, which they hope will allow for more targeted treatments. The finding helps to localize MS-related depression in the brain.
MS lesions can appear all over the brain.
Before the study, the scientists assumed the lesions were a factor in MS, unrelated to depression. However, using lesion network mapping and the connectome, they said they could see if both the lesions and depression used the same brain circuit.
In 2021, the same researchers identified common brain circuitry between brain lesions from stroke or head trauma and depression.
What to know about multiple sclerosis
Multiple sclerosis is a neurodegenerative disease that affects the central nervous system, which consists of the brain, spinal cord, and optic nerves, according to the National Multiple Sclerosis Society.
With MS, the immune system attacks the central nervous system, although what triggers this reaction is not yet fully understood. The damage disrupts communication to and from the brain.
Symptoms of MS include:
- Muscle weakness, often in the hands and legs
- Tingling and burning sensations
- Chronic pain
- Coordination and balance problems
- Vision problems
- Difficulty with bladder control
How depression affects MS
Many people with MS also have depression, decreasing their quality of life and increasing the risk of suicide, according to a report issued in 2021.
Depression is more prevalent in people with MS than in the general public.
“At least 50 percent of people with MS will experience depression or a depressive episode during their life,” says Dr. Barbara Giesser, a neurologist and MS specialist at Pacific Neuroscience Institute at Providence Saint John’s Health Center in California.
“Depression in persons with MS is most likely a combination of structural lesions, genetic predisposition, and situational factors, such as reaction to illness,” Giesser told Healthline. “Some medications used to treat MS, notably beta-interferons, have been observed to produce depression as well.”
Depression can worsen the symptoms of MS and can increase the risk of premature death and reduce the quality of life and daily functioning.
It can also worsen symptoms of fatigue and pain and is associated with decreased medication compliance and, therefore, can increase disease severity and disability. Depressive symptoms can sometimes be a warning sign of MS relapses.
Depression, and other mental health conditions, such as anxiety, are underdiagnosed in people with MS, according to Mental Health America.
Paying attention to mental health
It is normal to feel temporary sadness when first diagnosed with a chronic illness. However, if these feelings persist for over a few weeks, it could be depression, according to the National Institute of Mental Health.
“Depression in persons with MS should be treated in a standard fashion, for example, with counseling, therapy, and medication as indicated,” Giesser said. “Additionally, other issues for persons with MS, which can contribute to depression, such as fatigue, pain, medication effects, or sleep disorders, should be screened for and treated.”
The National Institute of Mental Illness lists the signs of depression as follows:
- Persistent sad, anxious, or “empty” mood
- Feeling hopeless or pessimistic
- Feeling irritable, easily frustrated‚ or restless
- Feeling guilty, worthless, or helpless
- Loss of interest or pleasure in hobbies and activities
- Decreased energy, fatigue, or feeling “slowed down”
- Difficulty concentrating, remembering, or making decisions
- Difficulty sleeping, early-morning awakening, or oversleeping
- Changes in appetite or weight
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not ease even with treatment
- Suicide attempts or thoughts of death or suicide
Experts say when you live with a chronic illness and depression, you might lack motivation.
“People with depression tend to burrow in at home,” Jamie Gold, CKD, CAPS, MCCWC, a wellness design consultant, told Healthline. “Making your home environment supportive – of depression and MS – can be empowering.
Some examples include:
- Creating a self-care corner where you gather items you already have and enjoy, such as a speaker for music, a cozy throw, or a favorite rocking chair, where you can spend time focusing on your well-being.
- Declutter a space in your home. This could be in preparation for creating your self-care corner or it could be the top of a table or a shelf in a cabinet. Bask in the sense of accomplishment once you finish
- If you experience mobility issues because of MS, think about what you enjoyed about your home before that you can’t now. For example, maybe you enjoyed cooking or baking and now find it difficult because of the inaccessibility of your kitchen. Work with an occupational therapist to come up with ways you can modify your environment to make it more accessible
- If you are concerned about getting in and out of your home for medical appointments, work to have a path free of obstacles between your front door and the area where you spend the most time. Knowing you can quickly get in and out of your home might provide peace of mind.
- If you are having problems sleeping, look at your bedroom. Is it conducive to sleep? Think about what you need to relax and what will best help you sleep. If you have trouble making changes, ask a friend, relative, or occupational therapist to help make your bedroom an oasis for sleep.
“Making your home more accessible and a place you feel relaxed can improve feelings of depression,” Gold said.