The Takeaway Depression and anxiety are common in people with MS, and both conditions are treatable with medication, psychotherapy, and lifestyle approaches. If you’ve been feeling consistently down, depressed, or hopeless for more than two weeks, or have little interest in doing things, talk to your healthcare provider about getting properly diagnosed and treated. Ongoing support through therapy, support groups, and continued treatment can help prevent a relapse of depression or anxiety, and provide coping strategies for the challenges of living with MS.
Anxiety Symptoms Symptoms of Anxiety People with an anxiety disorder often have intense, excessive, and persistent worry and fear about everyday situations. These feelings affect daily activities, are difficult to control, are out of proportion to the actual danger, and can last for a long period of time. Common anxiety signs and symptoms include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762961048571-1206-45b2-9f74-fb7d691e4079 Feeling nervous, restless, or tense A sense of impending danger, panic, or doom Increased heart rate Breathing rapidly Sweating Trembling Feeling weak or tired Trouble concentrating or thinking about anything else other than what you are presently worried about Difficulty sleeping Gastrointestinal (GI) problems Difficulty controlling worry The urge to avoid things that trigger anxiety Panic attacks
Ongoing Support The Value of Ongoing Support for Depression and Anxiety in MS While treatments for depression and anxiety are effective, anxiety disorders commonly recur, potentially over the course of years.e60dc2a1-f33c-4a05-9b50-8e3e8e59762960a1d02e-ce0f-49e5-89c8-a3d07cc37e21 And research suggests that about half of people with depression will relapse after being treated for the first episode. Ongoing care, after symptoms have improved, may help prevent a relapse.e60dc2a1-f33c-4a05-9b50-8e3e8e597629842764a2-a0f5-4b53-bafb-32cdb7219aff According to the American Psychiatric Association, psychiatrists usually recommend that patients continue to take medication for six or more months after the depressive symptoms have improved. And for some people, longer-term maintenance treatment may help reduce the risk of future depressive episodes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f2d43e1d-8afc-49ea-a870-bfffd5c06fda While 10 to 15 sessions of CBT can often lead to significant improvement, continuing with psychotherapy after the depressive episode has subsided may also be helpful.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299c5389ce-0da2-4c7c-865e-282ef8e63338 Since the stress and uncertainty of living with MS don’t really go away, making sure you have a good support system in place is essential. Connecting with MS support groups and people who are going through something similar can help you cope with the emotional challenges of living with the condition.
Treatment Treatment for Depression and Anxiety Depression requires treatment from a mental health professional, who may prescribe an antidepressant medication or other types of medication to stabilize your mood, and recommend other therapies. Medication For depression, a psychiatrist or healthcare provider may prescribe the following:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295491291f-b6c4-4fcd-b78e-f5c45c84c9bb Selective serotonin reuptake inhibitors , including fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro) Serotonin and norepinephrine reuptake inhibitors , including duloxetine (Cymbalta, Drizalma Sprinkle), venlafaxine (Effexor XR), desvenlafaxine (Pristiq), and levomilnacipran (Fetzima) Atypical antidepressants , including trazodone, mirtazapine (Remeron), vortioxetine (Trintellix), vilazodone (Viibryd), and bupropion (Forfivo XL, Wellbutrin SR) In some cases, other classes of psychiatric medications, such as mood stabilizers, may be prescribed.e60dc2a1-f33c-4a05-9b50-8e3e8e597629539e9659-cd10-45df-ab6d-052fec74e399 For anxiety, the following medications may help:e60dc2a1-f33c-4a05-9b50-8e3e8e597629d13bdb97-5ae6-4020-91f6-91568b72339ae60dc2a1-f33c-4a05-9b50-8e3e8e5976296376fcc9-6e4a-4e84-8b89-a79de187c0ba Antidepressants The anti-anxiety medication buspirone Sedatives and beta-blockers (used for heart conditions) in the short term to control physical symptoms of anxiety Psychotherapy Various forms of talk therapy are used to treat both depression and anxiety, alone or in combination with medication. Cognitive behavioral therapy (CBT) is particularly effective for anxiety.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b74e6656-1011-4038-b024-a6dcb254738f And it’s also been shown to be effective for depression. CBT focuses on identifying and reevaluating unhelpful or distorted ways of thinking, with the aim of challenging and changing those patterns and behaviors.e60dc2a1-f33c-4a05-9b50-8e3e8e59762900eb423a-9aad-4c63-ac19-f6dd2e6b553c However, other forms of psychotherapy are effective at reducing symptoms of depression, so it’s not necessary to limit your options to CBT.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296c14d16b-86f5-446c-8530-0794869d0cf1 Lifestyle Approaches In addition to benefiting your physical health, aerobic exercise has also been found to boost mood in people with MS, notes the NMSS.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ff56df7-efab-444e-b82a-4cf1692023df Getting enough sleep, following a healthy diet, and avoiding alcohol (a depressant) can help ease depression symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629322a6e43-ccdd-4abe-84d4-2a28c1c64acd For anxiety, stress management techniques and meditation can help, as can support groups. Caffeine can worsen anxiety symptoms so be mindful of your consumption.e60dc2a1-f33c-4a05-9b50-8e3e8e597629713cb4c5-2c14-4dcb-ba11-c8a47fc9b54e
Grief vs. Mood Disorder The Normal Grief and Anxiety of a Chronic Illness Being diagnosed with any serious chronic illness qualifies as a life crisis, and feeling grief, or having anxious, worried feelings, are natural human reactions to such a crisis. It’s entirely natural and common to grieve when you first learn that you have MS, or when you experience losses or changes caused by MS, such as the loss of your job or certain abilities. While mourning these losses may seem like depression, grief is typically time limited, as opposed to depression, which generally doesn’t improve without treatment.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a6f6ab51-76e0-4ee7-9f03-50391b73592a Although grief usually gets better on its own without treatment, counseling, self-help groups, and other support systems can be helpful. Support groups may also help you deal with normal anxiety and distress that may be caused by MS.
When people talk about common symptoms of multiple sclerosis (MS), they usually mention issues like vision problems, tingling and numbness, and fatigue. Mental health disorders such as depression and anxiety should also be on the list. Depression is one of the most common MS symptoms, according to the National Multiple Sclerosis Society (NMSS).e60dc2a1-f33c-4a05-9b50-8e3e8e59762952c84ff4-3715-4b58-a353-cc63175996ba Research has found a high prevalence of depression (about 30 percent) and anxiety (about 22 percent) in people with MS, compared with a 16 percent prevalence of either condition in the general population.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f1b4329f-48fa-4f65-afba-30d67d2a3210 Severe depression can be life-threatening, because it may include suicidal feelings and ideation. The rates of both suicide and suicidal intent are higher in people with MS than in the general population, according to studies.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294448d71f-eed4-496d-899e-74cf8e1f86bb
Diagnosis Do You Have Depression or Anxiety? According to the NMSS, your answers to the following two questions can help you figure out if you are experiencing normal grief that commonly occurs with MS, or clinical depression: During the past two weeks, have you often felt down, depressed, or hopeless? During the past two weeks, have you had little interest or pleasure in doing things? If you answered yes to either or both of these questions, you may be depressed. For a more detailed look at possible signs or symptoms of depression, you can get a free, confidential screening through Mental Health America . Your healthcare provider can also diagnose you or refer you to a mental health professional. You can also contact an MS Navigator online or at 800-344-4867 during standard business hours for help finding a mental health professional near you. If you answered no to these questions, but your mood is low, you may be experiencing grief or other emotional changes. To screen for anxiety, a self-administered test called the GAD-7 (GAD stands for generalized anxiety disorder) can help you assess whether you’re experiencing minimal, mild, moderate, or severe anxiety. Again, check in with your doctor, who can help you get a diagnosis and connect you with a behavioral health professional.
Depression Symptoms Symptoms of Depression Clinical depression is persistent and continuous, with symptoms lasting for most of the day for more than two weeks and clearly affecting daily functioning.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b0aeee96-12dc-4f04-86b9-bd3886709304 Depression symptoms include: Sadness or irritability Loss of interest or joy in daily activities Changes in appetite Sleep disturbances Agitation or slowing in behavior Fatigue Feelings of worthlessness or guilt Problems with thinking or concentration Persistent thoughts of death or suicide
Mood Disorder Causes in MS Causes of Depression and Anxiety in Multiple Sclerosis The unpredictability of MS and the life changes it causes can understandably lead to depression. However, depression is just as common in other immune-mediated, neuroinflammatory diseases, suggesting that inflammation may play a role in the condition.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292374fe47-d62b-458e-9e6d-d55479167f44 Researchers don’t yet fully understand why depression is so common in MS, but many factors seem to play a role, according to the NMSS. These include: The reaction to difficult life situations or stresses, such as an MS diagnosis Major transitions, such as exacerbations of symptoms, or when a significant change in function or abilities occurs The disease itself; MS damage can parts of the brain that are involved in emotional expression and control, causing behavioral changes MS-related changes that occur in the immune or neuroendocrine systems, which can be accompanied by mood changes Side effects of medications, such as corticosteroids and possibly interferon medications Anxiety is also common among people with MS.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296d53f4d8-d89e-488f-b429-d7568c4b9289 Anxiety can be caused by the uncertainty and unpredictability of living with MS, loss of function, and changes to life circumstances. Among people who are newly diagnosed, lack of knowledge about MS can also contribute to anxiety.
If you or a loved one is experiencing significant distress or having thoughts about suicide and needs support, call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24/7. For more help and information, see these Mental Health Resources and Helplines.
Anxiety Symptoms Symptoms of Anxiety People with an anxiety disorder often have intense, excessive, and persistent worry and fear about everyday situations. These feelings affect daily activities, are difficult to control, are out of proportion to the actual danger, and can last for a long period of time. Common anxiety signs and symptoms include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762961048571-1206-45b2-9f74-fb7d691e4079 Feeling nervous, restless, or tense A sense of impending danger, panic, or doom Increased heart rate Breathing rapidly Sweating Trembling Feeling weak or tired Trouble concentrating or thinking about anything else other than what you are presently worried about Difficulty sleeping Gastrointestinal (GI) problems Difficulty controlling worry The urge to avoid things that trigger anxiety Panic attacks
Ongoing Support The Value of Ongoing Support for Depression and Anxiety in MS While treatments for depression and anxiety are effective, anxiety disorders commonly recur, potentially over the course of years.e60dc2a1-f33c-4a05-9b50-8e3e8e59762960a1d02e-ce0f-49e5-89c8-a3d07cc37e21 And research suggests that about half of people with depression will relapse after being treated for the first episode. Ongoing care, after symptoms have improved, may help prevent a relapse.e60dc2a1-f33c-4a05-9b50-8e3e8e597629842764a2-a0f5-4b53-bafb-32cdb7219aff According to the American Psychiatric Association, psychiatrists usually recommend that patients continue to take medication for six or more months after the depressive symptoms have improved. And for some people, longer-term maintenance treatment may help reduce the risk of future depressive episodes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f2d43e1d-8afc-49ea-a870-bfffd5c06fda While 10 to 15 sessions of CBT can often lead to significant improvement, continuing with psychotherapy after the depressive episode has subsided may also be helpful.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299c5389ce-0da2-4c7c-865e-282ef8e63338 Since the stress and uncertainty of living with MS don’t really go away, making sure you have a good support system in place is essential. Connecting with MS support groups and people who are going through something similar can help you cope with the emotional challenges of living with the condition.
Treatment Treatment for Depression and Anxiety Depression requires treatment from a mental health professional, who may prescribe an antidepressant medication or other types of medication to stabilize your mood, and recommend other therapies. Medication For depression, a psychiatrist or healthcare provider may prescribe the following:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295491291f-b6c4-4fcd-b78e-f5c45c84c9bb Selective serotonin reuptake inhibitors , including fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro) Serotonin and norepinephrine reuptake inhibitors , including duloxetine (Cymbalta, Drizalma Sprinkle), venlafaxine (Effexor XR), desvenlafaxine (Pristiq), and levomilnacipran (Fetzima) Atypical antidepressants , including trazodone, mirtazapine (Remeron), vortioxetine (Trintellix), vilazodone (Viibryd), and bupropion (Forfivo XL, Wellbutrin SR) In some cases, other classes of psychiatric medications, such as mood stabilizers, may be prescribed.e60dc2a1-f33c-4a05-9b50-8e3e8e597629539e9659-cd10-45df-ab6d-052fec74e399 For anxiety, the following medications may help:e60dc2a1-f33c-4a05-9b50-8e3e8e597629d13bdb97-5ae6-4020-91f6-91568b72339ae60dc2a1-f33c-4a05-9b50-8e3e8e5976296376fcc9-6e4a-4e84-8b89-a79de187c0ba Antidepressants The anti-anxiety medication buspirone Sedatives and beta-blockers (used for heart conditions) in the short term to control physical symptoms of anxiety Psychotherapy Various forms of talk therapy are used to treat both depression and anxiety, alone or in combination with medication. Cognitive behavioral therapy (CBT) is particularly effective for anxiety.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b74e6656-1011-4038-b024-a6dcb254738f And it’s also been shown to be effective for depression. CBT focuses on identifying and reevaluating unhelpful or distorted ways of thinking, with the aim of challenging and changing those patterns and behaviors.e60dc2a1-f33c-4a05-9b50-8e3e8e59762900eb423a-9aad-4c63-ac19-f6dd2e6b553c However, other forms of psychotherapy are effective at reducing symptoms of depression, so it’s not necessary to limit your options to CBT.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296c14d16b-86f5-446c-8530-0794869d0cf1 Lifestyle Approaches In addition to benefiting your physical health, aerobic exercise has also been found to boost mood in people with MS, notes the NMSS.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ff56df7-efab-444e-b82a-4cf1692023df Getting enough sleep, following a healthy diet, and avoiding alcohol (a depressant) can help ease depression symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629322a6e43-ccdd-4abe-84d4-2a28c1c64acd For anxiety, stress management techniques and meditation can help, as can support groups. Caffeine can worsen anxiety symptoms so be mindful of your consumption.e60dc2a1-f33c-4a05-9b50-8e3e8e597629713cb4c5-2c14-4dcb-ba11-c8a47fc9b54e
Grief vs. Mood Disorder The Normal Grief and Anxiety of a Chronic Illness Being diagnosed with any serious chronic illness qualifies as a life crisis, and feeling grief, or having anxious, worried feelings, are natural human reactions to such a crisis. It’s entirely natural and common to grieve when you first learn that you have MS, or when you experience losses or changes caused by MS, such as the loss of your job or certain abilities. While mourning these losses may seem like depression, grief is typically time limited, as opposed to depression, which generally doesn’t improve without treatment.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a6f6ab51-76e0-4ee7-9f03-50391b73592a Although grief usually gets better on its own without treatment, counseling, self-help groups, and other support systems can be helpful. Support groups may also help you deal with normal anxiety and distress that may be caused by MS.
When people talk about common symptoms of multiple sclerosis (MS), they usually mention issues like vision problems, tingling and numbness, and fatigue. Mental health disorders such as depression and anxiety should also be on the list. Depression is one of the most common MS symptoms, according to the National Multiple Sclerosis Society (NMSS).e60dc2a1-f33c-4a05-9b50-8e3e8e59762952c84ff4-3715-4b58-a353-cc63175996ba Research has found a high prevalence of depression (about 30 percent) and anxiety (about 22 percent) in people with MS, compared with a 16 percent prevalence of either condition in the general population.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f1b4329f-48fa-4f65-afba-30d67d2a3210 Severe depression can be life-threatening, because it may include suicidal feelings and ideation. The rates of both suicide and suicidal intent are higher in people with MS than in the general population, according to studies.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294448d71f-eed4-496d-899e-74cf8e1f86bb
Diagnosis Do You Have Depression or Anxiety? According to the NMSS, your answers to the following two questions can help you figure out if you are experiencing normal grief that commonly occurs with MS, or clinical depression: During the past two weeks, have you often felt down, depressed, or hopeless? During the past two weeks, have you had little interest or pleasure in doing things? If you answered yes to either or both of these questions, you may be depressed. For a more detailed look at possible signs or symptoms of depression, you can get a free, confidential screening through Mental Health America . Your healthcare provider can also diagnose you or refer you to a mental health professional. You can also contact an MS Navigator online or at 800-344-4867 during standard business hours for help finding a mental health professional near you. If you answered no to these questions, but your mood is low, you may be experiencing grief or other emotional changes. To screen for anxiety, a self-administered test called the GAD-7 (GAD stands for generalized anxiety disorder) can help you assess whether you’re experiencing minimal, mild, moderate, or severe anxiety. Again, check in with your doctor, who can help you get a diagnosis and connect you with a behavioral health professional.
Depression Symptoms Symptoms of Depression Clinical depression is persistent and continuous, with symptoms lasting for most of the day for more than two weeks and clearly affecting daily functioning.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b0aeee96-12dc-4f04-86b9-bd3886709304 Depression symptoms include: Sadness or irritability Loss of interest or joy in daily activities Changes in appetite Sleep disturbances Agitation or slowing in behavior Fatigue Feelings of worthlessness or guilt Problems with thinking or concentration Persistent thoughts of death or suicide
Mood Disorder Causes in MS Causes of Depression and Anxiety in Multiple Sclerosis The unpredictability of MS and the life changes it causes can understandably lead to depression. However, depression is just as common in other immune-mediated, neuroinflammatory diseases, suggesting that inflammation may play a role in the condition.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292374fe47-d62b-458e-9e6d-d55479167f44 Researchers don’t yet fully understand why depression is so common in MS, but many factors seem to play a role, according to the NMSS. These include: The reaction to difficult life situations or stresses, such as an MS diagnosis Major transitions, such as exacerbations of symptoms, or when a significant change in function or abilities occurs The disease itself; MS damage can parts of the brain that are involved in emotional expression and control, causing behavioral changes MS-related changes that occur in the immune or neuroendocrine systems, which can be accompanied by mood changes Side effects of medications, such as corticosteroids and possibly interferon medications Anxiety is also common among people with MS.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296d53f4d8-d89e-488f-b429-d7568c4b9289 Anxiety can be caused by the uncertainty and unpredictability of living with MS, loss of function, and changes to life circumstances. Among people who are newly diagnosed, lack of knowledge about MS can also contribute to anxiety.
If you or a loved one is experiencing significant distress or having thoughts about suicide and needs support, call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24/7. For more help and information, see these Mental Health Resources and Helplines.
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