MS & Mental Health

Everyday living
1

Off the cuff question ive just come back from therapist that treats my PTSD and we were talking about the fight or flight part of the brain and how the brain works in processing and i asked if scaring on the brain could play a part as to why the part of the brain thats deals with organising & fight or flight isnt functioning properly , and i stated about the scar that was on the mri , im just wondering if anyone else has any thoughts or ideas or experience of a loss of a function due to scarring as i remember my MS nurse saying that the damage/scar will be bypassed and the brain finds an alternative route when it comes to the electrical pulses.

any thoughts welcomed

respect sheep

2

Hi Sheep,

I think sometimes, symptoms correlate very well with clear areas of damage, i.e. a neuro examining you would be able to predict where he would find lesions on the MRI, or conversely, looking at the MRI, he’d be able to predict what sort of problems you might be having.

However, I don’t think it’s always quite so one-to-one. There can be lesions that don’t seem to have any related symptoms (the majority of them, so I’ve read!), and symptoms that don’t seem to have any directly responsible lesions . The latter might be because the damage is too small to be seen by standard MRI, or because it has been caused by a different process that is still somewhat hypothetical, that doesn’t involve destruction of myelin, so wouldn’t be as visible on scans.

Either way, anxiety and depression are more common in MS than in the population at large. In some cases it may be linked to actual damage, but in others, it may simply be due to the psychological toll of living with a very difficult illness. I don’t think it’s always possible to pin down which category an individual falls into, or whether it’s a bit of both.

I was diagnosed with anxiety and depression well before MS, but looking back, I had already begun to feel physically ill by then, though I was not aware of it because it was so slow and subtle. I’d also begun to have problems with confidence - especially at work - because I was beginning to get the feeling I was not as good at things as I used to be, or that they were harder. As I was ill, that’s probably true, but when it happens so gradually you didn’t realise you were ill, it’s bound to affect confidence. All I was seeing was: “Why am I struggling so much with things that were easy ten years ago? I’m not that old, yet!”

Having said that, being told you definitely are ill, despite being a relief in one way (“There’s a reason I’m not coping so well!”), brings a whole new set of anxieties: What will it do to me? How soon? Will I need a wheelchair? Will I be able to feed and clothe myself?, and so on…

So I think it’s entirely understandable we tend to be a more anxious lot. I don’t know if any comparisons have been done with other serious illnesses, to see if anxiety is a feature of all of them - even ones that don’t attack the brain. I wouldn’t be surprised if ill people generally are more anxious than healthy ones.

If you do one of those online stress tests, having a major health problem is always right up there, along with divorce, bereavement, redundancy, and all the other biggies.

Tina

x

3

studies have shown that people with MS are more likely to have depression than people ith athritic conditions. Although both can suffer disabling loss of functions. So what’s different, possibly that the depression is also neurological as well as reactional. You can find the info on either MS society or trust. I spoke to MS nurse about this, and he was aware of the study too.

I have also been told we make new routes, around the scarring, but with time, they are not so affective as the original. This was from a Neuro. It makes sense really, if there is damage in the brain it could impact on any body system. Scarey stuff, if you over think it.

4

I found what you said really interesting Tina because I would have said that apart from fatigue for a few months before my first attack I didn’t have any symptoms of MS. However I was having problems with confidence at work and some anxiety, and I also took anti depressants for the first time for SAD the previous winter. I wonder if it was the build up to my first attack? I’ve got to go back to work (on a phased return) in two weeks after 6 months off and I’m petrified!

5

Hi PL,

I don’t feel it was the “build up”, as such. I just think that I was already getting ill, but it was so very gradual that the idea I might be ill somehow just didn’t dawn on me. I just felt as if everything was a lot harder, which undermined my confidence, because despite my increasing experience, I felt as if my performance was actually going downhill (which it probably was!)

It does certainly does affect your confidence if you suddenly feel daunted by tasks you used to tackle with ease. Looking back, it seems weird I didn’t guess I was ill, but I didn’t really understand what the problem was. I assumed it purely psychological, and didn’t understand why I couldn’t just “pull myself together” and"stop being so silly".

T.

x

6

Mine started off in much the same way (anxiety and then the fatigue kicked in). I still have problems with anxiety, but I’m pretty sure it’s because the MS has affected my autonomic nervous system, which controls the ‘fight or flight’ reflex…

7

I had my first severe bought of clinical depression over 10 years ago. After some treatment resistant episodes I was diagnosed with major depressive disorder a few years later. Fatigue has been an intermittent but constant symptom that first I put down to a possible viral infection, then I thought it was linked to the depression, then I wondered for a long time if I had ME or CFS. I was so very, very tired. And the came the MS diagnosis 2 years ago and It’s been suggested that the depression episodes were themselves initial symptoms of the MS and almost certainly linked to damage somewhere in my brain. I read somewhere that throughout the whole brain, about 95% of the lesions seen on an MRI do NOT correlate to any specific symptoms. However, when looking at just the cerebellum and brainstem, 95% of the lesions there DO directly link to particular symptoms. Out of the dozen or so lesions on my MRI, only 2 of them were not in the cerebellum/brainstem.

8

My neuro did say that MS can affect the “happy” part of our brain and I never had any issue with depression until MS diagnosis.

9

I’ve never been clinically depressed but I do have days when I’m well peed off. That’s normal though. Since my diagnosis last year, I’ve found I don’t cope with stress very well. This is so not normal for me. I am known for being the calm one. I suffer with chronic headaches, which get worse, with the slightest bit of stress. It really frustrates me. Noreen x

10

Thanks folks for all the replies , yep i wonder if maybe like some above when things started to go wrong (mental wise) that it was the 1st sign as before then i dealt with everything and nothing fazed me the horrible side of the job was comforted by the fact we were bringing something home to their loved 1’s , im guessing i had either a: reached my limit on how much i could absorb or b: it was the start of this illness as previous to it all starting on a horrible night i was both clinical and numb to what was going on , just seemed uncany that she should say something has gone wrong with the way you process things and me knowing there was damage upstairs and the memories are from the time i fell ill and onwards , the 1’s previous to feeling ill have never come back to haunt me yet the 1’s from that night on when i knew something wasnt right with me , or maybe its just coincidence and that i had reached my point of its all got too much , but great to read through some of the replies and i thankyou for them wholeheartedly as it seems the common factor in some cases is that the mental came before the phsyical.

respect sheep x

11

Bless you Sheep. :slight_smile:

I’m sure I’m not the only person to have been hugely relieved by my dx (?), as at least I now know why I feel like I do mentally, and it does help me a little in dealing with it.

I think one of the scaryist things about being told that your symptoms are down to a mental illness (from my perspective, anyway - 5 years dx with depression/anxiery, 4 years with ME/CFS/anxiety), is that you never know when you are going to ‘get better’. If you’re trying to deal with work and family pressures at the same time, it’s inevitably going to exascerbate the symptoms (both mental and physical).

I’m going back to see neuro psych (referred by MS Nurse) to see if I can develop some ‘coping skills’ for my anxierty, as I’m pretty sure it’s not ‘psychological’ (if that makes any sense) and it can be quite random at times (although I suspect my Modafinil isn’t helping). I shall post if I learn anything useful.

Mags xx

12

Hi Mags

I hope they help you my therapist is really good i was paying £50 per 45mins but this 1 is free as part of the nhs but normally only allowed 8 sessions but PTSD allowance is 14 , we are making head way too hope you have the same experience too

respect sheep x