Research has found an association between depression, suicide and a diagnosis of multiple sclerosis. This neurodegenerative disease causes many physical, emotional, and cognitive problems that negatively impact how a person functions as well as their quality of life. The risk for suicide is high due to the presence of depressive symptoms, isolation and reduced independence.
Multiple Sclerosis 101
Multiple sclerosis is a chronic disease of the central nervous system that causes a wide range of disabling problems stemming from disruptions between the brain and spinal cord. It is also considered an immune-mediated disease as it attacks myelin that covers nerve fibers, eventually destroying them. Symptoms of MS include numbness or weakness in the legs or trunk of the body, feelings of electric shock that occur with movement, tremor, loss of vision and other vision-related problems, slurred speech, fatigue, sexual problems and bowel and bladder difficulties.
Depression & MS
Depression is one of the most common symptoms associated with multiple sclerosis and is a risk factor for suicidal thinking and behaviors. Physicians and other healthcare providers should be prepared to discuss depression and suicide in people they are treating. It is a difficult topic to approach, but one that is vital to the well-being and safety of the person with MS. It appears that depression is more common in women with MS than in men. Depression can be associated with changes in the brain and psychosocial factors including poor coping and loss of hope.
Warning Signs for Depression and Suicide
The majority of people diagnosed with MS and have successfully committed suicide did so shortly after seeing their doctor or another healthcare provider. Watching for warning signs and knowing how to respond to them are crucial. Some people will verbalize their feelings of sadness and hopelessness and make statements such as “I don’t want to burden my family anymore” or “I can’t do what I love to do anymore, so why live?” Others may not be as vocal, so red flags to look for include:
- Sudden changes in health or behavior (increased drinking, becoming socially withdrawn)
- Positive depression screening
- Intense signs of ongoing bereavement
- Substance abuse
- Inadequate support system
- Worry about being a burden
- Concerned family members and friends
How to Respond
Keeping a careful eye on individuals diagnosed with multiple sclerosis who are depressed and potentially suicidal is only the beginning. The medical provider must also know how to sensitively and effectively respond to signs, symptoms and red flags for depression and suicide. It is important to assess the individual’s safety and environment. Schedule more frequent appointments and include their family if possible. Limit prescriptions to 30-day supplies to avoid overdose. Consult with psychological professionals to address depression, anxiety, sleep difficulties and substance abuse. Ask the right questions like “Do you think about harming yourself?” and “Do you have any guns at home?”
Take Away
Multiple sclerosis is a very serious, debilitating, chronic and degenerative disease that is associated with negative effects to one’s physical and emotional well-being. Depression most often accompanies MS and is a major risk factor for both suicidal thoughts as well as attempts to end one’s life. Knowing the warning signs and red flags can be helpful in identifying risk for suicide and self-harm. Responding to one’s cry for help may save a life.