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Psychological issues in people with multiple sclerosis

Published Jun 18, 2022 • By Berthe Nkok

Multiple sclerosis is a disease with an unpredictable course that can lead to a wide variety of disorders. It is therefore not surprising that it often causes psychological issues and can have a major impact on patients' quality of life.

So what are the psychological issues that patients with multiple sclerosis may experience?

We explain it all in our article!

Psychological issues in people with multiple sclerosis

Psychological problems, particularly depression and anxiety, are common in people with multiple sclerosis. These disorders are under-diagnosed, under-treated and associated with worsening disability, quality of life and compliance with treatment.

What psychological issues can patients with MS develop?

Three major mental problems are common in people with multiple sclerosis: depression, anxiety and emotional disorders. During the course of the disease, these disorders occur at a much higher frequency than in the general population.

Depression

Depression affects about 30% of people with MS at some point in their lives. In general, it is not depression but depressive episodes of moderate intensity.

They can be represented by different symptoms, namely grief, feelings of shame, guilt or self-judgement, sadness and/or anger.

The onset of depression in a person with multiple sclerosis can have two main origins:

  • A psychosocial origin: in this case, depression is reactive, which means that it occurs in response to an event or a situation. It can also be related to a loss of contact with family or friends who are an important source of support.
  • A neurological origin: brain damage caused by the disease can trigger a depressive episode.

Anxiety

Anxiety develops in about 22% of people with multiple sclerosis, but its frequency varies considerably. It is more common in women than in men. Anxiety is caused or exacerbated by a variety of triggers: for example, the diagnosis, the unpredictability of the disease, the fear of disability or loss of independence.

The symptoms of anxiety vary from person to person. On a physical level, it can include heart palpitations, heaviness in the chest, difficulty breathing or swallowing, and sometimes even a feeling of being on the verge of fainting. Emotionally, anxiety can cause the patient to become nervous more frequently or more rapidly, and lose patience.

Hyperemotionality

Hyperemotionality affects about 30% of people with multiple sclerosis. This disorder is represented by loss of emotional control and has two main characteristics:

  • Emotional instability, i.e. rapid transition from one emotion to another;
  • Emotional incontinence, which corresponds to an excessive and uncontrollable expression of emotions.

As a result, the patient can be happy and then, for a trivial reason, lash out at those around him or her with words that are much more violent than what the patient really feels.

Bipolar disorder

Bipolar disorder is characterized by manic or depressive episodes and affects 13% of MS patients. There are 2 main types of bipolar disorders:

  • Type I bipolar disorder, defined by the presence of at least 1 manic episode;
  • Type II bipolar disorder, defined by the presence of at least one hypomanic episode and at least one major depressive episode.

Bipolar disorder is under-diagnosed in the general population and is difficult to distinguish from depression when manic or hypomanic episodes are not identified. Substance abuse is often associated with bipolar disorders and further complicates the management of these patients.

Psychotic disorders

They are identified by the presence of hallucinations or delusions, language disorders and disorganized speech. Such mental disorders include schizophrenia, schizoaffective disorders, brief psychotic disorders, shared psychotic disorders, psychotic disorders due to the patient's general medical condition and substance-induced psychotic disorders.

Personality and behavioral disorders

Personality disorders include paranoid, schizotypal, antisocial, borderline, histrionic (hyperemotionality and attention seeking), narcissistic, avoidant, dependent and obsessive-compulsive personality disorders. The diagnosis of a personality disorder requires an understanding of the individual's long-term functioning patterns.

It is important for patients with multiple sclerosis to have both medical and psychological support, as various mental disorders caused by the disease can be very difficult to handle for patients themselves and for those around them.


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avatar Berthe Nkok

Author: Berthe Nkok, Health Writer

Berthe is a content creator at Carenity, specializing in writing health articles.  

Berthe is in the process of obtaining her Master's degree in International Trade and B-to-B Marketing and aspires to develop... >> Learn more

1 comment


dotzzz
on 6/24/22

My husband passed in March 2022. He never showed anxiety, depression and never said why me. I dedicated 25 years of my life being his caregiver. We enjoyed as normal a life as possible. We vacationed, went to concerts, sports events and remained socially active. I was lucky he was not depressed or abusive. We would talk about what bothered each other openly. Married just 6 mos short of 50 years of which 36 yrs were part of our MS journey together. After his passing, I feel so alone. Being together everyday, I am now without friends and a very small family who live far away. It is I, the caregiver me, who is dealing with depression and loneliness. I miss him but in reality was never prepared for a life without dedicating it to caregiving. I ask was I not fair to myself?

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