I truly believe that if one has a clinical depression, both therapy and medication are the key. I look at at the medication as a way to stabilize yourself and provide floorboards to enable you to grapple with the real tough stuff of therapy. I've done both for years and have been on 2 antidepressants (one to augment the other) for many years.

I see a psychologist that specializes in people with MS. It was very helpful in the beginning, particularly when I was having extreme anxiety from the shock of the diagnosis. Unlike many here, I never had an inkling of a strange symptom until the first event of optic neuritis. Yikes, I fainted when the doctor told me over the phone with the phrase "I have some bad news...."

Anyhow, the therapist I see believes there is a strong mind-body connection when it comes to MS. She notices it more with MS than other chronic diseases. That is why she said she liked working with MS patients because she can see real emotional and physical change. Based on the patients she has seen over the years she is convinced that when you finally deal with your "stuff" in therapy the physical symptoms and course of MS are just better. It's an interesting perspective. Of course you can't lay blame. And therapy isn't always easy or fun.

I did see my psychiatrist today who I really like (finally found a good one!). Over the years I've found psychiatrists more of a burden to deal with than psychologists or other therapists. Maybe it's the medication only perspective that many of them have.

We have a plan. I will try taking provigil every day for the next 10 days and see if that helps with sleeping all the time and lack of interest in socializing/and working. If I have more energy but still feel mentally depressed we will start a new antidepressant at a low dose, adding to the others but going back to Provigil as needed. If I feel better I will then go off of one of the other 2 AD's.

I like plans. They make me feel optimistic! Oh and the major stress of the teenage stepchild has been completely removed (no longer living with) so maybe the environmental changes will help too.

Watch the side effects of the provigil closesly. It can sometimes cause irritability and agitation. If that happens, call your doc. There are other stimulants out there that you can try if you don't like provigil. Keep us posted on how well it is working!



Tam