I'm thinking that depression is just a part of MS as you keep losing something you once could do. I know that depression is part of the grieving process at least as far as CMT. We are constantly in one stage of grief or the other. Something we could do is always being taken away. We know what causes CMT and that doesn't make any difference. There is no cure/treatment for it at the present time. I just try and deal with it and roll with the punches.

((((Natalie)))), so sorry. I did not suffer from depression in my youth. When my MS took hold, I started out with severe anxiety, complete with anxiety attacks...then the clinical depression set in. I was in very bad shape and just wanted to die.

I screamed for help and my Neuro/Psych heard me. He told me that Depression in MS is caused by the demylination of nerves and the anxiety disorder usually goes with. As the others wisely said, if you've got it it doesn't matter what caused it.

I am on Prozac now for the last 9+ years, but my saving meds were Buspar and then Paxil for the 8 years before that.. Prozac didn't help me early on but is great now (After Paxil stopped working), for keeping me steady.

The only difference that what causes your depression matters, is your meds. If MS has caused a chemical imbalance, then one of the Anxiety/depression meds(SSRIs), such as I mentioned (and many more), will usually work. If your depression is caused by your situation, then Psychotherapy, along with a milder dose AD may help you more?

Imo, a psychiatrist is key for someone like you who has had difficulty finding a SSRI that is effective sans side effects. Neurologists and PCPs rarely have the experience to do much more than the bare minimum when it comes to psych meds in most cases again, imo.

That said I have found many medications are changed prior to reaching the maximum dose and if there is even a partial response I would prefer to finish with one before moving to another. You could also consider augmenting with a second medication if one just isn't enough.

Good luck.

I firmly believe it's caused by both MS and the situational dealings with our daily stressors and sometimes our inability to handle those stressors due to nerve damage.

I think Debbie is right on this one. Although I have not yet been diagnosed, I can say that this latest episode of symptoms were accompanied by sudden and radical change in my mood, that my typical low dose SSRI wasn't able to stabilize. I had to have an increase in dose to stabilize my mood. I was still feeling low, but certainly not to the level of despondency I was feeling before.

Pain, stiffness, loss of function, sleep changes and appetite changes can radically effect mood, as well as nerves that are not able to appropriately transmit signals, and/or interpret them properly in the brain.

I do think that people with neuro disorders should see a neuro/psych, and or psychiatrist, whether they think they need one or not as part of their treatment plan. Many people with progressive illness minimize their symptoms of depression, thinking: "Of course I'm depressed! I have this horrible debilitating disease. How am I supposed to feel?" Just because you have a reason to be depressed doesn't mean you don't need treatment, especially when the cause of your depression is not going to go away, and is probably going to become worse over time.

Medication can be helpful in stabilizing mood, restoring a feeling of emotional well-being, AND decrease pain. A therapist is also helpful in addressing the real life stressors we deal with on a daily basis, and help us to gain some perspective on how well we are coping with our illness.

There are so many things we can do to help ourselves outside of meds and therapy. Laughter and music help to release endorphins that regulate and stabilize our mood. Broadening your support network to include more people you trust helps you to see worsening symptoms of depression, and provide an outlet to vent when we are not feeling well. Participating in activities with our social circle helps us to feel less isolated, and also helps to improve mood. Eating a balanced diet helps our bodies work properly, and if nothing else, promotes a sense of general health. Sleep....so important. The body heals when it sleeps. Even with debilitating disease, sleep allows our brain to release stress through dreams, and allows our neurons to recharge for the next round.

So....try watching a funny movie, go do something with your friends, sing, keep in touch with people you trust, eat some vegetables, and get some sleep! It may not help, but I don't think it will hurt either!

Tam

The chronic, unrelenting, and miserable pain is enough to cause depression, isn't it?

It sure is! Not every one with neuro symptoms also has depression that is caused by their disease. Sometimes the depression is situational, but it is none the less, depression.

In cases where depression is caused by the disease process, medication is used to balance the neurotransmitters that are affected by the disease. In cases where depression is situational (caused by symptoms and disability) medication is used to uplift mood, to give the person the opportunity to address symptom management and apply new coping mechanisms.

Regardless of the cause of depression in people with chronic disease, medication and therapy help. Finding a medication that works well for you may be a challenge, but good communication with your doc will help them to prescribe the correct meds. Keep an eye on your symptoms, and tell your doc if the medication is only helping some symptoms and not others. In psychiatry, medication is prescribed based on the symptoms that are reported by the patient and what the doc observes. So in other words, if you go to your doc and say "I feel just great!" But you haven't bathed in a week, chances are the doc is going to have a more in depth conversation with you about how you feel. That said, if you go there and say "I feel terrible! My life is awful, and I can't take it anymore!" then report that you need to make the appointment short because you are going to get your nails done, and then out to dinner with the girls, the doc will probably determine that you are not depressed to the point where you need medication.

A lot of people feel uncomfortable about seeking help for mental health issues when they are already exhausted by their illness, or feel that they are a burden, or feel they just need to ignore it. Depression is a real, physical illness, and should be treated.

Most of the people in this forum are here to find ways to improve their quality of life, or help someone improve theirs. Dealing with depression as a real illness that requires treatment is a fantastic way to improve your quality of life.