However, researchers from UCLA point out that depression among MS patients generally is not psychological, but linked to atrophy in a section of the hippocampus in the brain.Having worked with MS patients and their families for more than two decades, Dr Minden says some patients may hesitate to discuss depression and other mood changes with their doctors because they perceive this as signs of mental instability or weakness.

The good news, she says, is that emotional changes are treatable and often part of the illness process. For example, she adds that most people with MS become discouraged and disheartened when they have a relapse, or experience phases of mourning relating to the losses of function, lifestyle and future hopes if there is increasing disability.

Neurologists, doctors and psychiatrists can prescribe treatments for most MS-related emotional conditions – for example, depression is most effectively treated by combining psychotherapy and medication, in particular selective serotonin reuptake inhibitors (SSRIs), while mood stabilisers can be used to alleviate troublesome mood swings.

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