Multiple sclerosis can cause mental disorders - most often they are depression or anxiety disorders, but not only. In the event of mental disorders in the course of MS, the implementation of treatment of these conditions is extremely important - in the absence of therapy, mental disorders may even lead to premature termination of the patient's life.

Mental disorders in the course of multiple sclerosisare not uncommon. Multiple sclerosis (sclerosis multiplex, MS) can complicate patients' lives in many different ways. Indeed, the main symptoms of MS are neurological complaints, however, in this group of patients the incidence of mental disorders is also increased - mainly depression and anxiety disorders, but not only.

Mental disorders in the course of multiple sclerosis can appear as a result of many different mechanisms. The first of them is what this disease leads to - we are talking about demyelinating changes that occur in connection with MS, which in themselves may be the cause of mental disorders in patients. It is also taken into account when analyzing the relationship between multiple sclerosis and mental disorders that this entity often leads to significant stress in patients. Its source can actually be many aspects, such as the fact that MS is an incurable disease. Patients may also experience severe stress due to the fact that they are not able to predict when they will experience a relapse that disrupts their normal functioning. Meanwhile, significant stress can both weaken the function of the immune system, but also lead to the emergence of various mental disorders.

MS and mental disorders: depression

Pathological depressed mood is considered to be the most common psychiatric ailment in the population of patients suffering from multiple sclerosis. The risk of full-blown depression in this group of patients is significantly increased. According to some scientists, the risk of developing this affective disorder in people with MS throughout their life exceeds 22% (for comparison, in the general population this risk is estimated at around 16%). Depression in patients with MS is a very serious problem.essential. Overlapping of these two units in one patient may result in the deterioration of not only the basic level of his functioning, but also the results of treatment of multiple sclerosis may be worse. A patient experiencing a significant depression of mood may, after all, neglect taking his medications or miss check-ups with his neurologist.

MS and mental disorders: other disorders

Another mental disorder that is also common in MS patients is anxiety disorders. Generalized anxiety disorder occurs most frequently in patients, however, in the group of patients with MS, the frequency of other problems in this spectrum is also increased, such as panic disorders or obsessive-compulsive disorders. Another problem in the field of psychiatry that may be observed with increasing frequency in MS patients is the abuse of various psychoactive substances. There are various reasons for this, some patients begin to abuse, for example, alcohol due to the fact that they believe that the altered state of consciousness will allow them to forget about the disease for some time. However, all psychoactive substances are quite dangerous for MS patients. It should be taken into account here that the effect of their use may lead to damage to the cells of the nervous system - it is dangerous, for example, because in the course of multiple sclerosis, the nervous structures are degraded. Some patients with MS change their sensitivity to alcohol - they may develop a lower tolerance to this compound - so the negative effects of its use, such as an increased risk of falls, may appear after consuming much smaller (than in he althy people) The amount of alcohol is quite common, and up to 10% of MS patients may have some affect disorders. We are talking about states in which the patient - completely without cause and completely unadjusted to the current situation - experiences an attack of uncontrolled crying or laughing. However, such changes do not occur in all people suffering from MS - if they occur, they are rather in those who have an extremely advanced form of the disease or who have developed a progressive form of MS.

MS and mental disorders: side effects of pharmacotherapy

Psychiatric problems in patients with multiple sclerosis may appear as side effects of their pharmacotherapy. An example is the side effects of glucocorticosteroids, that is, drugs that are used forrelieve the course of MS relapses. GCS can primarily affect the mood of patients - the most common psychiatric side effect of using these preparations is affective disorders in the form of manic disorders (associated with elevated mood) or depressive disorders (based on depressed mood). A less common but possible side effect of glucocorticoid use is episodes of psychotic disorders. Glucocorticoids are not the only drugs used in the treatment of multiple sclerosis that can lead to psychiatric disorders. The same is the case with interferon preparations that are used to prevent the progression of the disease. The side effects of taking these drugs include, among others, just the risk of developing depressive disorders.

MS and mental disorders: treatment

The occurrence of any mental problems in MS patients must not be underestimated. This is due to the fact that some of them - such as depression - may lead to an increased risk of premature death of the patient related to committing suicide. If necessary, patients with multiple sclerosis should be under the care of not only a neurologist, but also a psychiatrist. Theoretically, any doctor can prescribe antidepressants for the patient, but in case of suspicions as to the mental he alth condition, it would be best to refer to a psychiatrist anyway. The specialist will be able to decide whether a depressed patient needs pharmacological treatment or whether psychotherapy alone can be initially used. A psychiatrist - who is in contact with psychotropic drugs on a daily basis - will also know which preparations can be safely used by a patient with multiple sclerosis (it is important that new drugs do not interact with those that the patient is taking so far. ).

MS treatment - new drugs, new therapies

The progress in the treatment of multiple sclerosis, new drugs and therapies available for patients with MS says Dr. n. med. Barbara Zakrzewska-Pniewska, Department of Neurology, Medical University of Warsaw. The statement was recorded during the scientific conference "Physiotherapy for he alth".

Category:

Neurology