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MS, Depression and mental health professionals

By Matt Cavallo

This time last year I was in the throes of a devastating MS relapse. I developed two new brain lesions and one spinal lesion. A year later, I am still recovering and wondering if I will ever be the same again. While the weakness and numbness on my right side is troubling, my biggest concern is my brain function. I have always been known for my drive and enthusiasm. Ever since my relapse, these two traits are missing in my life. Tasks that used to come easy to me are now really difficult. More recently, I have found that is hard to find the motivation to get out of bed most days.

I was so concerned about this that I brought it up at my last neurologist appointment. My neurologist said something surprising to me. He said that he thought I was suffering from a mild form of depression, most likely related to the brain lesions I suffered with my last relapse.

Depression? I thought. While I do have a family history of depression, there is no way that I am depressed. I am not sad. My marriage is strong and I love being a dad. Business is good. Whether it is writing or motivational speaking, I feel like I am making a difference. That feels good, but I am not experiencing the same level of enjoyment with these activities. There is no way I am depressed, right? Could I be depressed and not know it?

According to WebMD signs of depression include:
  • Difficulty concentrating, remembering details, and making decisions
  • Fatigue and decreased energy
  • Feelings of guilt, worthlessness, and/or helplessness
  • Feelings of hopelessness and/or pessimism
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Overeating or appetite loss
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • Persistent sad, anxious, or "empty" feelings
  • Thoughts of suicide, suicide attempts

Unfortunately for me, I had been experiencing the majority of these symptoms for an extended period of time. I believed that much like the numbness and tingling that won’t go away after my relapse, these symptoms were also a result of the brain lesions that I suffered. And much like the numbness and tingling, I was convinced that my feelings of withdrawal, lack of enjoyment, and loss of interest were my new normal.

My neurologist then recommended that I see a psychologist, preferably one that specializes in treating MS patients. I wanted to learn more about medical professionals who treat depression. Physicians, physician assistants, and nurse practitioners are trained to identify depression in their patients, and in some cases, treat it. However, once a person is identified as suffering from a possible depressive disorder they are often referred to a medical professional who specializes in mental illness.

Medical professionals who treat depression include:
  • Psychiatrist is a medical doctor who specializes in the diagnosis and treatment of mental illness, like depression. Psychiatrists are licensed medical doctors meaning that they can prescribe medications.
  • Psychologist is a person trained in counseling, psychotherapy, and psychological testing. While they are a Ph.D., they are not medical doctors, meaning they cannot prescribe medications.
  • Social Worker is a person who provides mental health services for individuals, families, or groups. Social workers use many “talk” therapies like counseling, crisis management, and support network mobilization. They often are a part of case management to ensure someone with a mental illness is compliant with medications and appointments.
  • Licensed professional counselors have a master’s degree in psychology. Licensed counselors are trained to diagnose and may provide counseling on an individual or group basis.
  • Psychiatric Nurses are nurses who are specially trained to treat patient with mental illness.

With so many different medical professionals who specialize in mental illness, like depression, where do you start? The first thing you want to do is to talk to your physician. In my case, my neurologist recommended that I talk to a psychologist who understands MS. Your doctor may want you to see someone different.

Most importantly, you have to decide to speak up. I had been avoiding the topic with my neurologist until it was affecting my work. I never thought I was depressed and most certainly didn’t think I needed to talk to someone about it. Now that I learned that I may be depressed, it is up to me to take action. I don’t have to feel like this and you don’t have to either. All you have to do is take action.