BIPOLAR DISORDER IS a relatively rare condition that is related to depression. It may be characterized by alternating periods of depression and mania, or just mania. Manic episodes are usually characterized by some combination of the following: unrealistic optimism; agitation and/or irritability; hyperactivity; sleeplessness; non-stop or rapid talking; a tendency to start myriad projects that are never completed; and uncontrolled expenditures of money.
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| Multiple Sclerosis Disease Symptoms |
Bipolar disorder is more common in people who have MS than in the general population. It is generally treated using a mood-stabilizing drug such as lithium or divalproex sodium (Depakote), although an antidepressant may also be necessary if there are depressive episodes. Manic episodes can be frightening and disruptive for everyone in the family, particularly when uncontrolled spending is part of the pattern. In this situation, legal safeguards should probably be considered to protect the financial stability of the family.
A Word About Suicide
SUICIDE - CONTEMPLATED, ATTEMPTED, and completed - is thought to be more common in MS than in the general population. A study in Denmark found that completed suicide was twice as common among people with MS than in the general public. In recent years, additional interest in this subject has been generated by the controversy over assisted suicide. Thoughts about suicide are so frequent in MS because of the high rates of clinical depression and because of the ways in which MS can erode quality of life and cast a pall over the future.
It is beyond the scope to enter into the philosophical debate concerning the "right" to commit suicide. We do know that suicidal feelings may pass when mood improves or one's life situation takes a turn for the better. Thus, the goal for all concerned - those with MS, their family members, and their healthcare providers - should be to ensure that the quality of life is the best that it can be given any limitations imposed by the disease. Effective symptom management and emotional support are essential factors affecting quality of life. All those who live or work with MS need to be aware that active intervention and support are of particular importance at those times when suicide seems like the only viable route.
Mood Swings
FAMILY MEMBERS HAVE long complained that one of the most difficult things to deal with are the mood swings of the person with MS. While everyone in the world probably has mood swings from time to time, people with MS seem to be at greater risk for them. Is this the result of some complex alteration in brain structure, or just the frustration that goes along with disability? We do not know. Whatever the cause, the bursts of irritability, anger, sadness, and frustration can make family life very unpleasant. There is no easy solution to this problem. Family counseling and support groups are often helpful. A mood-stabilizing medication such as divalproex sodium (Depakote) or one of the SSRI antidepressants is sometimes recommended. Most important are awareness and understanding on the part of all concerned, of the strong feelings that are being expressed. Quite often, exploration of these feelings will suggest possible ways to resolve some of them, thereby improving quality of life for the family as a whole.
Euphoria
EUPHORIA IS A relatively rare MS phenomenon, in which the person is unrealistically optimistic, happy, and even giggly in the face of seemingly dire circumstances that would make most people profoundly depressed. Euphoria is almost always associated with moderate to severe cognitive dysfunction.
Because euphoric expression seems to come out of nowhere and tends to be inappropriate to the situation, the euphoric individual is often emotionally "out of sync" with others. As a result, the person may feel emotionally isolated from family members, and they from him or her. Social isolation may make matters worse, and the individual who is severely disabled and euphoric would probably benefit from increased social contact. To find out more, you can check out Multiple Sclerosis Disease Symptoms.