Solutions
WE HAVE THUS far talked about adaptation and adjustment as if they were natural processes at which we are all skilled. To some extent, it is true that we all have within us the potential to cope with incredible stress and loss. However, there are a variety of ways to realize that potential to its fullest, and no two people (even in the same family) are likely to do it in exactly the same way.
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| Multiple Sclerosis Symptoms And Diagnosis |
The National Multiple Sclerosis Society offers a wide variety of educational programs and materials for individuals and family members living with MS, as well as a program specifically for the newly diagnosed entitled "Knowledge Is Power". Although not everyone who is newly diagnosed is ready to become an expert on MS, learning about the illness, both at the time of diagnosis and further down the road, can help restore some sense of control over what is essentially an uncontrollable disease. Focusing on the aspects of the illness that you can control - and acknowledging those you cannot - will enhance your chances of success.
Open communication between family members has been recommended so often that it has become a cliche. However, many forms of family strain can be prevented or relieved by the understanding and sensitivity that come from good communication. Even within the most close-knit families, personalities and coping styles may differ significantly. Thus, two members of the same family may respond to the MS with different, even conflicting, coping styles. Perhaps one wants to avoid all talk about MS and pretend for, as long as possible that it never happened. The other person wants to talk and read about it, go to MS meetings, and meet other families living with the disease. Family members need to acknowledge and respect one another's emotional needs and coping styles. There is no one "correct" way to deal with MS, and adjusting to it may require more time for one person than for another.
Support groups offer many people an opportunity to compare experiences and feel less alone. Family counseling can be extremely helpful, especially if you are finding that achieving effective communication on your own is blocked by angry feelings or different styles of dealing with stress and anxiety. There are many ways to "help nature along" and speed the process of putting MS in its place.
Emotional Changes
THE DISTINCTION BETWEEN emotional responses and emotional changes is somewhat arbitrary. In the previous posts, we talked about some of the emotional responses that are most common in MS (i.e., those that almost everyone goes through at one time or another in the ongoing adjustment process). They are referred to as responses because it is assumed that they involve reactions to the altered life circumstances brought on by MS.
Here, some of the less common emotional experiences that can occur in MS are discussed. These include more serious emotional changes, along with a few that have a physiological basis rather than being reactions to the stress of the disease. In reality, there is a great deal of overlap among these various categories of emotional experiences. Moreover, we are often guessing when we attribute a specific cause to any emotion because we do not know for certain what is caused by stress and what is the result of demyelination.
You may go through your entire life without experiencing any of the things described. However, if these changes are part of your life with MS, the discussion that follows should help you understand what is happening and why.
Depression
THE TERM DEPRESSION is used in a variety of ways. In everyday language, the term is used loosely to refer to feeling down in the dumps. You might hear someone say, "Oh, she's depressed because she got a C on her final exam." This is not depression in the technical sense, but rather a situational and transient sadness or "dysphoria." In contrast, clinical depression (or major depressive disorder) is a serious and, at times, life-threatening psychiatric condition that meets specific diagnostic criteria. These criteria include profound sadness, loss of interest in everyday activities, changes in appetite and sleep patterns, feelings of worthlessness and/or guilt, lassitude, and thoughts of death or suicide.
Major depressive disorder is more common in MS than in either the general population or among other disability groups. Research has shown that upward of half of all people with MS will have a full-blown, major depressive episode during the course of their illness. People are at particular risk for these episodes during exacerbations. The person who is in a major depressive episode may be unable to function and may withdraw from daily life and social interactions.
While such episodes are generally self-limited, there is considerable research showing that medication, either alone or in combination with psychotherapy, can help to shorten the episode and prevent or delay future episodes. In this situation, psychotherapy does not mean going to a support group, peer counselor, or other relatively informal form of intervention. Generally, a psychiatrist should be consulted and psychotherapy may be indicated with a mental health professional (e.g. psychiatrist, psychologist, or social worker).
The antidepressants most commonly used in MS today are the selective serotonin reuptake inhibitors (SSRIs) including fluoxetine (Prozac and generic formulation), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram HBr (Lexapro). Other antidepressants used in MS include buproprion HCL (Welbutrin), venlafaxine (Effexor), and trazodone (made by several manufacturers), as well as the older tricyclic medications (amitriptyline, desipramine, and nortriptyline, each of which is made by several manufacturers). To find out more, you can check out Multiple Sclerosis Symptoms And Diagnosis.