When you have multiple sclerosis (MS), symptoms like fatigue, numbness, and weakness may be your main concern. But depression is a common symptom, too.

People with MS are up to two or three times more likely to become depressed than those without the condition. There are a few reasons why up to half of people with MS will experience depression at some point in their lives:

  • Nerve damage can affect the transmission of signals
    related to mood.
  • Living with a chronic illness can cause stress and
    anxiety.
  • Drugs like steroids and interferons that treat MS
    can cause depression as a side effect.

Often, depression is the one MS symptom that’s overlooked and left untreated. Here are a few tips to help you care for your mental health while managing your MS.

Everyone feels down from time to time. A brief shift in your mood doesn’t necessarily mean you’re depressed. But if you’ve continuously been sad for two weeks or longer, it’s time to take a closer look.

Ask yourself these questions:

  • Do you always feel sad, hopeless, helpless,
    worthless, or empty?
  • Are you more irritable than usual? Do you snap at
    the people around you?
  • Have you lost interest in things you once loved to
    do? Does nothing you do seem to excite you?
  • Do you feel extra tired or drained of energy?
  • Do you have trouble sleeping, or sleep too much?
  • Do you have difficulty concentrating or
    remembering?
  • Do you notice strange aches and pains that you
    can’t connect to a physical cause?
  • Have you noticed any changes in your appetite?
    Either eating too much or too little?

If you’ve had any of these symptoms, call your doctor or a mental health professional for help.

If you think you’re depressed, tell your primary care doctor. Just as with other conditions, there are medications and alternative therapies available to help you feel better. Also, inform the specialist who treats your MS. It’s possible that a change in your MS medication could be enough to improve your mood.

It’s also helpful to talk to a mental health expert like a psychologist, psychiatrist, or counselor. They can offer strategies to help you cope better with the stresses of your condition. Ideally, find someone who has experience working with people who have chronic conditions like MS.

Caring for a chronic illness on top of everything else you have going on can feel overwhelming. When you’re stressed, your body revs into fight-or-flight mode — your heart pounds, your muscles tense, and your breathing becomes shallower.

Deep breathing quiets your mind and restores a sense of equilibrium to your body. It’s easy, and you can do it anywhere. Sit with your eyes closed. Breathe in through your nose for a slow count of four. Then release the breath out through your mouth for another count of four.

Try to set aside at least five minutes each day to practice deep breathing. To steer your mind away from the sources of your stress, add meditation into your practice. Focus on a word as you slowly breathe in and out. If thoughts drift into your mind, don’t dwell on them. Simply watch them float away.

Exercise releases a flood of chemicals called endorphins in your brain. Endorphins have a mood-boosting effect. It’s the same rush that runners refer to as the “runner’s high.”

For maximum effect, get your heart pumping most days of the week with aerobic exercises. Adapt your exercise routine to your ability level, whether you go for a daily walk outside or take a low-impact aerobics class at your local gym.

If you’re in pain, consider exercising in the water. It provides buoyancy to support sore areas of your body as you move.

When you’re alone, it’s easy to focus on what’s wrong with your body, and your life. Get out as much as you can and spend time with the people who make you happiest. If your condition prevents you from getting out much, connect with friends and family via phone, Skype, or social media.

Another way to get support is to join an MS group online. It can be comforting to talk to someone who understands how you feel and what you’re going through.

Finding real solutions to managing depression can take some effort. Alcohol or drugs may seem like an easier crutch to lean on, but these habits can cause more problems in the long run. They won’t solve your depression, and they can make you feel much worse.

If drinking or drug use has become a problem for you, seek help from a substance abuse hotline or treatment center.

Express your emotions through words, music, or art. Keep a journal of your feelings. Use it to release any negativity you’ve bottled up inside.

Draw a picture or play a song. It doesn’t matter if you’re not the best visual artist, you can use art as a vehicle to release your emotions.

The unpredictability and stress of living with MS can put a big strain on your emotions. If you think you might be depressed, talk to a doctor or mental health professional.

Take good care of your body by eating right, exercising, and practicing stress management techniques like deep breathing and meditation. If depression becomes persistent, consider speaking with your doctor about antidepressant medication or mental health counseling.

If you’ve had thoughts about hurting yourself, reach out to a mental health professional or the National Suicide Prevention Lifeline (800-273-TALK) right away.