Sunday, June 22, 2008

You Rock!...

Hats off to three of my colleagues who, as I type, are walking in the 20 mile "Out Of The Darkness" Suicide Awareness/Prevention Walk here in Seattle! These three dedicated mental health professionals each raised over $1,000 dollars and began their trek around 7:30PM this evening...they will be walking with a few hundred others until 5:00AM this morning...from dusk until dawn...out of the darkness.

I just left Husky Stadium around 1:00AM and can happily report all three remain in good health and spirits...continuing the remaining 9 miles of their distance, with a hopeful hot bath and pampering at the end of their journey.

You ROCK, ladies!!!

And while on the subject of suicide, here are excerpts from an interesting article in the BMJ...the information is now 10 years old, but still applicable to current Multiple Sclerosis statistics correlating depression and suicide with MS:

Mental illness leaves patients at risk for harming or killing themselves, none more so than major depression, with which a 15% lifetime prevalence of suicide has been consistently noted. Less clear is how these figures translate when applied to patients with neurological disease, particularly those conditions known to be associated with a high risk of comorbid depression.

An example is multiple sclerosis, the leading neurological cause of disability in young and middle aged adults. Depressive symptoms of sufficient severity and duration to warrant a diagnosis of major depression affect up to half of patients during the course of their illness. This is three times the prevalence reported for major depression and psychiatric comorbidity in community based samples, and it also exceeds that for other neurological disorders.

...a Medline search of all published data, which shows that patients with multiple sclerosis were generally more likely to attempt or commit suicide than patients with other common neurological disorders, and a Canadian study of 3126 patients with multiple sclerosis who were followed longitudinally at two clinics between 1972 and 1988. Comprehensive databases kept track of virtually all patients within the respective catchment areas, each of whom received at least a yearly follow up examination. Suicide accounted for 15% of all ascertained deaths during this 16 year period, proportionately 7.5 times that for the general population matched for age but not sex.

With these statistics, it is surprising that the treatment of depression in multiple sclerosis has received scant attention.

While the past decade has undoubtedly brought a greater awareness of the neurobehavioural sequelae of multiple sclerosis, the risk remains that clinicians may yet miss a treatable cause of morbidity and mortality. The measure by which disability is assessed remains the expanded disability status scale, which affords little weight to psychopathology. Attention remains largely focused on more easily discernable and quantifiable evidence of disease, such as how far patients can walk unaided, the degree of cerebellar disturbance, or measurements of visual acuity. The paucity of studies of treating depression related to multiple sclerosis attests to this. The problem is compounded by new treatment modalities such as interferon beta-1b, in which physical improvement may be offset by a potentially deleterious effect on mood.

While it is premature to conclude that depressed mood represents a core symptom of multiple sclerosis, it has taken psychiatrists and neurologists almost a century to realise that Charcot's astute observation of altered affect in the disorder he helped define demands prompt and careful management.


Tricia said...

Thanks for this post, it is information that needs to be shared. My husband suffers from mild depression all the time but did have a major depression last year and while suicide wasn't something he attempted he did some other things that were totally out of character and severely painful for me as a way to try and feel happy again. He was on Lexapro at the time and it wasn't working at all for him. It made him feel flat and one dimensional and worse than the sadness he was taking it to combat.

We went through a bunch of drugs trying to find one that worked for him. Prozac, Zoloft, and then finally they took him off antidepressants and put him on a mood stabilizer and now he feels better most of the time. It helps to level things out a bit. Stops the spikes of anger all the time.

For us depression has been one of the biggest and hardest to deal with symptoms of this disease. Definitely the most painful.


I agree that this is very important information. Depression entered my life years before the words multiple sclerosis ever hit my ears. And major depression is distinctly different than 'a case of the blues.' I still face this creature on a daily basis, if not, it may grow large and consuming.

I know that I am not depressed because I have MS. I do not have MS because I am depressed. But they do seem to be biologically connected somehow.

I have not had a major depressive episode in a little while. But it is something I try to keep in check on a dadily basis. Meds and cognitive behaviors help.

Spaz Attack said...

Hey BC,

Thanks for posting. Had to looke up Comorbidity: The coexistence of two or more disease processes.

You KNOW this is a subject I think EVERY MS specialist needs to face head-on with each patient.

Denver Refashionista said...

Thanks. I think this is a very important post.

harkoo said...

Thanks for the imformation--I lost 2 of my MS friends to suicide years ago and struggle with that issue on the bad days--notice those issues come up more during the heat/humid days when the MS symptoms seem to become very intense and you can't even think rationally