February 7, 2019 | News | Living with MS

Depression in MS can slow info processing

One of the more subtle effects of multiple sclerosis is its impact on cognition – your ability to think, plan and remember. Cognitive difficulties can begin early and usually become more common as you age. In part this is because during the course of MS, your brain suffers from repeated inflammatory flare-ups, which can take their toll on your mind and brain. About one-half of people may experience problems during the relapsing-remitting phase of MS, and about three-quarters of older people who have entered the secondary-progressive phase (Ruano and colleagues. Mult Scler 2016; epublished October 13, 2016).

People with MS commonly say that they process information more slowly, their attention span isn’t as good, they have trouble finding the right word, they have memory glitches, and they get more easily overwhelmed when trying to plan something (Benedict and colleagues. Nat Rev Neurol 2011;7:332-342; Kalmar and colleagues. Neuropsychology 2008;22:442-449).

The physical changes that can occur with MS are somewhat easy to determine. Assessing changes in thought processing is a more difficult proposition. There are many factors that affect how well the brain functions. Perhaps the most obvious is MS fatigue. Focusing on a book, clearly expressing your thoughts or working out the details of your daily schedule can feel like impossible tasks if you’re feeling fatigued. The problem is further compounded if you’re suffering from depression; “mental slowing” is a common symptom of depression even in people without MS.

If you have MS, fatigue and depression, it’s very difficult to know which problem is having the greatest impact on your ability to think and plan. So a recent study looked at how important depression was to cognitive impairment (Lubrini and colleagues. Mult Scler 2016;22:1607-1615). They found that overall, people with MS without depression had a slower reaction time (a measure of how quickly you process information) compared to people without MS. People without MS who were suffering from depression did show some mental slowing, but only when faced with more difficult tasks. In contrast, people with MS and depression had slower reaction times across a range of tasks, from the simplest to the most difficult.

What this means is that depression on its own has an impact on thought processing. When depression combines with MS, there’s a much greater impact on thinking abilities. MS is one form of attack on the brain; depression is another.

It’s important to note that the “cognitive impairments” seen in people with MS are not a type of dementia (such as Alzheimer’s disease). MS and dementia are different biological processes. But cognitive problems in MS aren’t a trivial matter – they indicate that MS relapses are causing an accumulation of damage, much like power surges will causes glitches in your computer. So it’s important to get what your mind and body needs – medications to control MS inflammation, counselling or treatment for symptoms of depression, and strategies for managing your energies to relieve your fatigue.

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