The American Academy of Neurology recently published guidelines for addressing psychiatric disorders in people with multiple sclerosis. That is an important, and most welcome, step.
As the AAN’s paper points out, people with MS are at increased risk of a number of psychiatric illnesses, particularly depression and a disorder called pseudobulbar affect, a phenomenon in which people laugh or cry at inappropriate times without feeling particularly happy or sad.
Despite the potentially debilitating effects of psychiatric illness, these disorders tend to get lost in the shuffle for many people, not just those with MS. So it’s good to see one of the nation’s leading health agencies addressing the matter. The report evaluates the extent to which psychiatric disorders affect people with MS and examines various therapies in terms of their likely utility in helping those people. This should all add up to enormous benefit to people with MS who do suffer from these disorders – and for their loved ones, too.
One of the many perplexing aspects of MS is that none of us who have been diagnosed can know exactly when we actually began to have MS. Symptoms can appear and disappear without particular notice for months and years before a diagnosis is made, and often those symptoms never end up being recognized as having been related to MS. For my part, I suffered a terrible bout of obsessive-compulsive disorder, which manifested itself in the form of obsessive worry and attendant behaviors, a few years before I was diagnosed. I was lucky that my doctors figured out pretty quickly that I had OCD, and a wonderful therapist guided me through cognitive-behavioral therapy that allowed (and continues to allow) me to manage my condition.
Whether my OCD is somehow related to my MS will probably never be known, and perhaps it doesn’t really matter. But the AAN’s report, recognizing and reminding mental-health professionals to be on extra lookout for psychiatric illness among patients with MS (given their elevated risk), should pave the way for life-changing help for many people.
So, thank you, AAN.