It’s Not All in Your Head: Depression, Anxiety, Mood Swings, and Multiple Sclerosis


You probably saw it on the internet as many times as I did: depression rates among patients with multiple sclerosis are considerably higher than in the general population or among patients with general medical conditions other than ms. Three main reasons are usually referred to explain this: a natural response to the diagnosis and to the many losses ms brings along the way; possible medication side effect (especially if you’re on interferons); and damage caused by ms lesions to the brain structures that regulate emotions and emotional responses.

However, this book takes it a step further, by pointing to research that suggests that depression may be an inflammatory disorder, much like ms. It is found to be an early sign of many inflammatory conditions. I remember my neurologist telling me the first symptoms of ms were fatigue and depression. I could understand the fatigue part but I couldn’t quite get how depression fit. This books explains why, emphasizing the role of cytokines in the process. So, instead of looking at depression as a consequence, maybe we should be looking at it as a different underlying mechanism.

Another thing I learned from this book was that pain and anxiety share some of the same biological mechanisms. Being that a lot of people with ms suffer from pain, improving patients anxiety levels could greatly relieve pain as well. Anxiety and depression can and should be dealt with through every option available, including medication, exercise and cognitive therapy.

The book then proceeds to suggest many different self-help techniques, illustrated by stories of people living with ms. Now, as a self-help book, Alison Shadday’s MS and Your Feelings will always be my favorite. I found It’s Not All in Your Head to be a bit repetitive at times and not delivering in some crucial moments. For instance, at a certain point, we’re invited to write down our roles in life, identify the stressors associated with each role, and then come up with solutions for each stressor. The author gives examples of roles (patient, parent, student, employee…), of stressors (MRIs, family holidays…) but no examples of solutions. I reckon however there are good tips in this book and therefore I recommend it.

Here’s the Amazon link if you wish to learn more:

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