Aa
Ms and mental illness
Hi all,
I'm wondering if there are any connections with ms and mental illness. It seems a " Tabu" subject as it seems under reported. People are embarrassed most likely , or don't want to talk about it.
Well.. I have had 3 separate episodes of irrational thoughts along with lightheartedness, usually a slight headache or a slight numbness that feels "internal " within my head. Having these internal dialogues with myself. Trying to calm myself down from becoming too panicky while feeling these strange emotions.
Ie: I was having lunch with a friend. It was a bit hot, and I was just coming off of a relapse. ( bladder). Then it started. I left to go home , I'm driving, and thoughts such as.. Oh.. Just drive off the road. " and then myself saying.. Stop . This is ridiculous. This is just a corky symptom. Don' let it get to you. If say this lasted approx an hour or so.
One other time was more recent. I was really tired. Went to lie down. I feel like I was hallucinating, feeling like I was on the floor. When I wasn't. Hearing noises and feeling like my husband was rocking the bed. But wasn't. Eventually drifted to sleep. Scary, I have an appt to talk to my doc about this but wanted any insights that may be out there. I know one of the larger lesions is within my frontal lobe. Not sure what can be done with this type of symptom. Unless this is just overall anxiety?? I also wasn't exersising at all. I was re doing our house. Wondering if there's a connection there. Anyway. I just want people to feel comfortable talking about this type of thing. It's scary acing a disease we don't understand. These support groups are essential. Thank you all. As always.
Andi
I'm wondering if there are any connections with ms and mental illness. It seems a " Tabu" subject as it seems under reported. People are embarrassed most likely , or don't want to talk about it.
Well.. I have had 3 separate episodes of irrational thoughts along with lightheartedness, usually a slight headache or a slight numbness that feels "internal " within my head. Having these internal dialogues with myself. Trying to calm myself down from becoming too panicky while feeling these strange emotions.
Ie: I was having lunch with a friend. It was a bit hot, and I was just coming off of a relapse. ( bladder). Then it started. I left to go home , I'm driving, and thoughts such as.. Oh.. Just drive off the road. " and then myself saying.. Stop . This is ridiculous. This is just a corky symptom. Don' let it get to you. If say this lasted approx an hour or so.
One other time was more recent. I was really tired. Went to lie down. I feel like I was hallucinating, feeling like I was on the floor. When I wasn't. Hearing noises and feeling like my husband was rocking the bed. But wasn't. Eventually drifted to sleep. Scary, I have an appt to talk to my doc about this but wanted any insights that may be out there. I know one of the larger lesions is within my frontal lobe. Not sure what can be done with this type of symptom. Unless this is just overall anxiety?? I also wasn't exersising at all. I was re doing our house. Wondering if there's a connection there. Anyway. I just want people to feel comfortable talking about this type of thing. It's scary acing a disease we don't understand. These support groups are essential. Thank you all. As always.
Andi
Thx ladies.. Your encouragement through it all helps. Alex I don't know how you do it. Your an inspiration for sure.
I am glad you have that figured out. Between MS and cancer and fatigue and PTSD I have emotional events I just can't explain. I used to be ashamed of emotional stuff now I just accept it as a part of who I am.
Alex
Alex
Just an update:
After a visit with my neuro, he suspected I was having anxiety mixed with frustration so to speak. The night episode he feels was more of a type of event that happens when your in a state of sleep or in and out of. There was a name for it but of course, I forgot. He ran an eeg just to put some worries aside and it came back " normal".. Whatever that means! We will discuss more in it next meeting in January.
All in all there is so much anxiety that comes with this. When fatigue hits it seems married with depression. There are ever changing emotions and sensations that occur within our bodies. It's a wonder we can function with any positivity at all. But it's a practice of thought I must strive for.
In the meantime, it's day to day.
And I'm going to get that book by David burns. I'm all about tools. If something works for you , then it works for you!
After a visit with my neuro, he suspected I was having anxiety mixed with frustration so to speak. The night episode he feels was more of a type of event that happens when your in a state of sleep or in and out of. There was a name for it but of course, I forgot. He ran an eeg just to put some worries aside and it came back " normal".. Whatever that means! We will discuss more in it next meeting in January.
All in all there is so much anxiety that comes with this. When fatigue hits it seems married with depression. There are ever changing emotions and sensations that occur within our bodies. It's a wonder we can function with any positivity at all. But it's a practice of thought I must strive for.
In the meantime, it's day to day.
And I'm going to get that book by David burns. I'm all about tools. If something works for you , then it works for you!
1 Comments
Thanks for the update. I am glad your neuro is listening and taking things seriously.
I think you are way over-intellectualizing this, and it's time to just plunge ahead. CBT has been around a long time and is very mainstream. There are many good books on this, so try your library--nothing to lose. One very popular and old time writer is David K. Burns, MD, whose books help you see the misassumptions you may be making about everyday situations and how to challenge them. If Burns is too self help for you, keep looking. If you find this kind of thing intriguing, find a therapist, or find some other kind of therapist.
ess
ess
The how and when is up to the professionals (if you're using a therapist) or just yourself if you're using something like CBT for Dummies (yes, that book exists!). There are a LOT of CBT books out there.
I've dealt with mental health services in three countries and they differ vastly, so without knowing where you are, it's difficult to get more specific.
CBT is an approach. It's not specific to MS or necessarily more commonly used in relation to MS depression. It was created to help deal with depression but is used in many areas, including simply general well-being these days.
CBT is NOT 'talk therapy'. You don't hash out old events. You identify irrational behaviours and thoughts and combat them in a managed way with quantifiable progress measurements. But all of this sounds very abstract, I'm sure!
Google around for some more information and resources that might be more specific to your geographical area or have a look in your library for some cost-effective information.
I pursued CBT to deal with some long-standing thought and behaviour patterns that pre-dated (but were exacerbated by) my dealing with my MS diagnosis.
I've dealt with mental health services in three countries and they differ vastly, so without knowing where you are, it's difficult to get more specific.
CBT is an approach. It's not specific to MS or necessarily more commonly used in relation to MS depression. It was created to help deal with depression but is used in many areas, including simply general well-being these days.
CBT is NOT 'talk therapy'. You don't hash out old events. You identify irrational behaviours and thoughts and combat them in a managed way with quantifiable progress measurements. But all of this sounds very abstract, I'm sure!
Google around for some more information and resources that might be more specific to your geographical area or have a look in your library for some cost-effective information.
I pursued CBT to deal with some long-standing thought and behaviour patterns that pre-dated (but were exacerbated by) my dealing with my MS diagnosis.
Cognitive Behavioural Therapy helps you determine and examine counterproductive patterns of thought and behaviour and retrains you to think differently. It's a LOT of work, but very worthwhile. I got more out of it than the year I spent as an inpatient, though I've chosen to continue with my SNRI as well.
There are self-guided books on it, but I did mine with a trained psychiatric nurse/therapist. People get out of it what they put into it. As I said, it's work but worth it. At least it was for me
There are self-guided books on it, but I did mine with a trained psychiatric nurse/therapist. People get out of it what they put into it. As I said, it's work but worth it. At least it was for me
I honestly don't know what cbt is..? Tools I can implement.. Such as yoga, mindful ess, ect?
COMMUNITY LEADER
CBT is usually the first treatment option these days, because CBT teaches you specific techniques to maximise your ability to keep your anxiety levels down, which additionally helps with making decisions, and having lower anxiety levels limits your anxiety from overly clouding your judgement, impulses, reactions etc
Antidepressants may not necessarily be needed after CBT, it entirely depends on the individual.....suicide only occasionally occurs and the higher risk is generally more related to the under 25yr old age group, in the first few weeks of taking one, changing medications, increasing dosage, and it also depends on the class of medication too.
It might help you to know that suicide or depression specifically from antidepressants is still highly debated, mental health is complicated with issues often overlapping etc but anxiety and depression when left untreated understandably carries the higher risk. Whilst the warnings are definitely valid, historically antidepressants actually lower the risk.
I do recommend before you start really worrying about antidepressant or their side effects, you seriously consider giving CBT a good try first and IF an antidepressant is additionally recommended, you discuss your concerns about antidepressants with your doctor and then make your decision.
Hugs........JJ
Antidepressants may not necessarily be needed after CBT, it entirely depends on the individual.....suicide only occasionally occurs and the higher risk is generally more related to the under 25yr old age group, in the first few weeks of taking one, changing medications, increasing dosage, and it also depends on the class of medication too.
It might help you to know that suicide or depression specifically from antidepressants is still highly debated, mental health is complicated with issues often overlapping etc but anxiety and depression when left untreated understandably carries the higher risk. Whilst the warnings are definitely valid, historically antidepressants actually lower the risk.
I do recommend before you start really worrying about antidepressant or their side effects, you seriously consider giving CBT a good try first and IF an antidepressant is additionally recommended, you discuss your concerns about antidepressants with your doctor and then make your decision.
Hugs........JJ
Possibly. But. Now my concern will be, on anti depressants, the side effects of suicidal thoughts, depression, .. That would make me more anxious!!
COMMUNITY LEADER
Um oops not sure why i've got a duplicate within the post......sorry about that lol i'll put it down to just being one of those days :D
Ah no not medical, lol coulda woulda shoulda....basically i'm just a geek with a life long interest in psychology, developmental disabilities, brain plasticity and the like, due to my complicated family history. My interested in mental health stems from my mother, we've always been opposites, i'm an adrenaline junky, athlete, optimistic and calm in a crisis......and she's just totally not, she was originally dx with manic depression and then the manic depression label changed to Bipolar but her most problematic mental health issue, is actually anxiety.
There are degrees of disassociation, and there doesn't actually need to be a mental health problem going on, mild levels of disassociation are part of every day life eg driving home on auto pilot, disconnecting from your bodies aches and pains to go to work, reading a good book and hours go by without your notice, being half asleep and telling hubby to let the cat out etc etc
Things like sleep deprivation, chronic fatigue, MS, Lassitude, medications etc can definitely cause and or enhance a dissociative episode and they can be truly scary experiences but I do think, regardless of the outcome with your neuro, you probably do need to take a more proactive approach with your anxiety. It can only benefit you to learn some specific anxiety techniques, that help you cope with what is happening!
Hugs............JJ
Ah no not medical, lol coulda woulda shoulda....basically i'm just a geek with a life long interest in psychology, developmental disabilities, brain plasticity and the like, due to my complicated family history. My interested in mental health stems from my mother, we've always been opposites, i'm an adrenaline junky, athlete, optimistic and calm in a crisis......and she's just totally not, she was originally dx with manic depression and then the manic depression label changed to Bipolar but her most problematic mental health issue, is actually anxiety.
There are degrees of disassociation, and there doesn't actually need to be a mental health problem going on, mild levels of disassociation are part of every day life eg driving home on auto pilot, disconnecting from your bodies aches and pains to go to work, reading a good book and hours go by without your notice, being half asleep and telling hubby to let the cat out etc etc
Things like sleep deprivation, chronic fatigue, MS, Lassitude, medications etc can definitely cause and or enhance a dissociative episode and they can be truly scary experiences but I do think, regardless of the outcome with your neuro, you probably do need to take a more proactive approach with your anxiety. It can only benefit you to learn some specific anxiety techniques, that help you cope with what is happening!
Hugs............JJ
Your incredibly helpful. Were or are you in the medical field? The more I think back.. I see the panic attack happening as a result from fear. My fears of bodily changes I cannot control . In addition to of course worrying about it. My first episode worrying of symptoms I wasn't sure why they were happening. Second coming off a relapse , worrying about symptoms after.. ( oh no. Am I having another one?)... The hallucinating I think I wAs going through I may have been drifting in and out of sleep- awareness.. I was exceptionally tired and nauseated from being so tired. However.. I'm still going to talk with my neurologist. He's also a dr. Of psychiatry in addition to an authority on ms. I will take notes as I'm sure we'll have an interesting convo. Thanks to all of you. Xo
COMMUNITY LEADER
There is definitely enough mental health research, to support taking the 'correct' M/H medication (and dosage) can significantly benefit a patients mental health and taking the 'wrong' medication (and dosage) can significantly worsen a patients mental health situation.......interesting to note, 'medications' for non psychiatric conditions can also negatively/positively affect mental health, as can the type of food and beverages we consume, environment (visual-audio-toxicity etc), behavioural etc etc etc
No, they're not rewiring, that's basically what cognitive behavioural training (CBT), counselling, talk therapy, self awareness etc is all about, mental health treatment is generally multi faceted, more than just medication. For anxiety disorders CBT is generally the first line treatment, CBT has a lasting positive affect, where as pharmaceutical treatments alone is dependant on the continuation of the medication, combined (therapy + medication) does actually have the better long term results though.
There are different classes of medications used to treat anxiety, the different classes of meds target different issues, SSRI's for example are suppose to work by multiplying the signal activity between the neurons that uses the chemical 'serotonin' to communicate with each other.
Psychiatrists will actually often prescribe Neurontin (gabapentin) to treat anxiety, the presumption being that it works like benzodiazepines, which directly affects neurons that use a chemical called GABA to communicate with each other, the thing is though they don't actually know how gabapentin works.....which is kind of interesting, if you consider it's very commonly prescribed to MSers (not for anxiety) hmmmmmm maybe the altered MS neural circuitry can cause more of an opposite affect, as can happen with some of the other neurological conditions and meds....
If you think of anxiety as being varying levels of worry about something that 'might happen at sometime' and panic attacks as being an intense episode of fear that something terrible is 'happening right now'. Panic attacks can be situational eg public speaking, social situations etc removal from the situation will lower the feelings generated but it can often lead to total avoidance and creating a more problematic phobia trigger.
Panic attacks can also be unexpected, but whilst they seem like they happen spontaneously, typically there is an underlying anxiety issue going on with the individual, either acknowledged or not, preceding the actual panic attack. Unexpected panic attacks are actually thought to be predominately driven by fear that is sparked by certain bodily sensations that is then misinterpret as more meaningful.
It's not hard to understand why someone experiencing a panic attack, could mistakenly believe they are actually experiencing a catastrophic physical or psychiatric event, when you look at the common physical symptoms of a panic attack. One of the key components with anxiety is actually understanding your individual early warning signs and behavioural triggers, and through CBT learning specific techniques to alter your thoughts and behaviours before it escalates further.......I will always highly recommend CBT cause it truly does help to learn how to shut your panic attacks down!
Cheers.........JJ There is definitely enough mental health research, to support taking the 'correct' M/H medication (and dosage) can significantly benefit a patients mental health and taking the 'wrong' medication (and dosage) can significantly worsen a patients mental health situation.......interesting to note, 'medications' for non psychiatric conditions can also negatively/positively affect mental health, as can the type of food and beverages we consume, environment (visual-audio-toxicity etc), behavioural etc etc etc
No, they're not rewiring, that's basically what cognitive behavioural training (CBT), counselling, talk therapy, self awareness etc is all about, mental health treatment is generally multi faceted, more than just medication. For anxiety disorders CBT is generally the first line treatment, CBT has a lasting positive affect, where as pharmaceutical treatments alone is dependant on the continuation of the medication, combined (therapy + medication) does actually have the better long term results though.
There are different classes of medications used to treat anxiety, the different classes of meds target different issues, SSRI's for example are suppose to work by multiplying the signal activity between the neurons that uses the chemical 'serotonin' to communicate with each other.
Psychiatrists will actually often prescribe Neurontin (gabapentin) to treat anxiety, the presumption being that it works like benzodiazepines, which directly affects neurons that use a chemical called GABA to communicate with each other, the thing is though they don't actually know how gabapentin works.....which is kind of interesting, if you consider it's very commonly prescribed to MSers (not for anxiety) hmmmmmm maybe the altered MS neural circuitry can cause more of an opposite affect, as can happen with some of the other neurological conditions and meds....
If you think of anxiety as being varying levels of worry about something that 'might happen at sometime' and panic attacks as being an intense episode of fear that something terrible is 'happening right now'. Panic attacks can be situational eg public speaking, social situations etc removal from the situation will lower the feelings generated but it can often lead to total avoidance and creating a more problematic phobia trigger.
Panic attacks can also be unexpected, but whilst they seem like they happen spontaneously, typically there is an underlying anxiety issue going on with the individual, either acknowledged or not, preceding the actual panic attack. Unexpected panic attacks are actually thought to be predominately driven by fear that is sparked by certain bodily sensations that is then misinterpret as more meaningful.
It's not hard to understand why someone experiencing a panic attack, could mistakenly believe they are actually experiencing a catastrophic physical or psychiatric event, when you look at the common physical symptoms of a panic attack. One of the key components with anxiety is actually understanding your individual early warning signs and behavioural triggers, and through CBT learning specific techniques to alter your thoughts and behaviours before it escalates further.......I will always highly recommend CBT cause it truly does help to learn how to shut escalating anxiety and or panic attacks down!
Cheers.........JJ
No, they're not rewiring, that's basically what cognitive behavioural training (CBT), counselling, talk therapy, self awareness etc is all about, mental health treatment is generally multi faceted, more than just medication. For anxiety disorders CBT is generally the first line treatment, CBT has a lasting positive affect, where as pharmaceutical treatments alone is dependant on the continuation of the medication, combined (therapy + medication) does actually have the better long term results though.
There are different classes of medications used to treat anxiety, the different classes of meds target different issues, SSRI's for example are suppose to work by multiplying the signal activity between the neurons that uses the chemical 'serotonin' to communicate with each other.
Psychiatrists will actually often prescribe Neurontin (gabapentin) to treat anxiety, the presumption being that it works like benzodiazepines, which directly affects neurons that use a chemical called GABA to communicate with each other, the thing is though they don't actually know how gabapentin works.....which is kind of interesting, if you consider it's very commonly prescribed to MSers (not for anxiety) hmmmmmm maybe the altered MS neural circuitry can cause more of an opposite affect, as can happen with some of the other neurological conditions and meds....
If you think of anxiety as being varying levels of worry about something that 'might happen at sometime' and panic attacks as being an intense episode of fear that something terrible is 'happening right now'. Panic attacks can be situational eg public speaking, social situations etc removal from the situation will lower the feelings generated but it can often lead to total avoidance and creating a more problematic phobia trigger.
Panic attacks can also be unexpected, but whilst they seem like they happen spontaneously, typically there is an underlying anxiety issue going on with the individual, either acknowledged or not, preceding the actual panic attack. Unexpected panic attacks are actually thought to be predominately driven by fear that is sparked by certain bodily sensations that is then misinterpret as more meaningful.
It's not hard to understand why someone experiencing a panic attack, could mistakenly believe they are actually experiencing a catastrophic physical or psychiatric event, when you look at the common physical symptoms of a panic attack. One of the key components with anxiety is actually understanding your individual early warning signs and behavioural triggers, and through CBT learning specific techniques to alter your thoughts and behaviours before it escalates further.......I will always highly recommend CBT cause it truly does help to learn how to shut your panic attacks down!
Cheers.........JJ There is definitely enough mental health research, to support taking the 'correct' M/H medication (and dosage) can significantly benefit a patients mental health and taking the 'wrong' medication (and dosage) can significantly worsen a patients mental health situation.......interesting to note, 'medications' for non psychiatric conditions can also negatively/positively affect mental health, as can the type of food and beverages we consume, environment (visual-audio-toxicity etc), behavioural etc etc etc
No, they're not rewiring, that's basically what cognitive behavioural training (CBT), counselling, talk therapy, self awareness etc is all about, mental health treatment is generally multi faceted, more than just medication. For anxiety disorders CBT is generally the first line treatment, CBT has a lasting positive affect, where as pharmaceutical treatments alone is dependant on the continuation of the medication, combined (therapy + medication) does actually have the better long term results though.
There are different classes of medications used to treat anxiety, the different classes of meds target different issues, SSRI's for example are suppose to work by multiplying the signal activity between the neurons that uses the chemical 'serotonin' to communicate with each other.
Psychiatrists will actually often prescribe Neurontin (gabapentin) to treat anxiety, the presumption being that it works like benzodiazepines, which directly affects neurons that use a chemical called GABA to communicate with each other, the thing is though they don't actually know how gabapentin works.....which is kind of interesting, if you consider it's very commonly prescribed to MSers (not for anxiety) hmmmmmm maybe the altered MS neural circuitry can cause more of an opposite affect, as can happen with some of the other neurological conditions and meds....
If you think of anxiety as being varying levels of worry about something that 'might happen at sometime' and panic attacks as being an intense episode of fear that something terrible is 'happening right now'. Panic attacks can be situational eg public speaking, social situations etc removal from the situation will lower the feelings generated but it can often lead to total avoidance and creating a more problematic phobia trigger.
Panic attacks can also be unexpected, but whilst they seem like they happen spontaneously, typically there is an underlying anxiety issue going on with the individual, either acknowledged or not, preceding the actual panic attack. Unexpected panic attacks are actually thought to be predominately driven by fear that is sparked by certain bodily sensations that is then misinterpret as more meaningful.
It's not hard to understand why someone experiencing a panic attack, could mistakenly believe they are actually experiencing a catastrophic physical or psychiatric event, when you look at the common physical symptoms of a panic attack. One of the key components with anxiety is actually understanding your individual early warning signs and behavioural triggers, and through CBT learning specific techniques to alter your thoughts and behaviours before it escalates further.......I will always highly recommend CBT cause it truly does help to learn how to shut escalating anxiety and or panic attacks down!
Cheers.........JJ
Jj..ess .. You are so full of information . Such a blessing to have all of you here. This is such a complicated issue. Jj , I do have anxiety. Always have. No stranger to panic attacks. What will be interesting.. Is now what. Do I treat as if I have daily anxiety. ? Well I don't. Do I take something to relax me as things are happening? Assuming it happens again?
It's long been said mental illness is a brain chemistry imbalance. But I wonder. the meds provided seem to help those with anxiety- depression., why? If not re balancing. Then what are they doing? Certainly not re wiring ? What do you think?
It's long been said mental illness is a brain chemistry imbalance. But I wonder. the meds provided seem to help those with anxiety- depression., why? If not re balancing. Then what are they doing? Certainly not re wiring ? What do you think?
COMMUNITY LEADER
I had a look at that article but it was way short on providing any details, I did find another partial copy though unfortunately it too was lacking.....
http://www.researchgate.net/publication/6454622_The_Differential_Diagnosis_of_Multiple_Sclerosis
What i did notice from the part i did get to read, they seem to be drawing this conclusion, at least in part from data collected from the REFERRAL's to 3 MS clinics, this wouldn't typically be misdiagnosis stats but the totality of those 'referred' to the MS clinics who they did not diagnose with MS. One of which dated from 1979-1983 and pre MRI's, interestingly they also reported the lowest referred rate who had a psychiatric condition Dalhousie 14 ((27%) , Colorado 63 (45%), Marshfeild 53 (76%)
I've tried to find others but so far not finding anything that would support the conclusion that that particular study did.....
Still looking..........JJ
http://www.researchgate.net/publication/6454622_The_Differential_Diagnosis_of_Multiple_Sclerosis
What i did notice from the part i did get to read, they seem to be drawing this conclusion, at least in part from data collected from the REFERRAL's to 3 MS clinics, this wouldn't typically be misdiagnosis stats but the totality of those 'referred' to the MS clinics who they did not diagnose with MS. One of which dated from 1979-1983 and pre MRI's, interestingly they also reported the lowest referred rate who had a psychiatric condition Dalhousie 14 ((27%) , Colorado 63 (45%), Marshfeild 53 (76%)
I've tried to find others but so far not finding anything that would support the conclusion that that particular study did.....
Still looking..........JJ
Hi, Andipw3! I'm glad that you're going to be able to talk with your doctor about these episodes. I hope you'll be able to speak with a psychiatrist and/or psychotherapist, as they may have ideas on how to manage these episodes or even address their root causes before they happen. Have you told any loved ones or friends about your episodes? Would you feel comfortable letting someone know so that you can reach out to them or they can check in on you occasionally?
One note I'd also like to make is that sometimes psychiatric disorders are misdiagnosed as multiple sclerosis. Perhaps this is something you can speak with your neurologist about. Here is an example of a study supporting this point that you may want to show to your doctor: http://www.ncbi.nlm.nih.gov/pubmed/17351525
One note I'd also like to make is that sometimes psychiatric disorders are misdiagnosed as multiple sclerosis. Perhaps this is something you can speak with your neurologist about. Here is an example of a study supporting this point that you may want to show to your doctor: http://www.ncbi.nlm.nih.gov/pubmed/17351525
COMMUNITY LEADER
I have long disagreed with the theory of mental health disorders being caused by a chemical imbalance, and steadfastly held on to the theory behind brain plasticity, today the evidence is mounting that mental health is caused by the brains neural development and or neural deterioration.......
"While the neuroscience discoveries are coming fast and furious, one thing we can say already is that earlier notions of mental disorders as chemical imbalances or as social constructs are beginning to look antiquated. Much of what we are learning about the neural basis of mental illness is not yet ready for the clinic, but there can be little doubt that clinical neuroscience will soon be helping people with mental disorders to recover."
http://www.nimh.nih.gov/about/director/2011/mental-illness-defined-as-disruption-in-neural-circuits.shtml
ADHD, ASD, OCD, Dyslexia, Bipolar, Anorexia, PSTD, anxiety, major depressive disorders etc are generally understood to have varying complex combinations of cognitive and psychiatric components, and whilst the historical focus has been on rebalancing the chemicals within specific parts of the brain that are improperly balanced......research is actually proving that these conditions demonstrate abnormal neural circuitry.
Basically the brains neural wiring is faulty either developmentally or degeneratively, which will go a long way towards understanding why cognitive behavioural therapy (uses brain plasticity principals) makes a significant difference with many conditions that never were thought to be neurological...
Food for thought..........JJ
btw if anyone's interested, recent HFA/Asperger research is finding repetitive cognitive training may actually be detrimental to those with higher functioning ASD, due to the repetition inadvertently compounding their inability to neurologically adapt to repetitively trained visual expectations.
"While the neuroscience discoveries are coming fast and furious, one thing we can say already is that earlier notions of mental disorders as chemical imbalances or as social constructs are beginning to look antiquated. Much of what we are learning about the neural basis of mental illness is not yet ready for the clinic, but there can be little doubt that clinical neuroscience will soon be helping people with mental disorders to recover."
http://www.nimh.nih.gov/about/director/2011/mental-illness-defined-as-disruption-in-neural-circuits.shtml
ADHD, ASD, OCD, Dyslexia, Bipolar, Anorexia, PSTD, anxiety, major depressive disorders etc are generally understood to have varying complex combinations of cognitive and psychiatric components, and whilst the historical focus has been on rebalancing the chemicals within specific parts of the brain that are improperly balanced......research is actually proving that these conditions demonstrate abnormal neural circuitry.
Basically the brains neural wiring is faulty either developmentally or degeneratively, which will go a long way towards understanding why cognitive behavioural therapy (uses brain plasticity principals) makes a significant difference with many conditions that never were thought to be neurological...
Food for thought..........JJ
btw if anyone's interested, recent HFA/Asperger research is finding repetitive cognitive training may actually be detrimental to those with higher functioning ASD, due to the repetition inadvertently compounding their inability to neurologically adapt to repetitively trained visual expectations.
COMMUNITY LEADER
I believe the first 2 incidents you mention could still fit a mild anxiety attack, your internal dialogue was 'challenging' the negative thoughts that were popping into your mind, and basically talking your self down from a full panic attack. Being brief enough to be your self again not long afterwards and your wording, suggests to me that your fatigue, self esteem, stress, frustration levels etc were likely exacerbating your anxiety and wouldn't in general be outside of anxiety...
The 3rd whilst you were also fatigued, is the type of situation that doesn't typically fit with anxiety because it involved audio and physical hallucinations, any situation that makes you unable to comprehend reality should definitely be cause for concern!
BUT before becoming really anxious that this type of isolated incident, could only be caused by a more serious type of mental health issue or symptomatic of more MS lesion damage, you need to keep in mind that psychotic issues are 'rare' (1-3%) in MS and theoretically it's more likely this situation was to do with your level of sleep deprivation, migraine, medication, dehydration, state of your mental health at the time etc and or the combination of....
Hugs........JJ
The 3rd whilst you were also fatigued, is the type of situation that doesn't typically fit with anxiety because it involved audio and physical hallucinations, any situation that makes you unable to comprehend reality should definitely be cause for concern!
BUT before becoming really anxious that this type of isolated incident, could only be caused by a more serious type of mental health issue or symptomatic of more MS lesion damage, you need to keep in mind that psychotic issues are 'rare' (1-3%) in MS and theoretically it's more likely this situation was to do with your level of sleep deprivation, migraine, medication, dehydration, state of your mental health at the time etc and or the combination of....
Hugs........JJ
Mood disorders are a bit easier for me to understand. It's a vast over-simplification, but moods are largely chemical releases and re-uptakes or lack thereof. Not the right amount or the right timing and moods, or feelings, come adrift. That's why medications can be helpful, as they re-regulate chemical releases. I imagine this is much like the way the pancreas secretes insulin, or doesn't, but insulin can be added to help this process.
Disregulation of thought, however, is much more complex. I really don't know how much of the brain is involved in this and in what ways, or what causes our perception of reality to go off the rails. There are, of course, anti-psychotic drugs, so obviously there is chemistry involved, but what these do I have no idea. I do know of people whose mood disorders become so severe that the patient became psychotic and dangerous, so there obviously can be a connection.
If anyone knows of a Cliff Notes explanation, please let us know. There's probably a Mental Illness for Dummies book out there, because there's a Dummies book for everything else, it seems. But it's my guess that brief and transient misperceptions of reality in MS come largely from fatigue, pain, sleep disturbance, worries and similar factors secondary in MS,
ess
Disregulation of thought, however, is much more complex. I really don't know how much of the brain is involved in this and in what ways, or what causes our perception of reality to go off the rails. There are, of course, anti-psychotic drugs, so obviously there is chemistry involved, but what these do I have no idea. I do know of people whose mood disorders become so severe that the patient became psychotic and dangerous, so there obviously can be a connection.
If anyone knows of a Cliff Notes explanation, please let us know. There's probably a Mental Illness for Dummies book out there, because there's a Dummies book for everything else, it seems. But it's my guess that brief and transient misperceptions of reality in MS come largely from fatigue, pain, sleep disturbance, worries and similar factors secondary in MS,
ess
Wow! Lots to digest. One thing I do know for certain. There have been 3 instances I know that have been scary. I don't think in a truly psychotic episode you can " talk yourself out of it". During the moments the changes in my thinking took place, I was calming myself down. Once I got home I seemed to settle. Nobody around me would know these thoughts were passing through. I guess I just can't figure out which category this falls under. In looking above. I know I'm subject to anxiety but have always handled it well. Depression I had briefly with a new diagnosis. That was more situational. I'm not sure what my Neurologist will say. But I need to tell him. The next mri will be interesting. More lesions? And more importantly.. Where.
More than anything I want people to talk about it.
More than anything I want people to talk about it.
COMMUNITY LEADER
Depression and anxiety are more widely recognised but there are other psychiatric issues connected with MS, definitely not as common but there is a bit of concern that it's more to do with under reporting and or not getting relevant psychiatric assessments. The first 2 articles are specifically mentioning Bipolar disorder in MS and the 3rd is just more 2015 research on bipolar....
2008:
"Neuropsychiatric symptoms are also commonplace and are occasionally the first presentation of MS.7,8 As many of the characteristic signs and symptoms are nonspecific and pseudoneurologic in nature, patients are often suspected of suffering from a primarily psychiatric condition,9 and diagnosis may be delayed."
"Bipolar disorder is also twice as common in MS patients as in the general population13,21 and often presents later in the course of MS, as in the case of Mr. A, who presented with his first episode of mania at age 41 years. While treatment with high doses of corticosteroids may precipitate mania, the increased prevalence of bipolar disorder does not appear related to this treatment alone.14
Though rare, there have been case reports of patients diagnosed with MS only after presenting with acute, lateonset mania in the absence of neurologic signs.8 Mr. A's late onset of manic symptoms would be highly atypical for primary bipolar disorder and suggests that MS lesions in critical brain regions may be a substantial contributing factor to his presentation.21
For example, lesions along the orbitofrontal prefrontal cortex circuit lead to impulsivity, mood lability, and personality changes, symptoms frequently seen in acute mania.8 On the other hand, a history of manic or hypomanic symptoms in Mr. A may have been long overlooked given the complexity of his neurologic and cognitive presentation, leading to a delay in diagnosis of bipolar disorder."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528238/
2014:
"Compared to controls, MS patients had a higher lifetime prevalence of DSM-IV Major Depressive Disorders (MDD; P<0.0001), BD I (P=0.05), BD II (P<0.0001) and Cyclothymia (P=0.0001). As people with MS had a higher risk of depressive and bipolar spectrum disorders, ratio MDD/bipolar spectrum disorders was lower among cases (P<0.005) indicating a higher association with Bipolar Spectrum Disorders and MS."
"This study was the first to show an association between BD and MS using standardized diagnostic tools and a case-control design. The results suggest a risk of under-diagnosis of BD (particularly type II) in MS and caution in prescribing ADs to people with depressive episodes in MS without prior excluding BD. The association between auto-immune degenerative diseases (like MS) and BD may be an interesting field for the study of the pathogenic hypothesis."
2015 on bipolar and the cerebellum:
"Sometimes, a new way of looking at something can bring to light an entirely new perspective.
Using a different type of MRI imaging, researchers at the University of Iowa have discovered previously unrecognized differences in the brains of patients with bipolar disorder. In particular, the study, published Jan. 6 in the journal Molecular Psychiatry, revealed differences in the white matter of patients' brains and in the cerebellum, an area of the brain not previously linked with the disorder. Interestingly, the cerebellar differences were not present in patients taking lithium, the most commonly used treatment for bipolar disorder."
http://www.sciencedaily.com/releases/2015/01/150106081217.htm
It's definitely early days in the identification of psychiatric disorders primarily caused by neurological conditions like MS, and with a pre-existing MS dx it might be difficult to determine the exact cause for various MS related reasons.......what came first the chicken or the egg, primary sx of MS vs secondary etc but maybe the question should be....does the causation truly matter apart from the relevance to the differing pharmaceuticals treatment options? hmmmmmm interesting thought.
I expect due to the nature of health anxiety, conversion-functional disorder patients etc it will still come down to the 'absence' of the abnormal neuro clinical signs and other typical MS diagnostics but some M/H patients may actually be less black and white and more grey than first thought, which might make a primary dx of M/H a tad harder to accept for some, and probably delay getting the medical help they need.....
Cheers..........JJ
2008:
"Neuropsychiatric symptoms are also commonplace and are occasionally the first presentation of MS.7,8 As many of the characteristic signs and symptoms are nonspecific and pseudoneurologic in nature, patients are often suspected of suffering from a primarily psychiatric condition,9 and diagnosis may be delayed."
"Bipolar disorder is also twice as common in MS patients as in the general population13,21 and often presents later in the course of MS, as in the case of Mr. A, who presented with his first episode of mania at age 41 years. While treatment with high doses of corticosteroids may precipitate mania, the increased prevalence of bipolar disorder does not appear related to this treatment alone.14
Though rare, there have been case reports of patients diagnosed with MS only after presenting with acute, lateonset mania in the absence of neurologic signs.8 Mr. A's late onset of manic symptoms would be highly atypical for primary bipolar disorder and suggests that MS lesions in critical brain regions may be a substantial contributing factor to his presentation.21
For example, lesions along the orbitofrontal prefrontal cortex circuit lead to impulsivity, mood lability, and personality changes, symptoms frequently seen in acute mania.8 On the other hand, a history of manic or hypomanic symptoms in Mr. A may have been long overlooked given the complexity of his neurologic and cognitive presentation, leading to a delay in diagnosis of bipolar disorder."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528238/
2014:
"Compared to controls, MS patients had a higher lifetime prevalence of DSM-IV Major Depressive Disorders (MDD; P<0.0001), BD I (P=0.05), BD II (P<0.0001) and Cyclothymia (P=0.0001). As people with MS had a higher risk of depressive and bipolar spectrum disorders, ratio MDD/bipolar spectrum disorders was lower among cases (P<0.005) indicating a higher association with Bipolar Spectrum Disorders and MS."
"This study was the first to show an association between BD and MS using standardized diagnostic tools and a case-control design. The results suggest a risk of under-diagnosis of BD (particularly type II) in MS and caution in prescribing ADs to people with depressive episodes in MS without prior excluding BD. The association between auto-immune degenerative diseases (like MS) and BD may be an interesting field for the study of the pathogenic hypothesis."
2015 on bipolar and the cerebellum:
"Sometimes, a new way of looking at something can bring to light an entirely new perspective.
Using a different type of MRI imaging, researchers at the University of Iowa have discovered previously unrecognized differences in the brains of patients with bipolar disorder. In particular, the study, published Jan. 6 in the journal Molecular Psychiatry, revealed differences in the white matter of patients' brains and in the cerebellum, an area of the brain not previously linked with the disorder. Interestingly, the cerebellar differences were not present in patients taking lithium, the most commonly used treatment for bipolar disorder."
http://www.sciencedaily.com/releases/2015/01/150106081217.htm
It's definitely early days in the identification of psychiatric disorders primarily caused by neurological conditions like MS, and with a pre-existing MS dx it might be difficult to determine the exact cause for various MS related reasons.......what came first the chicken or the egg, primary sx of MS vs secondary etc but maybe the question should be....does the causation truly matter apart from the relevance to the differing pharmaceuticals treatment options? hmmmmmm interesting thought.
I expect due to the nature of health anxiety, conversion-functional disorder patients etc it will still come down to the 'absence' of the abnormal neuro clinical signs and other typical MS diagnostics but some M/H patients may actually be less black and white and more grey than first thought, which might make a primary dx of M/H a tad harder to accept for some, and probably delay getting the medical help they need.....
Cheers..........JJ
JJ, these citations are interesting. I've never researched this issue, but have long known that depression can be primary in MS, resulting from lesion activity in the part or parts of the brain that control mood.
This past summer, while I was having IV steroid infusions for TN, my neuro by chance came into the room, and we had a wide-ranging chat about many things MS. Although fortunately I don't have depression, I asked about this occurrence, and specifically about mood disorders other than depression, since depression is all I'd read of. He agreed that MS can also cause primary anxiety, which makes sense. I then asked about bi-polar illness, and he said no, that's not MS. Hmm. He usually is one to offer very specific research data to back up his statements, and what he said contradicts what is above.
I didn't pursue this or even think to look it up later, because it was just a hypothetical question as I don't have a mood disorder, but this area certainly gets a lot of posts on the forum. Often they seem to come from posters without MS but with severe health OCD, which as we well know can cause many very real symptoms.
ess
This past summer, while I was having IV steroid infusions for TN, my neuro by chance came into the room, and we had a wide-ranging chat about many things MS. Although fortunately I don't have depression, I asked about this occurrence, and specifically about mood disorders other than depression, since depression is all I'd read of. He agreed that MS can also cause primary anxiety, which makes sense. I then asked about bi-polar illness, and he said no, that's not MS. Hmm. He usually is one to offer very specific research data to back up his statements, and what he said contradicts what is above.
I didn't pursue this or even think to look it up later, because it was just a hypothetical question as I don't have a mood disorder, but this area certainly gets a lot of posts on the forum. Often they seem to come from posters without MS but with severe health OCD, which as we well know can cause many very real symptoms.
ess
COMMUNITY LEADER
Some Mental Health conditions are now well recognised as potentially being a direct result of neuron damage, but keep in mind that M/H issues can be hard to pin down because they can also be the indirect result of DMD's, symptom treatment medications and living with the chronic MS issues too eg cognitive impairment, fatigue, sleep issues, chronic pain, limited mobility, etc etc etc
Research information:
"The mood and affective disorders can be divided into four broad categories including major depression, bipolar affective disorder, euphoria, and pseudobulbar affect. Behavioural changes such as confabulations, paranoid ideas, irritability, pathologically increased libido, and alcohol and substance abuse have been reported sporadically in MS patients with extensive brain lesions, requiring specialized psychiatric management [McDonald and Compston, 2006]."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/
Morphological correlates of psychiatric MS symptoms.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/table/table1-1756285608100325/
Prevalence of psychiatric disorders in MS and general population.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/table/table2-1756285608100325/
Correlation of psychiatric symptoms with MS features.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/table/table3-1756285608100325/
Personally i don't understand why different countries have differing levels of tabu that often surrounds M/H issues, it doesn't really make sense to connect any negative connotations towards someone, who has a medical condition that no one, no matter your life story, ever gets a choice.......
Hugs.........JJ
Research information:
"The mood and affective disorders can be divided into four broad categories including major depression, bipolar affective disorder, euphoria, and pseudobulbar affect. Behavioural changes such as confabulations, paranoid ideas, irritability, pathologically increased libido, and alcohol and substance abuse have been reported sporadically in MS patients with extensive brain lesions, requiring specialized psychiatric management [McDonald and Compston, 2006]."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/
Morphological correlates of psychiatric MS symptoms.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/table/table1-1756285608100325/
Prevalence of psychiatric disorders in MS and general population.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/table/table2-1756285608100325/
Correlation of psychiatric symptoms with MS features.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/table/table3-1756285608100325/
Personally i don't understand why different countries have differing levels of tabu that often surrounds M/H issues, it doesn't really make sense to connect any negative connotations towards someone, who has a medical condition that no one, no matter your life story, ever gets a choice.......
Hugs.........JJ
Have an Answer?
You are reading content posted in the Multiple Sclerosis Community
Top Neurology Answerers
Australia
ON
Queensland, Australia
Queen Creek, AZ
Find out how beta-blocker eye drops show promising results for acute migraine relief.
In this special Missouri Medicine report, doctors examine advances in diagnosis and treatment of this devastating and costly neurodegenerative disease.
Here are 12 simple – and fun! – ways to boost your brainpower.
Discover some of the causes of dizziness and how to treat it.
Discover the common causes of headaches and how to treat headache pain.
Two of the largest studies on Alzheimer’s have yielded new clues about the disease
