First, know you're not alone. Depression is very common among people with multiple sclerosis (MS). Between the physical loss of function and lifestyle changes, it's easy to understand how MS could cause depression.

Some evidence also suggests that MS itself may cause changes in the body that make you more vulnerable to depression. Whether your depression is a reaction to or caused by MS, there are effective treatments.

Know the symptoms

Recognizing depression is not always easy. Some of the physical and mental symptoms, such as fatigue and cognitive problems, are common to MS as well. It's also important to distinguish between a fleeting case of "the blues" and true depression.

Some common signs and symptoms of depression include:

• Feeling sad or irritable most of the day
• Loss of interest or pleasure in activities
• Significant weight loss or gain or a decrease or increase in appetite
• Sleeping too much or being unable to sleep
• Persistent fatigue or loss of energy
• Feeling worthless or guilty with no apparent cause
• Inability to concentrate or make decisions
• Recurrent thoughts of death or suicide

You may have all or only a few of these signs and symptoms. The hallmark of depression is that your symptoms persist, usually lasting at least two weeks.

Get help

If you're depressed, don't wait to reach out for help. Talk with your doctor or neurologist first to determine your next step. He or she can help you with treatment or refer you to someone who can help.

Treatments for depression may include:

• Medication. Many types of antidepressants are available for depression. These types of drugs generally take a few weeks to reach their full effect. Your doctor will work with you to find the right dosage and best medication for your symptoms.
• Talk therapy. This type of treatment ranges from individual sessions with a licensed therapist to support groups. One type, cognitive behavioral therapy, has proved to be very effective in treating depression for people with MS. Many doctors combine drug therapy with some type of counseling.

Studies show that exercise can also significantly improve mood and quality of life for people with MS.