It's probably both. It makes common sense that people who are less symptomatic may feel less depressed. However, depression can be an actual part of an MS diagnosis, just like numbness or weakness or vision loss. Both MS and depression tend to affect young women, so there would be a high rate of patients having both diagnoses even if there were no relationship between the two diagnoses.
However, MS probably causes depression in some people, because there is a higher rate of depression in people with MS than there is in matched controls, and this is NOT accounted for by the presence of disabling symptoms in patients with MS. (Depression does not cause MS by the way.)
Most likely MS causes depression, in some people, by affecting neurotransmitters and/or disrupting nervous system pathways. So, theoretically, treating the MS, decreasing brain inflammation, could help those pathways and neurotransmitters to function better again and improve depression.
However, patients with depression and MS should be treated essentially the same as patients with depression and not MS, generally with antidepressants, counseling, and/or lifestyle modifications. And, of course, whether the depression is related to the MS or not, such patients require monitoring to make sure their depression is not worsening and they are not at risk for suicide.View Thread
I would recommend that you see a multiple sclerosis specialist in an effort to get an accurate diagnosis. You do not want to be told that you have MS if you do not, but if you do, you want to find out so proper treatment can be started. And an MS specialist is in the best position to determine what the best treatment is. It is also possible that your symptoms are "nonorganic" in nature. This would not mean that you are "crazy" or that it is "all in your head". It would only mean that it is important to make the right diagnosis so you can be properly treated. Patients may not like hearing a "nonorganic" diagnosis, but all doctors care about is alleviating your suffering which means making the correct diagnosis so proper treatment can be initiated, whether that diagnosis by multiple sclerosis, "nonorganic", or something else.View Thread
As with all MS disease modifying agents, Tysabri only slows MS down, it does not cure it, so you can certainly have relapses on Tysabri. The symptoms that you describe sound a bit unusual for an MS relapse, but it is possible. Tysabri can cause an infection called PML which can cause neurological symptoms that mimick an MS exacerbation, but is actually a life-threatening infection. Your symptoms don't necessarily sound like that either, but it is a possibility. The bottom line is that you need to work with your doctor to try to figure out what your symptoms are due to, which could be an MS exacerbation, but could also be many other things.View Thread
You should follow the advice of your doctors. A second opinion is usually a good thing, because the more minds you have working on a problem, the more likely someone is to come up with the answer. While no one test can rule in or rule out multiple sclerosis, a spinal tap can often provide very useful information, which when put together with the patient's history and other tests, can significantly raise or lower the possibility of MS.View Thread
For patients with MS and cognitive concerns, formal neurocognitive testing can be very beneficial for multiple reasons. First, it can help determine whether there really is any affect on cognition from the multiple sclerosis; people with MS (and without MS) can have cognitive complaints for lots of reasons, not necessarily due to MS. Second, it will also serve as a baseline for possible repeat testing in the future if concerns for (worsening) cognitive effects of the disease arise later. Thirdly, if cognitive problems are revealed by the testing, it will serve as a guide for cognitive rehabilitation to focus on specific cognitive spheres which are most greatly affected. Also, Aricept or similar medications may have some benefit for the neurocognitive dysfunction of MS, based a few small, but reasonably well-designed studies.View Thread
Sometimes a multiple sclerosis diagnosis is quite straightforward. Other times it can be very challenging. There is no one test that can say definitely yes or definitely no, so the doctor has to take all the possible information and use his or her best judgement. That is the art and science of medicine. While we want to make an MS diagnosis and start treatment as quickly as possible to minimize the negative consequences of MS, this has to be balanced against the certainty of the diagnosis and the negative consequences of a misdiagnosis, being labelled with and treated for MS if you end up not having it, and perhaps not being treated for something that could have been treated a different way.View Thread
Do you have a known diagnosis of multiple sclerosis, or is you diagnosis still completely unknown. Spasms of the forearms would be an unusual symptom for MS. It is important to keep working with your doctor until you have a diagnosis. I would not encourage you to "doctor shop" until you get a diagnosis that you like, but a second opinion might be reasonable, if the first doctor cannot provide a satisfactory answer. Treatment without a diagnosis is sometimes okay, but often not recommended because you are likely to just end up on an ineffective medicine putting you at risk for side effects or other adverse effects. For example, if the pain in your forearms is not due to nerve pain, gabapentin/Neurontin is unlikely to help.View Thread
Sexual dysfunction in multiple sclerosis can happen for many reasons. As suggested, it can happen because of lack of sensation, or it can happen for any reason that any woman or man even without MS develops it, such as psychological issues. Sexual dysfunction also often goes along with bowel or bladder dysfunction because the anatomical pathways overlap to a large extent. Sexual dysfunction in MS is usually best managed by a urologist (or a gynecologist for a woman), and is treated essentially as for patients with sexual dysfunction who don't have MS. For men, this usually means with medications like Viagra or Cialis or sometimes with external or internal mechanical devices. For woman, it is unfortunately much harder to treat--if it is pain or lack of sensitivity then medications directed towards that issue could help, but are often ineffective, if it is lack of libido then addressing possible psychological issues could help.View Thread
It is impossible to make a diagnosis or suggest treatment options based on the information given. The symptoms are very nonspecific and do not point to any particular diagnosis. Although multiple sclerosis can cause cognitive dysfunction, the way in which these symptoms are described sounds unusual for MS (and Parkinson's). Severe headaches would also be unusual as a symptoms of MS or Parkinson's. As suggested by "hackwriter", you need be confident that your doctor is doing a good job of trying to sort out the possibilities, and, if not, then get a second opinion.View Thread
There are many anecdotal reports from patients of either a vaccine or an illness causing an MS exacerbation, but no real good scientific evidence to support these claims. As with everything in medicine, the pros and cons have to be weighed. If you are at high risk for complications from the flu, you should definitely get the flu vaccine. If you are young and otherwise healthy, I personally would probably still get the flu vaccine, but some people with MS would choose not to. As for the shingles vaccine, there is certainly no evidence that it would cause an MS exacerbation, and shingles can be very painful, so I would probably get it. The shingles vaccine (called Zostavax) has been recommended since 2005 for all persons over age 60 to prevent shingles and postherpetic neuralgia.View Thread
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