That is a great article for me to read if only to make me feel better! During my last excacerbation I got more down than I ever had been. As I started to feel physically better, It lifted. It's so hard to not see a simple stimulus-response connection is why I like what Why said in the first sentence of the post. I've always felt that way also, but the other side is almost where I end up. I do think that it can be compounded simply by state of mind. It's easy to get bummed out with MS, so I don't know if I'll ever feel that it is 100% ilness related, but I definitely agree that at least the catalyst can be 100% physiological.