Emotional Issues, Is it MS caused?

If it's on your mind and it has to do with multiple sclerosis in any way, post it here.

Postby LiquidSkin » Thu Jun 19, 2008 1:44 am

Thanks Guys, even if I cant fix it now, I have something to go the doctor with.
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Postby MrsGeorge » Fri Jun 20, 2008 3:17 am

That's interesting to know. I am a person that doesn't cry normally but I get really weepy at nothing these days. I almost burst into tears a few times at work on monday but had no reason.
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Postby jimmylegs » Sat Jun 28, 2008 11:44 am

i was researching some non-MS info for a friend and ran across this interesting tie-in:

Essentials of the Neurological Evaluation

1.1 Introduction

The evaluation of the psychiatric patient is enhanced by the use of a general systems approach. Biological, psychological, and sociological systems variables should be identified and their interaction assessed. A central part of this evaluation concerns the role that the nervous system plays in the expression of mental and behavioural disorders. Our understanding of "functional" psychiatric illness has been irrevocably influenced by the prevalence in our patients of causative or contributory central nervous system (CNS) dysfunction.

...As a prerequisite, the examiner must have an understanding of the structure and function of the nervous system. For example, a systemic illness that eventually influences the central nervous system may present initially with a peripheral nervous system sign and a nonspecific mental state change. This change in behaviour may be ignored, whereas in actual fact it represents a focal central neurological finding.
In addition to the division of the nervous system into central and peripheral anatomic components, a functional division into voluntary (skeletal) and involuntary (autonomic) can be made. Traditionally, conversion syndrome diagnoses have been based on functional voluntary nervous system symptoms, sometimes ignoring the subtle neurological signs that would confirm the presence of central nervous system disease.

Multiple sclerosis has been the "great masquerader" for functional psychiatric illness and is commonly misdiagnosed as conversion reaction. Similarly, involuntary nervous system dysfunction may not necessarily indicate parasympathetic or sympathetic neuropathology because we now know that both classical and operant conditioning paradigms affect autonomic nervous system function. Thus, involuntary autonomic signs can exist as a result of a learned reaction rather than tissue dysfunction. Autonomic nervous system activity is constantly monitored and interpreted by higher cortical centers... especially those in the temporal lobe, modulate and affect production and consequently shape the organism's behavioural response...


2.2.6 Demyelinating Disease: Multiple Sclerosis

Clinical lore has it that one of the most difficult differential diagnoses in neurology or psychiatry is between the diagnosis of multiple sclerosis and hysteria/conversion syndromes. The diverse effects of multiple, widespread, and apparently unrelated demyelination of the central nervous system produce a puzzling clinical picture that is further obscured by the recurrent remitting nature of the disease. Psychopathological complaints may be more impressive than motor or sensory complaints when the former include affective dyscontrol (e.g. hypomania, depression, temper outburts, and labile emotionality), psychosis, or nonspecific personality change.
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Postby jimmylegs » Sun Jun 29, 2008 6:50 pm

hi again i was looking at some of the nutrition concerns in psychiatric illness and ran across some options like omega 3 fatty acids and such, and thought i'd relay a pair of abstracts. originally, i was going to post the abstract below, and then go into b12 and ms. i had intended to use an article that debunks multiple sclerosis and b12 deficiency, and then i was going to hack the study design and demonstrate that their assumptions were wrong. confusingly, i can't find that abstract. i would have thought it would be easy. they used a serum status of 300 pg/ml i believe, as the dividing line to assess deficient vs not. now, however, when i google search, the amount of linkages between b12 and MS are so all over the place that i can't even figure out why it's a differential diagnosis. it all seems like part of the same thing. i wish i could remember more about my research path in early '06, because surely all this info was available then! anyway, in relation to the current thread:

The linkage of cobalamin and folate deficiency to psychiatric illness has been studied and debated since these vitamins were first discovered in the 1940s. The clinical relevance of these deficiencies remains the subject of investigation and scholarly discussion. This article reviews case reports and studies derived from a MEDLINE search for English-language articles related to folate, cobalamin, and psychiatric illness. Emphasis is given to clinical research and recent developments. Preclinical evidence for direct effects of folate and cobalamin on brain functioning is compelling, and numerous associations of their deficiencies to psychiatric illness are evident. These vitamin deficiencies may typically present initially with psychiatric symptoms, but any direct causal relationship to specific neuropsychiatric illnesses are not well defined. The relationship of these vitamins in dementia is significant, but they may only rarely be a cause of truly reversible dementia. Folate deficiency appears most tightly connected with depressive disorders, and cobalamin deficiency with psychosis. Contrary to intuition, vitamin deficiencies appear to occur infrequently with eating disorders. Other diagnoses have been investigated much less extensively. The diagnosis and management of these deficiencies in the context of neuropsychiatric illness is still a matter of discussion. The quality of clinical research in this area is improving, but there are many unanswered questions that affect clinical practice. Clinicians should remain vigilant to the possibility of deficiencies of folate and cobalamin in diverse psychiatric populations. Normal hematological indices do not rule out the deficiencies. Further study is needed to refine the detection and clinical management of these vitamin deficiencies in psychiatric populations.
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Postby msmything » Sun Jun 29, 2008 7:09 pm

Yep emotional lability is a hallmark of the disease itself, then add on the stresses of medications, and the every day stress of not being at optimal performance level.
At first I thought I was just becoming an old crotchety B**** so it's kinda cool to have scientific data supporting my B****iness LOL!
Oddly enough though, things that used to make me feel like going off don't, and relatively benign situations make me have to bite my tongue.

My poor husband doesn't know how often the sound of his breathing has made me feel murderous..(he doesn't snore, he's not a particularly loud breather, but sometimes I feel like screaming shut up!

Nice huh?
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Postby jimmylegs » Sun Jun 29, 2008 7:19 pm

i know what you mean msmt! i'm glad i've been taking my b vitamins because with all the other insanity going on in this house, i am on eggshells anyway never mind being ready to snap myself. frustrated, yes. inappropriately, no. sigh! but i guess we can try to do something about it with good ol b vitamins.

cheer, reading back over the thread i noticed this:
My husband had signs of depression and anxiety for years before his MS diagnosis and beginning Copaxone, so we knew his was pre-existing.


so what with those psychiatric abstracts, and mention of ms, seems like there're some strong linkages there, as if the depression might possibly have been a kind of early warning that they missed?
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Postby msmything » Sun Jun 29, 2008 7:28 pm

Dr. Arnason at the univeristy of Chic says that panic disorders are very common among our population as is depression.

Chicken or the egg.

My current doc says that my disease course probably started at about 20, and was ramping up pretty good in my 30's. I had only one panic attack, but it lasted the whole decade.. ...
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Postby jimmylegs » Sun Jun 29, 2008 7:40 pm

yep, sounds like b12 and folate may be one of a few interrelated usual suspects in both ms and depressive scenarios. interesting.
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