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Suicidal Thoughts Not Uncommon in MS
New research has identified risk factors for suicidal thoughts among people with MS. Find out what you should watch for.
By Jennifer Acosta Scott
Medically Reviewed by Pat F. Bass III, MD, MPH
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Many people have some awareness of the physical symptoms of multiple sclerosis (MS), but another challenge lurks for those with the condition: an increased risk of mental health problems, including suicidal thoughts.
As many as 50 percent of people with MS will experience major depression in their lifetime, compared to less than 20 percent of people without MS, according to the American Academy of Neurology.
MS and suicide are also linked: Suicide may be twice as likely among those with MS, the Academy says. And now, new research has highlighted factors that may help identify MS patients particularly at risk for suicidal thoughts.
Risk Factors for Suicidal Thoughts
A six-month study published in April 2014 in the Journal of Psychosomatic Research attempted to determine how common suicidal thoughts were in people with MS, as well as what personal characteristics and/or symptoms related to MS raised the likelihood of having such thoughts.
The findings could help doctors uncover emotional problems in their patients that might otherwise stay hidden, says Scott Patten, MD, a professor at the University of Calgary in Canada, who co-authored the study.
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“Suicide remains highly stigmatized,” Dr. Patten says. “What often happens is people have those thoughts, and there’s a sense of shame or failure that goes along with that. So they don’t reach out for help from others.”
The study found that the following factors predicted suicidal thoughts in people with MS:
Older age. In the study, people aged 65 and older with MS were four times as likely to engage in suicidal thoughts (sometimes called suicidal ideation) as younger people with MS.
Bowel and bladder problems. The study found that participants who reported bowel and bladder symptoms as a complication of their MS were more than twice as likely to have suicidal thoughts.
Low self-efficacy. Participants in the study were given a quiz and asked to rate their ability to perform difficult tasks or to deal with unexpected events. Those who gave themselves lower ratings were more than three times as likely to have suicidal thoughts.
Speaking and swallowing problems. People whose MS symptoms involved trouble with swallowing or talking were almost three times as likely to experience suicidal ideation.
Emotional coping style. The MS patients in the study were given a questionnaire to determine how they dealt with adversity. Patients who said they coped with difficulty in an emotional way were more likely to have suicidal thoughts than those who dealt with problems in a task-oriented manner.
How to Help a Suicidal Friend or Relative
If you have a friend or family member with MS who has any of the problems or characteristics listed above, it’s important to know that they are considered risk factors for suicide and to take them seriously. Here’s how you may be able to prevent a suicide related to MS or its complications:
Watch for signs of depression. Depression is a major predictor of suicide. People with severe depression are twice as likely to commit suicide as those without it, according to a review published May 2013 in the Journal of Affective Disorders.
Signs of depression include irritability, difficulty sleeping, persistent sadness, and loss of interest in activities that were once enjoyable. Depression shouldn’t be accepted as just a part of having MS, says Rosalind Kalb, PhD, vice president of clinical care at the National Multiple Sclerosis Society.
Treatment for depression can include medication, cognitive-behavioral therapy, other forms of psychotherapy, or a combination of approaches.
Encourage your loved one to seek help. People with MS often react very emotionally to complications like bladder problems or difficulty speaking, Dr. Kalb says. But once they learn ways to treat or deal with the symptoms, they become less likely to have suicidal thoughts.
Incontinence, for example, usually isn’t an unavoidable part of having MS. Medications, nerve stimulation therapies, and even catheterization may help. Speech and swallowing problems can be treated with help from a speech therapist.
If your friend or relative is experiencing bladder, bowel, speaking, or swallowing problems, encourage him to tell his doctor.
Talk to the doctor yourself. Sometimes people at risk for suicide are reluctant to tell their doctors about the health issues that are causing them emotional distress — or the fact that they are experiencing emotional distress. If you find this happening to a friend or family member with MS, you may want to call the doctor yourself.
“When you’re depressed, sometimes you don’t even know it anymore,” Kalb says. “It’s important to let the doctor know if the person with MS isn’t talking about it.”
The sooner the difficulties are dealt with, the easier it will be to solve them, she adds.
“Trying to wait it out is just not a good strategy,” she says.
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