Research News: Good news about MS & Depression

So there I was last week complaining that the boffins weren't connecting the dots - between MS and depression - and all the while there was the latest paper from the HOLISM Study sitting in my inbox, and it's looking into exactly that! 
It's a very useful paper, especially for those of us living with MS, and as you might imagine, it contains both good news and bad news.

The bad news is that people with MS are considerably more likely than the general population to experience depression. We also have higher risk than people with other chronic conditions. But if you have MS, you probably knew that already... 

The good news is that there are things we can do - or "modifiable lifestyle factors" as the study calls them - that can make a significant difference! OK, you probably guessed that too, but doesn't it seem more solid now we know there is peer-reviewed scientific evidence to prove it?

Don't Do This

The study found that certain lifestyle factors are associated with increased risk of depression in people with MS. These are:

• Poor diet
• Little exercise
• Obesity
• Smoking
• Social isolation
• Taking interferon

I imagine these would increase anyone's risk of depression, come to think of it! 

I must admit to cringing a little as I read this, as I know that I get nothing like as much exercise as I could! 

Do This

The study's recommendations make much cheerier reading. The researchers point out that making the following changes will reduce our risk of depression:

• Healthy diet including some fish
• Supplementing with daily Omega 3 oil
• Supplementing with vitamin D3
• Regular exercise
• Regular meditation
• Social support 
• Stopping smoking

Of all these factors, it was perhaps meditation that showed the greatest risk reduction for depression. The study found that people with MS who meditated at least once a week halved their odds of getting depression. That's pretty encouraging stuff in my book!

Anyone following the OMS Recovery Programme will already be doing most if not all of these, and of course there is detailed discussion of some of the evidence supporting these measures in Prof Jelinek's book. In the coming weeks I'll be posting more information about each one in turn, so watch this space!

To read the full paper - free of charge - go to the BMC here.

How are you?

The trouble with any kind of autobiographical writing is that the story isn't finished yet. As philosopher Joseph Campbell and many psychologists would tell you, we humans generally use narrative structures, or stories, to understand and explain our experience of life. But a narrative requires a shape, ideally a pleasing arc, with a dramatic beginning, a problematic middle, and a satisfying end. Life, unfortunately for the would-be writer, is not very obliging in this respect.

Both the conditions that I live with are notoriously unpredictable. I'm not even able to answer the simple question "How are you?" with any accuracy. I always feel a need to clarify: "Do you mean how am I today, this week, this month, or this very moment?" Because, you see, it really is that changeable. 

This moment, as I sit here writing, I feel physically well, and mentally/emotionally a little fragile but more or less functional. However, whenever it is that you open this page, dear reader, I may be suffering a burning neuropathic pain, or straining against a bone-deep fatigue, or training for a 10k run, or floundering in a suicidal mire. Five minutes from now, a difficult phone call, stray Facebook comment, or other apparently innocent interaction may trigger in me a dangerous rage or a soul-sucking depression that drives me back to the brink. Or a minor trip, bump, or upset may set off a full-blown MS relapse.

We wait for the neurologists and the psychiatrists to realise that a human being is a single entity that cannot be so neatly compartmentalised, and figure out what is really going on within the Bermuda triangle of MS,  depression, and emotional volatility. Meanwhile, those of us who are not content to wait for yet another liver-toxic drug - which would only treat the symptoms anyway - must find our own way to surf the stormy seas of our inexplicable lives. And find mine I will, even if it takes a lifetime.

So it would seem that I have no nuggets of wisdom to offer today. Today, I cannot write my life - blogger, columnist and almost-author though I may be - because the truth is I haven't finished living it yet.

A moment of choice

Sometimes it’s amazing how easy it is to take for granted just how far I’ve come on this journey back to health, even to the point of sulking when this “miraculous” healing doesn’t fit my schedule. Sometimes I am ashamed of my own ingratitude at the great fortune I’ve had.

This is what depression does: it hides the good stuff and emphasises the bad. But I’m learning that life always gives me the opportunity to choose a different reaction, to step back and look again. That’s why I’m sharing this one with you, dear readers, because I think it’s good to be honest about just how stupid we can be sometimes, and how simple it can be to make a better choice.

I walked for over two hours today, across country, up and down hill, with nothing but a five minute sit-down along the way. I didn't use a stick or lean on my husband. I didn't stumble. I didn't feel pain.

I feel miserable, defeated. Why? Because after walking for over two hours, I am now too exhausted to walk back. I'm sitting here in the middle of nowhere waiting helplessly while my husband walks all the way back to the campsite alone to get the car so that he can pick me up and drive me back to base. I wanted to train for my sponsored walk today, but I failed completely, and ruined my husband's day in the process.

Just a few hours ago I was blissfully happy, relishing the warm autumn sunshine, the spectacular Carmarthenshire countryside, and the unfamiliar sense of freedom, being able to just keep walking without worrying, without pain. What changed? Has all that disappeared?

By dosh13, via Wikimedia Commons

Suddenly the early evening sun catches the leaves and grass around me, in four dozen greens and yellows, and I hear myself exhale deeply. A surprising little thought slips quietly into the back row of my mind: What if I chose not to see this as a failure? What if I could play "Pooh" in this story instead of "Eeyore"?

It's a seductive idea. I try it on for size, testing how it might be to feel "ok anyway", checking that it will take the weight of my cynicism. It holds; I can trust this. I realise that it's safe to make a new choice, and let go and relax into that.

I begin to notice more: the sounds of the kids playing in this park where I'm sitting, the heaviness beginning to release my tired feet and legs. I check my watch and realise that my husband will get here soon. I'd better make the most of this moment of quiet in the sunshine while I can. I begin to feel excited to be here in this little village park in the Welsh countryside, so far from the racket and tension of the city, and the gloom of my ordinary life. An hour where I can only sit and rest, and “just be” in this moment - what a gift!

I walked for over 2 hours today, across country and up and down hill, with nothing but a five minute sit-down along the way. I didn't use a stick or lean on my husband. I didn't stumble. I didn't feel pain.

I feel proud of a great achievement and grateful for my health. What a difference a moment makes.

How do you build a new woman?

We can rebuild her, we have the technology >>>>>>>>>>

Yesterday was a "Why" moment. Today is about the "How".

If we take Einstein's definition of insanity, "to keep doing the same thing and expect a different result", then I've been insane for years. So has the whole human race.

On that basis, here's what I won't be doing any more:

1. Beating myself up for getting sick. Usually I blame myself when I have an MS relapse or a depressive episode, and usually this involves crediting any of the following heinous crimes:

• eating the "wrong" foods
• not getting enough exercise
• not sleeping 8 hours a night
   and mostly, these days ...
• getting too stressed about any of the following:
  my job - my marriage - my "To Do"  list - "unethical" shopping habits - the Middle East - the state of British politics and how little I'm doing about it - casual racism - dealing with call centres - regrets about not having children - regrets about past mistakes - regrets about things that were never my fault in the first place - feeling guilty about not being at work while my husband is working his butt off - feeling guilty about spending money when I'm not earning any myself - feeling guilty about everything ...
  

2. Getting a whole new plan in my head, being completely unrealistic about how much difference it will make in a very short time (usually about 3 days), and then getting so disheartened / self-critical that I end up ...

3. Eating rubbish or bingeing on TV box sets before quickly returning to Step 1.

So what will I be doing?

I know that there are lots of things I could do - and have done - to support the body-mind's build-in repair and maintenance systems. I also know that I need to do something new (like the physicist said). Or possibly something old, but in a new way. 

So I need to make room in my head for intuition. I have always followed what my rational mind told me to do, even to the point of over-riding my voice of my intuition. When I started this last job contract, my intuition was shouting at me, "No, not now, not this!", and I ignored it because I couldn't rationalise it. This is something I'm aware of doing over and over throughout my adult life. It's left me indecisive, stuck between what my intellect wanted and what my intuitive self was counselling.

So this time, just as an experiment, I'll listen to my intuition. Starting with - for no other reason than it feels like a good idea - a complete physical and mental cleanse. I've read memoirs of people who have used cleansing to open up more space in their lives, to clear out old mental and emotional habits, all the baggage that we carry from the past, our parents, our society. Apparently cleansing can clear out a lot of physical problems too. It includes cutting out poisons like TV, news, caffeine, pain pills etc and replacing them with music, oxygen, exercise, enemas, meditation and sleep. It won't mean a huge change in diet because I already "eat clean" anyway (more on this later). And even if it doesn't do any of these things I've read about, I can reasonably expect clearer skin and better sleep within a week or so. Might save a few quid on newspapers and coffees too.

Seems a long way from the arse-kicking bionic woman, but I'm happy to start small. 
That's another new thing: making small quiet changes instead of dramatic grand gestures.

Life begins at 39 and 11 months

You may have read astounding, inspiring life stories of people who have miraculously healed from terrifying illnesses, diseases that we think of as incurable and fatal, diseases that we fear so much that we use euphemisms to avoid saying their names. I certainly have, and I love these memoirs - they inspire me and I often turn to them when I need to remember that life is infinitely more unpredictable and mysterious than we tend to believe.

This is not one of those stories. I am not dying. The problem is, I'm not living either. Can you relate? I'm nearly 40, and I'm afraid of everything, except perhaps death itself. No, death is a rather friendly thought in my imagination, it represents the end of my grey existence. A final letting off the hook of the life I'm too scared to live. I do fear my deathbed though. I have no doubt that if I were dying today, the regret would be total, it would be suffocating.

And today - as I recover from my 5th attack of Multiple Sclerosis and as the steroids and midsummer Sun burn the faintest break in the thick cold cloud of the depression that has been my prison for over 2 decades - today, I begin to create a new me. A new everything. Because I don't want to be too afraid to live any more. I am making a promise to myself, a solemn vow right here on this Tuesday afternoon pavement table, surrounded by rucksacked tourists, street traders and baby buggies, to do whatever it takes to finally inhabit my own life. There are no sacred cows here. There is nothing I will not do, try or sacrifice if I believe it is required.

Those stories, the ones that end with the once terminally ill person dancing off into the sunset - happy, healthy, healed - they always seem to start from a life-and-death moment, don't they? They're in the hospice, with days to live. The tumours have spread to every organ system. The doctors are about to switch off the machines.

If I carry on for the next 20 years as I have for the last 20 - flash forward to 60 years old - that could be me. And maybe I too would have a miraculous recovery, write a book, and dance off into the sunset. I believe it's possible: I know that the body has an astounding ability to heal itself, given a chance. So why wait to get that sick? 

When would now be a good time to start?

For once, I'm making a proactive choice. I'm not going to wait till I'm dying to start living.