Treating depression in any of its forms is almost invariably helpful. The nice thing about depression, unlike MS, is that we have a large range of very effective things that can be done to treat it. For most depressions psychotherapy can be very helpful. It can be of significant help for the person with MS in accepting and adjusting to his or her new condition. Psychotherapy facilitates normal mourning, it helps develop and strengthen coping skills, and it examines and exposes malfunctioning thinking that can exacerbate or cause a depression.
Many depressions respond to psychotherapy alone, sometimes quickly, sometimes more slowly.
Medication is likely to be needed when a depression has direct physiological roots. It is very likely to help when MS lesions interfere with those areas of the brain that relate to mood. It is also indicated when the depression seems unrelated to environmental factors, or when psychotherapy alone does not seem to be helping. It is particularly important when the depression has gotten sufficiently severe that self destructive acts are contemplated or if sleep is so disturbed as to prevent normal functioning during the day. Family, couples and group therapies are also often very helpful.