FATIGUE AND DEPRESSION
By:
Prof. Dr. Nevin M. Shalaby.
Professor of Neurology – Cairo University and moderator of Multiple Sclerosis Unit – Cairo University.
Prof. Dr. Hatem S. Shehata, Professor of Neurology – Cairo University.

Multiple sclerosis (MS) is a chronic disease that affects the quality of life for the patients as it causes major changes in the patients’ view to the future in addition to changing the dynamics of dealing with surroundings.
These changes occur with many chronic diseases, but they become more obvious with MS, being a disease with bad reputation and many misconceptions regarding physical handicap, occupational functions, social relationships and psychological status. 
Specifically M.S is associated with major psychological changes and depressive manifestations owing to several reasons;
(1)    The disease comes in unexpected bouts which make the patient has a sense of fear all the time.
(2)    It is a mysterious disease for most of the patients as it is unclear compared to other heart, liver, and kidneys diseasesand even stroke, sothe patient feels that something obscure like a ghost with many hidden masks is trying to steal the joy of his life in the most vital years. Then he/she begins a journey to find the truth about the disease from sources which may not be reliable, leading to getting false beliefs about it.
(3)    High expenses of the treatment make the patient feels thathis basic therapy is out of reach.
(4)    Absence / inadequate patients’ education and weak medical and social awareness.
In order to live with a chronic and ambiguous illness we should know our weapons and we have to overcome our weaknesses depending on the "four-analysis" of the situation ‘SWOT’ analysis:
•    STRENGTHS: the elements of power in your personality and that differentiate you from the others. 
•    WEAKNESSES: weaknesses in your personality and how to overcome them.
•    OPPORTUNITIES: that can come from the outside (financial, emotional supports).
•    THREATS: that can come from the outside (as social threats like a possibility to leave work, marriage failure... etc.)