It hit like a body blow – fast, hard, and unexpected. In the course of a day, I went from feeling unwell but reasonably happy to deeply depressed. I heard myself begin to apologize for every bit of space I inhabited, for every need, for every way that my life touched the lives of those around me. For the past few weeks I have awakened morning after morning sad, lonely, and insecure. It is as if all the years I spent developing a place for myself in the world and building loving, egalitarian relationships have suddenly melted away and I have reverted to the damaged child I was when I emerged from my difficult childhood. Even as the weight of my life rests on my shoulders, the cause of my sudden, desperate sadness is clear to me: after months of trying different treatments, my breathing problems have persisted, and the pain and fatigue have finally worn me down. For the first time in the months of struggle against this symptom I lost track of the loving care I consistently receive from my family, friends, and doctor and fell into the narcissistic abyss of self-loathing.

Of course, I am not the first person with MS to become deeply depressed. In the 19th century, Jean-Martin Charcot, known as The Father of Neurology, was the first physician to provide a detailed clinical description of the disease we now call MS. He observed patients over their lifetimes and then studied them post-mortem, thus confirming that the source of their symptoms was MS scarring in the brain and spinal cord. His lectures on MS describe an array of symptoms he charcotsuggested physicians use to identify MS in their patients. As early as 1870, when referring to a patient he called Mademoiselle V, Charcot identified severe depression as one symptom of her disease. Charcot’s connection of Mademoiselle V’s depression to her disease was supported by the fact that she also suffered from a host of symptoms we now know are common to MS—emotional lability (inexplicable and uncontrollable fits of laughter or tears), double vision, vertigo, paralysis, and spasticity so extreme that she could not stand without the assistance of two aides.

Over a century later, I think of Mademoiselle V and her role in Charcot’s lectures, her pained body moving in ways she could not understand. What, I wonder, was she thinking? Her intellect was probably unaffected by the disease, so she was aware of her body’s slow deterioration and I can’t help but imagine that she felt misery and loneliness when that deterioration intruded on her life day after day. The illustration that appears on the cover of the collection of Charcot’s lectures that contains Mademoiselle V’s story portrays a naked woman, her arm throwncharcotookcover over her head in what appears to be an uncontrollable spasm, and a contorted face full of pain and fear. What Mademoiselle V could not have known is that by the 21st century MS would be considered the most common neurological disease and that according to the National Multiple Sclerosis Society it affects 2.1 million people worldwide. She could not have known that there would be a host of organizations whose work is to support patients, to help fund research, and to provide information to MS sufferers and their caregivers. More than that, she could not have known that one day the Internet would provide people with MS companionship and that we could communicate with others whose experiences are similar to our own and who can sustain us as we struggle to understand the debilitating changes our bodies impose upon us.

As Mademoiselle V stood before those men, her body and emotions out of her control, she also could not have known that even in the 21st century the symptoms she experienced would still be significant impediments to the happiness and comfort of people with MS and that even at this late date there would be no cure for the disease. The paralysis, spasticity, difficulties with speech, vertigo, emotional lability, and depression that were so much a part of her life would still plague people with the disease. While contemporary sufferers certainly have medications that help control MS symptoms, their effectiveness is sometimes hit and miss and more often than not a drug that relieves a symptom like spasticity exacerbates others—like muscle weakness and fatigue. I am deeply moved when I think of Mademoiselle V; I wish I could reach back to her, offer her support and camaraderie, and tell her that her suffering changed my life, that she not only helped give my disease a name but also helped me know that my own depression has a reason, that it makes sense and can be explained. I would be sorry that I would have to tell her that even after all this time MS cannot be cured and that in many cases its progression cannot be halted.

This brings me back to my own recent struggles with depression. Approximately 50% of people with MS will in their lifetimes experience some form of depression, and these depressive episodes can range from short-lived to chronic. There seem to be three main causes of MS depression: stressors like the progression of disability, loss of career and livelihood, changes in familial and/or romantic situations, etc.; demyelination of nerves in the brain that control emotions and emotional expression; and medications used to control symptoms or to help decrease the number of relapses in patients suffering from the relapsing-remitting form of the disease. Of course, many more circumstances faced by people with MS can cause or contribute to depressive symptoms, but these are considered the three most common.

As I say above, depression seems an obvious and even rational response to the daily experience of progressive MS. In my case, the severe spasms in my bronchial tubes and the girdling sensation I described in my last post distract me from most of the activities that are important to me. I awake each day determined to write a blog post, to participate in my online support groups, to answer e-mails, or to engage in the other activities that bring me joy and comfort these days. But day after day I find myself distracted and fatigued by the struggle to breathe against the intense spasms. More often than not, I am quickly reduced to a quiet sadness. Lately, as I have read about Mademoiselle V and pictured her there alone, sad, and in pain before those healthy men I want nothing more than to sit with her, to offer her some companionship, to share with her a song called “I am Willing” (performed by MUSE, Cincinnati’s Women’s Choir)   that brings me solace when I feel most alone, and to let her know that though Charcot is credited with naming and describing MS, her suffering contributed in ways she could not have known. I would tell her that it brings me real comfort to know that my own depression has an explanation that can be traced back to the earliest acknowledgement that my disease exists and that I thank her for that.

16 thoughts on “Mademoiselle V, Depression, and Multiple Sclerosis
  1. Nicely written. Your description of M. V. reminds me of so many women I have known who have MS. We know more about it than we ever thought there was to know, yet a cure is illusive. This is a very, very difficult disease.

    • Yes, and can you imagine how frightening and painful it must have been for her to wonder what was going on with her body? I imagine her as lonely and confused and it touches me deeply.

  2. Such ugly disease so beautiful written about. You got right to the painfull and heart rending point of it.
    How strong you are writing this despite of your troubles. Bless you.

    • Thank you for your kind words. I am always struck by how confusing this disease is; you never know what it’s going to throw at us next.

  3. Awesome Post! Although it is hard to read this, it amazes me how well you can express what you are feeling!! Love it!!

    • Thanks, Sis. I love knowing that you are always here reading. You are so generous with your love and support. I hope you know how much that means to me.

  4. Thanks for sharing! So happy to have another blog from you!

  5. Schultz, Lucille (schultlm)

    Oh, Michelle, I’m sending hugs even as I write . . . I love that you’ve tracked down the work of Charcot and Mlle. V . . . and are teaching your readers about it. Thank you for that, and for your tenderness for Mlle V. And like everyone who is dear to you, I’m so sorry that depression has caught up with you . . . and am hoping/praying for relief, however it might come. Meanwhile, whenever you feel up for a short visit, please let me know. And I hope you keep on writing; I find your posts very moving . . . and I hope that writing them is helpful, in whatever way, to you. Be assured that you are encircled with love . . . and that some comes from me. Lucy

    • Thank you so much, Lucy. Honestly, writing that post did a lot to make my mood a bit better. I think that learning about Mlle. V helped somehow. Besides that, I needed to remember that I have loving and compassionate friends like you.

  6. I am always ready to announce that, no, it is not depression, thank you very much. It is grieving, and that is why I get sad. The grieving is endless, as the opportunities for grief keep coming. But, at some point, there may be a tipping point. I don’t know what that would be for me, where I would concede that, just maybe, I might be depressed. Antidepressants and I have mostly not gotten along in the past so I guess I will continue to do the emotional work. I have to. You were very brave in how you have addressed this issue. Good luck. You really need to catch a break.

    • You have an excellent point, Judy! The word “depression” so often allows the assumption that the depression itself is the problem. It’s not; the problem is the MS. MS came first and the depression is a result of (not a cause of) the symptoms. You are also right, though, that sometimes the grief builds and builds to a “tipping point” and spills out all around us.

  7. Jane Lake Birt, this really helps to explain your current mental state. Also to illuminate for the rest of us the journey that you are taking.
    Thank you. the chicken in the sky looks down on us all.
    Love, Jane

  8. The blessed Chicken in the Sky, beautifully painted by you, watches over me as I write.

  9. Michelle, I hope you know that others (me and many I am sure) are sitting with you and Mademoiselle V looking for hope. Thanks for the information and for the song and for being your self…however that is.

  10. Hello! This post couldn’t be written any better! Reading through this post reminds me
    of my good old room mate! He always kept talking about this.

    I will forward this write-up to him. Fairly certain he
    will have a good read. Thank you for sharing!

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