Ask The Doctor: August 2021
Q. A dear friend of mine was just diagnosed with multiple sclerosis (MS), but she recently turned 60. I always thought that MS was a disease that developed at a much younger age. Is this unusual?
A. The typical age of onset for MS is between 20 and 40, but the condition can affect people on either side of that range. It seems your friend has what is commonly referred to as “late-onset MS,” which affects about 5 percent of people with multiple sclerosis. MS is a disease of the nervous system, in which the communication between the brain and the body becomes disrupted. The flow of information within the brain is also affected.
There are two forms of MS: relapsing-remitting and progressive. In the relapsing-remitting form, people have recurrent episodes with symptoms such as numbness, tremor, dizziness, and vision problems, and periods where they are symptom-free. Older individuals who are diagnosed with MS usually have the progressive form, in which symptoms don’t come and go. In fact, symptoms tend to get worse over time.
But the progression of symptoms can be gradual, especially if an individual with MS eats a healthy diet, exercises regularly, gets enough sleep and manages stress, which can be a trigger for worsening symptoms. Medications may also help slow the progression of the disease.
Q. Are there any aspects of memory that improve or at least stay the same as you get older, or do all aspects of memory decline?
A. Episodic memory—recalling specific details about the events in your life—tends to decline as we age. It’s a frustrating development, but it’s a part of age-related memory loss that affects just about everyone. Semantic memory, however, often lasts a long time without change. Semantic memory is the part of your long-term memory that is more focused on ideas and concepts, as well as knowledge not drawn from your personal experience. Semantic memory includes things like recalling state capitals, identifying colors and sounds, and knowing how to tell time.
As you live your life, the bits and pieces that make up your semantic memory tend to grow. You do become wiser in many ways as you get
older. While this doesn’t help when you’re trying to remember a computer password or the name of a new neighbor, it can be comforting to know that a certain amount of knowledge obtained throughout your life should remain intact.
Q. I’ve been told that if I quit taking antidepressants “cold turkey” that I could go into antidepressant withdrawal. Does that mean that I’m addicted to these medications?
A. A person who experiences antidepressant withdrawal isn’t necessarily addicted to an antidepressant. Addiction to a drug or alcohol is usually marked by severe cravings, little or no ability to control the use of the substance, and negative consequences in everyday life related to the dependence on that substance. Antidepressants don’t cause these problems.
In fact, antidepressant withdrawal is also referred to as antidepressant discontinuation syndrome to better distinguish it from withdrawal symptoms related to traditional drug addiction. Antidepressant discontinuation syndrome is characterized by feelings of anxiety and irritability, insomnia and/or fatigue, dizziness, headaches, and other flu-like symptoms.In many cases, depressive symptoms can return.
If you want to stop taking your antidepressant, or your doctor believes you may not be getting any ongoing benefit from the medication, you two should work on a plan to gradually discontinue use of the antidepressant. In some cases, a doctor might prescribe a different
antidepressant or another medication to reduce the severity of symptoms while your body adjusts to the change. Your doctor may also recommend that you gradually reduce the dose of your antidepressant.
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