MS and Suicidal Thoughts: Warning Signs and Where to Get Help

Introduction

Living with multiple sclerosis (MS) is often described as fighting a battle on two fronts—physical and emotional. While the physical symptoms like numbness, fatigue, and muscle weakness are widely acknowledged, the emotional toll is often less visible and harder to talk about. Depression and suicidal thoughts are not uncommon in people with MS, but they remain deeply stigmatized and misunderstood.

If you or someone you love is silently struggling, this article is here to offer understanding, validation, and support. You're not alone—and there is help available.

Looking for online therapy? Click here.

🧠 Why MS Increases the Risk of Suicidal Thoughts

MS is more than a neurological condition—it’s a life-altering diagnosis that affects every aspect of your identity, relationships, independence, and sense of control. The risk of suicide among people with MS is significantly higher than in the general population.

Why? Here are several reasons:

Inflammation-related depression: MS is a disease of the central nervous system, and the inflammation associated with it may contribute to biochemical depression.
Chronic pain and fatigue: Living in a body that doesn’t cooperate can wear down even the most resilient people.
Cognitive dysfunction: Brain fog, forgetfulness, and slowed thinking can cause frustration, shame, and self-doubt.
Social isolation: MS can make it difficult to maintain a job, participate in activities, or feel understood by others.
Loss of autonomy: Fears about disability, dependency, and unpredictability can lead to hopelessness.

Knowing this, it’s vital to recognize suicidal ideation not as a personal failure but as a serious mental health symptom that deserves compassionate attention—just like any other MS symptom.

⚠️ Common Warning Signs of Suicidal Thoughts in People with MS

Suicidal ideation can be passive (“I wish I wouldn’t wake up tomorrow”) or active (“I’m thinking about ending my life”). People don’t always say it outright—so it’s important to watch for emotional and behavioral red flags, both in yourself and others.

Emotional warning signs:

Persistent feelings of hopelessness, worthlessness, or being a burden
Sudden mood changes—especially a calm period after deep depression
Loss of interest in previously enjoyed activities
Anxiety or agitation that seems unmanageable

Behavioral warning signs:

Talking about death, dying, or “disappearing”
Giving away possessions or saying goodbye
Withdrawing from friends and family
Changes in sleep, eating, or hygiene habits
Risky or self-destructive behaviors

Physical changes:

Increased fatigue or chronic pain
Worsening of MS symptoms related to stress or mood

If you recognize these signs in yourself or someone else, it’s essential to act early. Waiting doesn’t make things better—compassionate intervention can.

🛑 “But I Don’t Want to Be a Burden…”

One of the most common thoughts among those experiencing suicidal ideation is the belief that their loved ones would be “better off without them.” This is especially common in chronic illness where independence has been compromised.

But let’s be clear: This is a symptom of depression. It is not the truth.

You are not a burden—you are a human being facing enormous challenges. Your life holds value beyond your productivity. Your existence brings connection, learning, love, and meaning to others, even when you can’t always see it.

📞 What to Do If You’re Having Suicidal Thoughts

First, know that help exists and recovery is possible. Many people with MS have been in the dark place you're in—and they found a way forward.

Here’s what you can do:

1. Tell someone you trust

Speak with a friend, family member, or caregiver. You don’t have to say “I’m suicidal”—you can start with:

“I’m not doing okay.”
“I feel really overwhelmed.”
“I’ve been having dark thoughts.”

2. Call a crisis line

You don’t have to be at rock bottom to reach out. Trained professionals are available 24/7. Some options include:

USA: 988 Suicide & Crisis Lifeline (call or text 988)
Canada: Talk Suicide Canada at 1-833-456-4566
UK: Samaritans at 116 123
International: Befrienders Worldwide

3. Talk to your neurologist or MS nurse

Let them know how you’re feeling. They can refer you to a therapist or psychiatrist familiar with MS.

4. Seek professional mental health support

A therapist can help you make sense of your feelings, learn coping tools, and feel less alone. There are many therapy styles available (CBT, ACT, trauma-informed therapy) that can be tailored to your needs.

Looking for online therapy? Click here.

🧰 Coping Strategies That Can Help in the Moment

When your emotions feel unbearable, try these grounding techniques to create a sense of safety and control:

🖐️ The 5-4-3-2-1 Grounding Exercise

Identify:

5 things you can see
4 things you can touch
3 things you can hear
2 things you can smell
1 thing you can taste

🧘 Box Breathing

Inhale for 4 counts → hold for 4 → exhale for 4 → hold for 4. Repeat. Want to try breathwork? Click here.

📒 Write down the thoughts

Getting your thoughts out of your head and onto paper can reduce their power and help you see patterns.

📱 Text a crisis line

Typing out your thoughts to someone who won’t judge can make a huge difference, especially in the middle of the night.

🧠 Depression vs. Suicidality: Know the Difference

Not everyone with depression has suicidal thoughts, and not everyone with suicidal thoughts is clinically depressed—but they are closely linked.

Depression in MS is often underdiagnosed, as some symptoms overlap with MS itself:

Low energy and fatigue
Poor concentration
Changes in appetite or sleep

But emotional pain, loss of pleasure, and intrusive thoughts should never be ignored. It’s not “just part of MS”—it’s a serious condition that deserves treatment.

🫂 What Family and Friends Can Do

If someone you care about has MS and you notice warning signs, don’t wait for them to ask for help. Gently express concern:

“I’ve noticed you’ve been quieter lately—how are you really doing?”
“You matter to me. I’m here if you ever want to talk.”
“Would it help if we called someone together?”

Avoid:

Offering clichés like “Just stay positive.”
Minimizing (“Others have it worse”).
Trying to “fix” it with logic.

Do instead:

Listen without judgment.
Ask open-ended questions.
Help them find resources.
Check in regularly.

🛠️ Therapies That Help Suicidal Thoughts in MS

1. Cognitive Behavioral Therapy (CBT)

Helps you challenge unhelpful beliefs and reframe thought patterns.

Looking for online therapy? Click here.

2. Acceptance and Commitment Therapy (ACT)

Teaches you to accept your feelings without being ruled by them.

3. Dialectical Behavior Therapy (DBT)

Focuses on emotional regulation and crisis management skills.

4. EMDR (Eye Movement Desensitization and Reprocessing)

Can help process trauma related to diagnosis or hospital experiences.

5. Medication

In some cases, antidepressants or mood stabilizers may be helpful—especially when depression is linked to inflammation.

💡 A Note on Hope

Hope isn’t about pretending everything is fine. It’s about believing in the possibility of change, even when things feel bleak.

You don’t need to know exactly how you’ll get through this—you just need to believe that with help, you can.

❤️ You Are Not Alone

Suicidal thoughts are more common in MS than people realize—and that makes talking about them even more important. Whether you’re in crisis or just starting to feel the weight of despair, you deserve to be heard and supported.

There is no shame in struggling with your mental health.
There is no weakness in asking for help.
You are not a burden.
You are a person—worthy of love, healing, and care.