b'Medication-Induced PsychosisThe prevalence of schizophrenia and/or psychosis among people with MS issmall, but still higher than that of the general population. Symptoms of psychosisinclude delusions (false beliefs) and hallucinations (seeing or hearing things thatothers do not see or hear). Other symptoms can include incoherent or nonsensespeech and behavior that is inappropriate for the situation. A person in a psychoticepisode also may experience depression, anxiety, sleep problems, social withdrawal,lack of motivation, and diculty functioning overall.At times, psychosis may be induced by certain medications used in the treatmentof MS, particularly corticosteroids used to treat relapses. This is a rare and reversibleside eect, of which anyone taking steroids should be aware. However, a personexperiencing delusions or hallucinations may not recognize that they have aproblem. It is useful to make a family member or friend aware of this potentialside eect when being treated with corticosteroids. Fear of this very rare side eectshould not stop you from accepting steroid treatment if recommended by yourhealthcare team.How Your Mental Health Aects Your Physical Health As you read through the symptoms of the various mental health conditions MS cancause, you may have noticed that physical symptoms are not uncommon. Mentalhealth can aect sleep, appetite, digestion, heart rate, and breathing. In people with MS,untreated mental health conditions also worsen fatigue, pain, and cognitive symptoms. Over time, these eects become even more serious than they may appear at rst.In the long term, untreated mental health conditions can contribute to a variety ofserious health problems:High blood pressureWeakened immune system Respiratory conditionsObesity Diabetes Digestive health problems Arthritis Reduced life expectancy The increase in risk is not small. One study of people with untreated mentalhealth conditions found those living with high levels of anxiety and depression were65 percent more likely to develop a heart condition, 64 percent more likely to havea stroke, 50 percent more likely to develop high blood pressure, and 87 percent morelikely to have arthritis than people who did not have anxiety or depression. Why do these conditions contribute to such serious health problems? For avariety of reasons, some physical and some behavioral. People with poorly managedmental health issues are more or less likely to engage in certain health behaviors.More likely to: Less likely to:Smoke See a doctor regularAbuse substancesSeek social supportEat poorly Stay active/exercise9'