Bringing the Outdoors In: Virtual Nature Walks for Depression in Multiple Sclerosis (MS) Patients

Inclusion Criteria: * Confirmed diagnosis of progressive Multiple Sclerosis (MS, primary or secondary) by a neurologist or an MS center * Patient-Reported Outcomes Measurement Information System (PROMIS) Depression T-scores \>55 at baseline * Ability to provide informed consent and participate in VR sessions at home * For Some Participants (Groups 1 and 2) currently receiving antidepressant or psychotherapy treatments (Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), or psychotherapy) for the management of depression Exclusion Criteria: * Severe cognitive impairments or visual deficits that may interfere with VR use, including contraindications like agoraphobia, claustrophobia, or motion sickness * Current participation in other clinical trials targeting depression * Severe psychiatric conditions that require hospitalization, or suicidal ideation, passive or active, psychosis, or active substance and alcohol abuse (score greater than 1 on CAGE (Cut down, Annoyed, Guilty, Eye-opener) Adapted to Include Drugs (CAGE-AID)) * Another neurological or autoimmune disease per protocol * Participants that require vision correction, unless that vision correction is mild (± 1), or the participant has prescription contact lenses.