Tuesday, September 20, 2022

Can Stress Make Ms Worse

What Is An Autoimmune Disease

Why do people with MS feel worse when they experience stress?

Autoimmune diseases develop when a persons immune system goes after its own tissues and organs. Autoimmune disease can affect all parts of the body. For example:

  • Type 1 diabetes. This is the type that usually affects kids and develops when abnormal antibodies attack certain cells in the pancreas, leaving it unable to produce enough insulin, so the body cant regulate blood sugar properly
  • Rheumatoid arthritis. Multiple joints and other organs become inflamed the cause is unknown, but the presence of autoantibodies and other abnormal immune function suggest it is an autoimmune disorder.
  • Pernicious anemia. In this condition, anemia develops when the immune system produces antibodies that prevent absorption of vitamin B12 from food.

And these are just a few. Autoimmune conditions are especially scary because the immune system goes rogue for no apparent reason.

Autoimmune Disease And Stress: Is There A Link

A new study has raised the possibility that stress may cause autoimmune disease, such as lupus or rheumatoid arthritis, because it found a higher incidence of autoimmune diseases among people who were previously diagnosed with stress-related disorders.

I have patients who heard about this research and are saying, “I knew it!”

But before we accept a potential link between stress and autoimmune disease, lets look at some details of the study and consider how we define the terms “autoimmune disease,” “stress,” and “stress-related disorder.”

What Are The Main Risk Factors For Multiple Sclerosis

Multiple sclerosis results when your immune system attacks the cells of the brain and spinal cord. It is an autoimmune disease, a condition in which the bodys immune system is misdirected and attacks its own cells.

The exact cause for MS is not known, however, and several factors can put you at risk of getting MS:

  • Age: MS can occur at any age, but the most common age group is 15 to 60 years.
  • Sex: MS is more common in women than in men.
  • Genes: Although MS is not hereditary, you are more likely to get MS if you have a family history of MS.
  • Smoking

The factors listed above often act interdependently to cause MS rather acting in isolation. For example, female individuals with a family history of MS are more likely to get MS compared with those females who have no family history of MS.

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What Is An Ms Relapse

An MS relapse is caused by acute inflammation in the central nervous system damaging the protective myelin. As a result, new MS symptoms occur or old symptoms worsen, but to be defined as a relapse they must be separated from the previous flare-up by at least 30 days and last for at least 24 hours. There must also be no other explanation for the symptoms for example fever, acute infection or acute stress in such cases the new symptoms would be classified as a pseudo-relapse.

Symptoms will vary from person to person and can range from mild sensory disturbance to severe new disability. For example, in some cases it can be just one symptom while others may experience several new symptoms at the same time.

MS relapses can last from several days, to weeks or even months. In relapsing-remitting MS, exacerbations are followed by remissions. Some people will find that they go back to how they were feeling before the exacerbation but going into remission doesnt mean that symptoms always disappear.

What Is The Prognosis For People With Multiple Sclerosis

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In some cases, multiple sclerosis does lead to disability and loss of some physical or mental function. But thanks to advances in treatment, most people with MS will continue to lead full, active and productive lives. Taking steps to manage your health and lifestyle can help improve your long-term outcome.

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We Know Ms & Stress Dont Mix

This article should be no surprise to those who know even a little bit about multiple sclerosis. There have been numerous studies done confirming that stress is a problem for those with the disease. There have even been some studies trying to pinpoint it as a cause of MS. I could link a lot more studies, but again, I feel like this is all pretty well-known stuff thats been covered before. Im here more to talk about how its affected me. Like everything I write, I hope it explains what it can be like to have MS. If this article can help you explain it to others by sharing it with them, or if it even just makes you feel like someone else understands, then Ill be happy. As always, I hope for some good discussion in the comments as well!

Motor Symptoms And Ms

Difficulty with walking or a change in walking style can be one of the first MS symptoms noticeable to others, for example beginning to stumble or trip.

Nerve demyelination can cause damage to the nerves that direct the affected muscles, causing incoordination. In some people, balance may also be affected, if special areas of the brain are demyelinated, and can lead to feeling off-balanced and leaning to one side, or difficulties in perception of where the body is in space .

Balance and walking problems vary considerably from one person with MS to another and may include:

  • tripping, stumbling or falling
  • unsteadiness when walking or turning
  • needing support from walls, furniture or other people
  • a heavy feeling in the legs when stepping forward
  • leg weakness when weight bearing
  • difficulty placing the foot squarely on the ground
  • taking slower, shorter steps
  • loss of confidence when walking.

Spasticity is a symptom of MS that causes your muscles to feel stiff, heavy and difficult to move. A spasm is a sudden stiffening of a muscle which may cause a limb to kick out or jerk towards your body and can also cause pain.

Not all motor problems are caused by MS, so it is important to seek professional advice. A health professional, such as a neurologist, an MS nurse, GP or physiotherapist can work with you to determine the cause of your walking and balance problems and advise on management.

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Can Stress Make My Ms Worse

Numerous studies over the years have looked at whether stress can trigger an MS relapse. A decade ago, a meta-analysis of 14 studies found that there was an increased risk of having a relapse following a stressful life event . The effect was small, but the authors noted that the harmful impact of stress on relapses was actually greater than the beneficial effect of interferon-beta on relapses. A subsequent meta-analysis agreed that stress can worsen MS, but found it was a little difficult to be definitive because of the way the studies were done .

Different studies may measure different kinds of stress so it isnt clear if certain types of stressors cause more problems than others. At the extreme end is the stress of war. During the war between Israel and Lebanon in 2006, Israelis with MS experienced an increase in relapses . The people who were worse off were those who reported the highest level of stress. That is, the perceived threat appears to be as important as the physical threat itself. Another observation was that people felt the stress more acutely when they were having a relapse compared to when they were in remission, presumably because they felt more physically vulnerable.

So the stress-relapse relationship works both ways. Stress worsens MS, but MS also worsens your feelings of stress.

So what did they find when all of this slicing and dicing was done?

In Part 2 well look at what can be done about stress.

How Is Ms Diagnosed

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The diagnosis of MS is complex. The symptoms and clinical signs of MS often come and go, and symptoms are not the same for every person. A diagnosis of MS is not based on one specific physical finding, laboratory test, or symptom, but rather the appropriate combination of findings, tests, and symptoms with the appropriate time course. The diagnosis of MS in some people is quite quick, taking a few weeks, when the person has a very typical presentation. It may take months or even years, when a persons presentation is less typical.

To make a diagnosis of MS, a healthcare provider will complete a thorough evaluation of the persons history and perform a physical examination. A magnetic resonance image of the brain is almost always also required. Additional testing, including MRI of the spinal cord, spinal fluid analysis, and visual evoked potential tests, as well as repeated neurological examinations and imaging over time, may also be needed to definitively make the diagnosis of MS.

Although many of the symptoms cannot be seen on examination, there are specific guidelines that have been developed to help a healthcare provider make the diagnosis of MS. For a person to be diagnosed with MS, the healthcare provider must:

  • Find evidence of damage in at least two separate areas of the central nervous system , which includes the brain, spinal cord, and optic nerves. AND
  • ALSO, all other possible diagnoses must be ruled out.
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    How Is Multiple Sclerosis Managed Or Treated

    There is currently no cure for MS. Treatment focuses on managing symptoms, reducing relapses and slowing the diseases progression. Your comprehensive treatment plan may include:

    • Disease-modifying therapies : Several medications have FDA approval for long-term MS treatment. These drugs help reduce relapses . They slow down the diseases progression. And they can prevent new lesions from forming on the brain and spinal cord.
    • Relapse management medications: If you have a severe attack, your neurologist may recommend a high dose of corticosteroids. The medication can quickly reduce inflammation. They slow damage to the myelin sheath surrounding your nerve cells.
    • Physical rehabilitation: Multiple sclerosis can affect your physical function. Staying physically fit and strong will help you maintain your mobility.
    • Mental health counseling: Coping with a chronic condition can be emotionally challenging. And MS can sometimes affect your mood and memory. Working with a neuropsychologist or getting other emotional support is an essential part of managing the disease.

    Getting Help From A Professional

    If the anxiety you experience feels totally overwhelming, and you can’t manage it alone, you can get help from your GP, MS nurse or other health or social care professional.

    You may find it helpful to talk to a clinical psychologist who understands MS and anxiety or fear. They can help you find ways to change your thinking styles.

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    What To Do If You Have A Fever When You Have Ms

    If you have a fever it is important to keep in mind that a change in core body temperature can worsen MS symptoms and that heat is the most common culprit for this. It is therefore important to keep your temperature down if you are ill with a fever. The best strategy is to ride out the fever by keeping it as close to 37°C as possible. Talk to your doctor or pharmacist about over-the-counter medications that can reduce your fever, and keep the right supplies in stock in case illness strikes.

    If you experience worsening MS symptoms make sure that you listen to your body and try the different strategies below so that you find the one which works for you:

    How To Manage Ms Fatigue

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    It can be useful to learn to recognise the early signs of fatigue and how it affects you. Likewise, talking with family, friends and/or colleagues may help them understand any limitations.

    MS fatigue often results from secondary factors, such as co-existing medical conditions, poor diet, lack of fitness or sleep, medication side effects, stress, depression, hormonal changes or heat sensitivity. Identifying any contributing factors, should help you to develop a tailored management plan.

    Fatigue management strategies include:

    • Stay active exercises to increase your stamina and strength may be useful.
    • Monitor sleep patterns and address any issues.
    • Manage other contributing MS symptoms, such as depression.
    • Rest/take breaks.
    • Vary heavy with lighter tasks for example, if you have more fatigue in the afternoon, do harder jobs in the morning.

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    Responsive Mattress With Pressure Relief

    While this may sound too good to be true, mattress science has come a long way in the past few years and what used to sound like a unicorn mattress has become available in beds like Purple. For MS, pressure relief is important to promote spinal alignment and reduce pain points, but if you find yourself needing to reposition frequently, memory foam is probably not the right option.

    , you could find better pain relief, and fall asleep quicker.

    How Is Multiple Sclerosis Diagnosed

    No one test can provide a definitive MS diagnosis. To understand whats causing symptoms, your healthcare provider will do a physical exam. You may also have blood tests and imaging tests, such as MRI. An MRI looks for evidence of lesions in the brain or spinal cord that indicate multiple sclerosis. Lesions develop as a result of damage to the myelin sheath surrounding the nerves. A spinal tap may also need to be done.

    If these tests dont provide a clear answer, your neurologist may recommend an evoked potentials test. This test checks your nerve function by measuring electrical activity in the brain and spinal cord.

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    Common Triggers Of An Ms Flare

    MS symptoms are different for everyone and may change from one flare to another, but there are triggers everyone with multiple sclerosis should be aware of. “Although a flare or relapse can occur without any warning, certain triggers are common,” says Matthew McCoyd, MD, a neurologist, assistant professor, and associate neurology residency program director with the Loyola University Health System in Illinois.

    Here, the most common triggers of an MS flare-up:

    Sensory Symptoms And Ms

    Anxiety Or MS Symptoms?

    Changes in sensations such as numbness, pins and needles and tingling are common MS symptoms, related to damage to nerve covering in certain areas. These sensations can occur anywhere on the body such as the arms, legs and face. They can be mild or could interfere with your ability to use the affected part of your body, such as difficulty in writing with a pen.

    The new onset of sensory symptoms may be associated with a relapse and should be reported to your MS healthcare team.

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    How To Stop Ms Anxiety

    While you should talk to your doctor about ways to control your own personal multiple sclerosis anxiety, it’s not a bad idea to consider treating it like its own condition. Remember, most anxiety is caused by fear as a result of the disorder , not literally by the lesions in the brain . Furthermore, even when MS causes anxiety directly, your own coping ability can still contain that anxiety so that it doesn’t affect you as much.

    Experts recommend the following to deal with MS-related anxiety:

    • Exercise Talk to your doctor about exercising. Exercise is an east and natural way to reduce anxiety. It is a great natural antidepressant and tool for reducing your anxiety, especially when used in combination with other treatment approaches.
    • Learn Breathing Techniques There are several breathing techniques that can also be useful for controlling anxiety. Deep breathing appears to be a very effective relaxation strategy, and the breathing techniques associated with yoga also seem to contribute to reduced anxiety and stress.
    • Stay Busy/Active Inactivity and a lack of mental stimulation may trigger or worsen anxiety as well as make it more likely that you’re focusing too much on your disease. Keep yourself busy with projects and tasks so that you’re not overwhelmed by the illness.

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    Stress Reduction Strategies In Ms

    Stress and anxiety can take a toll on your life. Not only do these symptoms have the potential to impair your ability to function at your best with MS, but they can also prevent you from enjoying everyday life. Of course, stress can also make you less productive at home and at work, as you might not be able to focus and prioritize getting things done.

    There are many ways of coping with stress if you have MS. The key is to give yourself permission to get the help you need.

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    The Usual Caveats About Observational Studies

    Its important to emphasize that a study of this type cannot conclude that stress-related disorders actually cause autoimmune disease. There could be other explanations for the findings. For example, it is often impossible to identify a precise date that an autoimmune disease or a stress-related disorder began. So, despite the researchers requirement that the autoimmune disease be diagnosed well after the stress-related disorder, its possible that the autoimmune condition was already present before the stress-related disorder was diagnosed. If that was the case, the stress-related disorder could not have caused the autoimmune disease.

    In addition, its possible that something other than the stress-related disorder was to blame for the higher rate of autoimmune disease. For example, people who have been through severely stressful circumstances may be more likely to smoke, and smoking has been linked to an increased risk of certain autoimmune diseases, including rheumatoid arthritis and multiple sclerosis.

    One more point: this study appears to have included type 2 diabetes among the 41 autoimmune diseases it considered. Although this is the most common type of diabetes , it is not considered an autoimmune disease. Different results might have been noted if stricter definitions of autoimmune disease had been applied.

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