Monday, January 30, 2023

Does Stress Make Ms Symptoms Worse

Multiple Sclerosis Cold Chills

Does heat make your MS symptoms worse?

Although cold chills can be felt because of exposure to a cold environment, they are often felt with a fever and can cause shivering and shaking. This is because your muscles are relaxing and contracting rapidly while the vessels in your skin constrict. The chills can be constant and can last from several minutes to an hour. Your body may be using the chills to boost its core temperature, so although you may feel cold, your body temperature could be high .

Treatment will depend on whether your chills are accompanied by a fever. Over-the-counter medications can fight the chills by reducing a fever. Make sure that you drink plenty of fluids and rest. Although taking a cool shower can reduce a fever, cold water can trigger an episode of chills, so ideally sponge your body with lukewarm water or wait until the fever has passed.

Is It Common For People With Multiple Sclerosis To Experience Depression

Depression is very common in people with multiple sclerosis . In fact, symptoms of depression severe enough to require medical intervention affect up to half of all people with MS at some point during their illness.

Depression may be the result of a difficult situation or stress. It is easy to understand how having MS, with its potential for progressing to permanent disability, can bring on depression.

Depression might be actually caused by MS. MS may affect the insulating myelin that surrounds nerves which transmit signals affecting mood.

Depression is also a side effect of some drugs used to treat MS, such as steroids or interferon.

Who Diagnoses Multiple Sclerosis

Many conditions could cause similar neurological symptoms. Getting an accurate diagnosis is sometimes difficult. Some people see multiple providers over years before receiving a diagnosis. While the search can be frustrating, its important to keep looking for answers. Identifying and treating MS as soon as possible can help slow the diseases progression.

If your primary care provider suspects you may have MS, you will need to see a neurologist. A neurologist is a doctor who specializes in treating conditions that affect the nervous system, which includes your brain and spinal cord.

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What Questions Should I Ask My Doctor

You may want to ask your healthcare provider:

  • How do we know for sure that I have multiple sclerosis and not another neurological condition?
  • Do I need to start taking disease-modifying therapy medication?
  • What are the benefits and risks of various DMTs?
  • Will I need to stay on medication for the rest of my life?
  • What lifestyle changes can I make to help manage MS?

A note from Cleveland Clinic

Multiple sclerosis is a disease that affects the central nervous system . It is an autoimmune disease that causes your immune cells to mistakenly attack your healthy nerve cells. These attacks lead to inflammation and damage to the myelin sheath that covers and protects your nerve cells. This damage causes neurological symptoms such as loss of balance, vision problems and muscle weakness. Several effective treatments exist for MS. These medications reduce relapses and help slow the progression of the disease. Most people with MS are able to manage their symptoms and lead full, active lives.

Last reviewed by a Cleveland Clinic medical professional on 02/10/2021.


Putting My Health First

Dr. Egilius Spierings, MD,PHD, Neurology Specialist ...

I have learned to not let myself get as riled up as easily as I used to. Also, if there is drama going on around me, or with friends I will be there to listen, but I dont involve myself into the situation, because I just cant deal. I feel bad when people call/text me for help, or advice, and I dont respond to them. Im not TRYING to be rude, its just that, I probably cant deal with that kind of stress/anxiety at the moment. Im not trying to distance myself from people, or not supportive, but Ive got to think about my health first and foremost. If that makes me selfish, then oh well.

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Can Stress Make Ms Symptoms Worse

Learn what research says about the connection between stress, MS, and overall health.

Multiple sclerosis is a disease of the central nervous system, where the immune system attacks myelin, a delicate later of tissue that covers and protects nerve tissue. MS can cause a wide variety of neurological changes and impairments, impacting the way a person moves, thinks, feels, and what they are capable of doing day by day.

Stress is often a part of the discussion about MS. Patient education materials often discuss ways to reduce stress. A number of studies have made the claim that stress can trigger MS relapses or worsen disease progression, but the relationship between stress and MS is unclear and not fully understood. Here, we look at what is known about the connection, and why reducing stress is important to your health and wellbeing.

What the research says Much research has looked at the impact that stress might have on MS. Some studies have looked at the role stressful life events can play in the onset of MS. Others have looked at whether stress can trigger flare-ups or relapses. Others have looked at the impact that mindfulness and stress management have on disease progression. There are a number of challenges researchers face in producing consistent results. MS is unpredictable and affects everyone differently. A wide range of people have MS, people with different backgrounds, personalities, coping mechanisms. And stress can be difficult to quantify and measure.

Conditions Commonly Mistaken For Multiple Sclerosis

Many disorders share symptoms with MS, sometimes complicating its diagnosis.

Getting a correct diagnosis of multiple sclerosis can be a challenge. In fact, a study published in May 2019 in the journal Multiple Sclerosis and Related Disorders suggested that nearly 1 in 5 people with other neurologic conditions are mistakenly diagnosed with MS.

These errors in diagnosis likely result from the fact that there is no single test that can determine an MS diagnosis conclusively. Also, not everyone has all of the common symptoms of MS, such as numbness, tingling, pain, fatigue, and heat sensitivity. And to complicate matters, the symptoms you do have may resemble those of some other conditions.

To figure out whats causing possible MS symptoms, doctors look at your medical history, the results of a neurological exam, and an MRI and sometimes do a spinal tap , says Jack Burks, MD, a neurologist and chief medical officer for the Multiple Sclerosis Association of America. “The diagnosis can also require eliminating the possible MS mimicker diseases,” he says. That leads to an MS diagnosis by exclusion.

Here are some of the conditions that are sometimes mistaken for multiple sclerosis:

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Problems With Thinking Learning And Planning

Some people with MS have problems with thinking, learning and planning, known as cognitive dysfunction.

This can include:

  • getting stuck on words
  • problems with understanding and processing visual information, such as reading a map
  • difficulty with planning and problem solving people often report that they know what they want to do, but can’t grasp how to do it
  • problems with reasoning, such as mathematical laws or solving puzzles

But many of these problems aren’t specific to MS and can be caused by a wide range of other conditions, including depression and anxiety, or even some medicines.

Conversion And Psychogenic Disorders

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

Conversion and psychogenic disorders are conditions in which psychological stress is converted into a physical problem such as blindness or paralysis for which no medical cause can be found. In a study published in September 2016 in the journal Neurology, 11 percent of subjects definitely or probably misdiagnosed with MS actually had a conversion or psychogenic disorder.

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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.

Neuromyelitis Optica Spectrum Disorder

NMOSD is an inflammatory disease that, like multiple sclerosis, attacks the myelin sheaths the protective covering of the nerve fibers of the optic nerves and spinal cord. But unlike MS, it usually spares the brain in its early stages. Symptoms of NMOSD can be similar to MS but can also include sudden vision loss or pain in one or both eyes, numbness or loss of sensation in the arms and legs, difficulty controlling the bladder and bowels, and uncontrollable vomiting and hiccups.

Treatments for MS are ineffective for and can even worsen NMOSD, so getting an accurate diagnosis is extremely important. A blood test known as the NMO IgG antibody test can help to differentiate between MS and NMOSD.

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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:

How Can I Deal With Stress


Nobody can say what will be stressful for another person, and people have individual ways of dealing with stressful situations.

It might not be possible to remove all of the sources of stress in your life, but it may be possible to manage your own stress by changing the way you think about it, or reducing some of the stressful elements. There are techniques you can learn to help you cope better with stress and develop healthier habits of thinking. These may take time to have an effect.

There are three stages in stress management:

  • Recognise the effect stress is having on your health.
  • Identify what is causing you stress.
  • Take action to remove or reduce the cause of stress.

Ideas to help you deal with stress:

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What Is The Link Between Multiple Sclerosis And Stress

A number of published papers have shown that stress affects RRMS. Here are a few:

  • At UCLA, studies showed stress can precipitate MS relapses and worsening disability through a variety of mechanisms including excessive inflammatory response and worsening degeneration. The immune system balance of Th1 versus Th2 cytokines is intimately involved in the development of relapses in people with MS.
  • In Switzerland, researchers studied 14 healthy medical students to see whether a psychologically stressful event could modify Th1 cytokines levels. The students showed a significant increase of an inflammatory cytokine starting the next day this cytokine has been shown to be elevated in MS relapses.
  • In Pittsburgh, a study by the Department of Psychiatry at the University of Pittsburgh followed 50 women with MS to see how major life events affected their MS disease activity. Nearly half of all major life events were followed within six weeks by a relapse.
  • US researchers have studied the development of new MRI lesions in 36 people with MS and correlated these with stressful life events. After major life stresses, people were roughly 1.6 times more likely to develop a new lesion in the next eight weeks. This study also noted that those with coping mechanisms could reduce this risk.
  • In 2006, the same research group summarized the effects of stress on MS:

How To Describe Ms Fatigue To Others

It can be complicated to describe your MS fatigue to friends, family, colleagues and healthcare professionals, but helping others to understand can make your daily life with MS fatigue less frustrating.

Sometimes friends and family may notice the effects of MS fatigue. For example, a relative might notice that you are walking more slowly later in the day, or they may notice that after completing certain tasks you become much slower in responding to conversations. Seeing the effects of MS fatigue can help those around you to offer assistance and support.

There will be times when your MS fatigue is not obvious to others, because it is an invisible symptom. Using analogies or metaphors to describe MS fatigue can help friends, family and colleagues understand and relate to what you are experiencing.

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Myth #: Fatigue And Cognitive Dysfunction Are Not Related To Depression

Truth: Fatigue is one of the most common MS symptoms, but it can also be a sign of depression. And so can certain cognitive issues, such as poor concentration and indecisiveness. MS can mask some of these depression symptoms, making it difficult to diagnose this condition.

In addition to being a symptom of depression, cognitive issues may also lead to or worsen depression. MS may affect cognitive functions such as memory, attention, information processing and reasoning. Problems with any of these functions may negatively affect a persons self-image and self-worth.

One way that individuals with MS can keep track of cognitive changes is to participate in a cognitive evaluation, suggests Hughes. This test can be performed by a psychologist experienced in working with patients who have medical problems, such as a rehabilitation psychologist or neuropsychologist. It is often a good idea to get this test done at the first signs of difficulties, as it can provide a baseline for future comparison, says Hughes. This evaluation can also help determine if treatment, such as cognitive behavioral therapy or cognitive rehabilitation, would be beneficial for improving fatigue, mood, and/or cognitive symptoms.

MS-related depression can be difficult to identify and understand. Recognizing and clearing up some of the most common myths is a great place to start helping MS patients and their families get proper diagnosis and treatment.

Why Are Females More At Risk

Anxiety Or MS Symptoms?

Females may be more at risk of MS because their bodies suppress the immune system while pregnant.

Vitamin D deficiency may also be linked with MS. Some researchers believe that there is a link between MS and the differences in the ways that male and female bodies process vitamin D. However, more studies are necessary.

Other researchers theorize that X chromosomes play a direct role in autoimmune function. X chromosome inactivation in females may result in them having more MS susceptibility genes. Again, more research is necessary.

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Myth #: People With Ms And Depression Always Look And Act Depressed

Truth: Its important to note that depression in MS may look different than our typical notions and assumptions about depression, says Hughes. Sometimes, an individual with MS may experience depression as irritability, anger, not feeling like oneself and/or uncertainty about the future.

Symptoms of depression based on recognized diagnostic criteria include fatigue and difficulty concentrating, which overlap with symptoms of MS. Therefore, they are not always a good indicator that someone with MS is depressed, explains Hughes.

A physician might use a questionnaire to help identify signs of depression in MS patients. If a patient comes to the appointment with a family member, it can be helpful for the family member to share their observations and provide examples of specific behaviors. Keeping a daily diary to track the frequency and severity of mood symptoms can also be helpful, suggests Hughes.

Can Stress Cause Ms

In the 1930s, Selye was struck by the idea that physical and mental stressors have profound effects on the body. The general concept that emerged was that acute stressors mobilize the body to action and increase the immune response, whereas chronic stressors tend to have the opposite effect. If stressors influence how the immune system works, its fair to ask if a person living a stressful life has a greater risk of developing MS.

Theres no evidence that stress in itself is a cause of MS. An analysis of over a quarter-million women in the Nurses Health studies found that people with high levels of stress at home were not more likely to develop MS . Even people suffering the extreme stress of physical or sexual abuse werent at higher risk of MS. One study isnt definitive, but it does suggest that stress whatever its effects on the immune system doesnt play a major role in the development of MS.

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Myths About Multiple Sclerosis And Depression

Multiple sclerosis is a serious condition that comes with a variety of symptoms, often different for each person. But about half of people with MS share a common condition depression. Although MS-related depression is well-known in the medical community, it is still widely underreported, underdiagnosed and undertreated. There are also several misconceptions surrounding MS and depression. Rehabilitation psychologist Abbey Hughes, Ph.D., works with individuals with MS and their loved ones to help clear up some of these myths and help them address and manage mood symptoms.

Study: Stress Bad For Ms

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Multiple Sclerosis Exacerbations Linked to Stress

Despite MS patients’ widely held belief that stressful events bring on sudden worsening of symptoms, the idea has been controversial among doctors. But a look at published research shows that in this case, the patients know best.

David C. Mohr, PhD, director of the Behavioral Medicine Research Center at the University of California, San Francisco, and colleagues looked at every major published study of MS and stress. Their analysis shows that stressful events worsen MS at least as much, if not more, than an effective MS drug — beta interferon — makes it better.

“The negative effects of stress on exacerbation of multiple sclerosis are at least as great as the positive effects of a class of drugs widely considered to produce clinically meaningful results,” Mohr and colleagues write in the March 20 issue of the British Medical Journal.

MS is a disease of the brain, spinal cord, and optic nerves that can cause problems with muscle control and strength, vision, balance, sensation, and mental functions. The cause is unknown. Most people with the disease suffer the relapsing form. This means that they are stable for what may be a long time — then, they get a barrage of symptoms that subside over the following weeks or month. Very often, these “exacerbations” leave long-lasting impairment in their wake.

British Medical Journal

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