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!
Speak With Your Health Care Provider Or A Counselor
Your health care provider can be a great resource for managing stress. They can suggest stress management techniques that are suitable for you and your health status, and they may also provide other resources and referrals for stress management. It is also important to discuss your levels of stress with your doctors because some medications and treatments wont be as effective if you have high levels of stress.
If your stress levels start to feel unmanageable, you might also seek counseling or therapy. Therapists and professional counselors can provide a place to voice your frustrations and also offer you suitable coping tools. The National Multiple Sclerosis Society can work with you and provide referrals to counselors in your area.
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:
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I Had To Be Carried Out Of My Wedding
For example, I had a family member at my wedding who was pretty “take-charge” and trying to help out with everything. In the end, it only caused me more stress and resulted in me literally being carried out at the beginning of the reception. My legs went completely numb and I couldnt stand. My right side was burning with searing pain and my brain was foggy. I spent most of my wedding back in our hotel room because of stress-induced MS symptoms. So, sometimes stress and MS dont only ruin small things, they can ruin big things too. .
What Is Multiple Sclerosis
Multiple sclerosis is an autoimmune disease of the central nervous system that can affect the brain, spinal cord and optic nerves. It can result in a range of symptoms and functional impairments.
MS symptoms are varied and unpredictable, depending on which part of the central nervous system is affected, and to what degree. It is important to remember that some people may not have many symptoms at all. Symptoms may last for a short time or only occur during the short period of a relapse, depending on the affected areas and the degree of inflammation present.
Symptoms can be a combination of changes in:
- sensory function
- bladder function
- bowel function
The symptoms of MS can be both visible and invisible to others. They can also be unpredictable and vary from person to person and from time to time. Symptoms can also interact with each other and other co-occurring conditions or diagnoses.
The key goals in managing MS are to:
- minimise relapses
- slow down brain atrophy at all stages of the disease
- restore function
- minimise the impact of symptoms on your day-to-day life.
See your doctor or specialist MS healthcare team for investigation and diagnosis of any new symptoms, as some symptoms can be caused by other illnesses or may be indicative of a relapse.
Watch this MS Australia animation about the invisible symptoms of MS.
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Speech And Swallowing Changes With Ms
Speech and swallowing changes can occur due to affected nerves being damaged. This may present as changes to the voice tone and quality, or coughing when eating.
These symptoms should be reported to your MS healthcare team for assistance from a speech therapist, who can advise on appropriate management.
Tips To Help Manage Cognitive Challenges
Make a note of it
Set reminders, keep notes, and record messages to yourself on your phone. Or leave sticky notes for yourself around the house, office, or anywhere else you need them.
Manage time wisely
Do the most mentally demanding tasks when your brain is the least foggy. Break big tasks in to small, easy-to-achieve chunks. Give yourself more time to complete tasks for days when you arent at your best. If youre tired or cant focus, chill for a while. Cut out distractions like TV in the background.
If your mind wanders during conversations, start repeating a small part of what the person just said. I may seem weird at first, but youll get used to it. And theyll love it that youre paying attention.
Play mind games
If you have trouble with names, make visual and verbal associations, like picturing a crown on someone named Mr. King.
Keep items like your keys or phone in the same places, and do things in the same order.
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S Used To Evaluate Stress And Results: Progression Studies
Progression studies can be classified into two categories: those that evaluated the stress patients experienced in a period of time before a relapse retrospectively after the relapse occurred and those that evaluated stress systematically before the relapse occurred .
In the first category, Warren et al. used a questionnaire and different scales and observed a significant positive relationship between stress and MS exacerbation: patients scoring 5 or above in Goldberg and Hilliers General Health Questionnaire-28 had a relative risk of exacerbation of 3.1 . In contrast, Gasperini et al. used a structured interview to determine whether patients had undergone a single stressful event and found no differences between MS patients who had relapsed and those who had not, although cumulated stressful events were associated with a nonsignificantly higher risk of MS relapse .
Schwartz et al. using a self-reported stressful event scale every 6months also found a bidirectional relationship between stress and MS exacerbation, in which MS progressed after stress and stress increased after MS exacerbations in a vicious cycle. More than one stressful event increased the risk of disease progression and disease progression increased the risk of self-reported stress .
Sexual Function And Ms
Sexual dysfunction is common in MS. It can be directly related to MS from brain or spinal cord lesions, or more indirectly related due to other MS symptoms such as depression and fatigue, or from wider relationship and social issues stemming from MS.
Although a difficult area to talk to your health professional about, it is an important area to maintain your quality of life and self-confidence. There are many avenues of help available from physical to psychological and your GP, MS nurse or neurologist can point you in the right direction for the most appropriate assessment and assistance.
How To Address Ms
Depression, together with anxiety, may worsen thoughts of suicide and shouldnt be left untreated. In most cases, it can be effectively managed with a combination of antidepressants and cognitive behavioral therapy. This type of therapy focuses on identifying and shifting thoughts, beliefs and behaviors that may contribute to emotional distress.
Cmsc Informs: How Stress Affects Multiple Sclerosis Symptoms
Wednesday, March 8, 2017
As part of MS Awareness Month, we want to talk about the role stress plays in multiple sclerosis. Having any chronic illness is likely to increase stress levels and MS is no exception. However, stress is more likely to exacerbate the symptoms of MS and bring about a flare or relapse.While we know its impossible to go through life without getting stressed out, its important for MS patients to try and avoid triggers as much as possible and to get into good lifestyle habits that can help manage and reduce stress.Find out more about Multiple Sclerosis Awareness Month here.If you find yourself feeling unexpectedly sad, angry, anxious or more fatigued than normal, you are probably suffering from stress. Tackling stress and taking positive steps to reduce it will benefit your overall physical and emotional health. Getting plenty of rest is one way to try and reduce stress. If youre well rested, youll be better prepared to handle difficult situations. If you know you have a potentially stressful situation coming up, planning ahead can help you cope better with the event. Dont be afraid to decline invitations to events that may make you anxious and leave early if youre feeling uncomfortable.Take time out of your day to unwind by doing something relaxing like listening to music, painting, yoga or going for a walkanything that helps you to forget your worries for a while.
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Lack Of Sleep Can Worsen Ms Symptoms
Getting enough restful sleep can be challenging when you have MS. Pain, restless legs, urinary or bowel symptoms, or temperature dysregulation are some of the top symptoms that can interfere with nightly zs, according to the National MS Society.
While no one likes being sleep deprived, it can be an even bigger issue for people with MS, says Dr. Conway. “Most people with MS have a lower reserve of energy,” and a lack of sleep can worsen MS symptoms, he says.
A 2018 review of studies published in Current Neurology and Neuroscience Reports found significant associations between sleep disturbance and cognitive dysfunction in MS. Objective sleep measures generally predicted objective impairments in processing speed and attention, according to the analysis.
Other consequences of poor sleep can include increased pain, anxiety, fatigue, and problems with coordination, according to the National MS Society.
In some cases, sleep difficulties for people with multiple sclerosis may be due to an underlying sleep disorder, such as obstructive sleep apnea, says Scott Ireland Otallah, MD, a neurologist who specializes in multiple sclerosis at Atrium Health at Wake Forest Baptist in Winston-Salem, North Carolina.
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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The Danger Of Anxiety: Avoidance Behaviors
If youve ever experienced anxiety, you know it can make daily life difficult. One way some people deal with anxiety is by avoiding its source. When you get anxious about getting dizzy while driving, your instinct may be to avoid getting in the car. Or if you are afraid of having a bowel accident in public, not leaving the house may seem like a good solution. These avoidance behaviors could make you skip a doctors appointment, reduce your time with friends or stop you from doing what you enjoy.
People who have both MS and anxiety are more likely to have suicidal thoughts, adds Beier. Although data varies, it is estimated that up to 15 percent of people with MS die of suicide. If you notice avoidance behaviors, or anxiety that is impacting daily life, its important to start a conversation with a doctor.
Psychological Aspects Of Ms
Mood issues can be very common in MS, not just around the time of diagnosis, but at various stages of life. The most common mood disturbances are depression and anxiety which can be short or long term.
The most important thing to remember is to talk to your MS healthcare team as soon as you start to notice symptoms, so that you can access appropriate help, to improve your quality of life.
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Study Setting And Participants
Based on purposive sampling with maximum diversity , 26 patients were selected among those referred to the Isfahan MS Association. In purposeful sampling, information-rich cases related to the phenomenon are identified and selected. Persons who can provide the needed information to address research questions. The inclusion criteria of individuals with MS were: 1) having MS diagnosed by a neurologist, 2) having MS for more than 1year, 3) Having not a chronic disease other than multiple sclerosis, and 4) being able to participate in the interview and sharing their experiences. Individuals were excluded if patients were unable to cooperate and talk due to the worsening of the disease or other reasons and were not willing to continue the interview at the time of the interview.
Summer Heat Is A Common Cause Of Pseudoexacerbations
Increased body heat is a common trigger for MS pseudoexacerbations. In fact, “in the old days, a hot-bath test was one of the ways doctors diagnosed MS,” notes Dr. McCoyd. The person with MS was immersed in hot water, and if their neurological symptoms appeared to worsen, it was considered evidence they had MS.
Typically, heat causes the appearance or worsening of MS symptoms in areas that have been impacted by previous relapses, says Otallah.
So if a person has an area previously affected by demyelination for example, say, a person had numbness on the left side for a couple of weeks two years ago even though theyve recovered from that attack, if they get overheated by being out on a hot day for a long time, their left side might start to feel numb, he says.
It doesnt take much, Otallah adds: An elevation of just half a degree or more of body temperature can make those old MS symptoms come out.
Temporary worsening of neurological function in MS caused by increased core temperature is commonly called Uhthoffs phenomenon. Symptoms due to Uhthoffs phenomenon go away following short periods of rest, removal of heat stressors, or use of active cooling methods, according to StatPearls.
Getting into air-conditioning, taking a cool shower, or wearing a vest filled with cooled water usually helps reduce heat symptoms, says Otallah.
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Sometimes Its Something Big
Obviously, if something small can cause me enough stress to worsen my symptoms, something much bigger can as well. Sometimes just anticipating a big event can cause me enough stress to make me miss it. Even if its something fun that Ive been looking forward to. Other times, stress that might be bearable for most can make me crumple, literally.
Heat Sensitivity And Ms
People living with multiple sclerosis often experience a reaction to heat and a build-up of symptoms as a result. Depending on your situation, you may notice an increase in fatigue, blurred vision, loss of balance or a flare up of problems with concentration, memory or other cognitive symptoms particularly on a hot day, during exercise or in an overheated space. The effects of heat dont cause permanent damage to nerves and you should feel better once cool.
You might also experience heat sensitivity with colds, flu or other infections that cause a rise in body temperature. Remember that symptoms subside as your body temperature decreases, so its good to find ways to keep cool.
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