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Does stress affect MS? – Part 2

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Living with multiple sclerosis (MS) can be very stressful – on top of all of life’s other stresses and frustrations.  A single big stress – a relationship break-up, a death in the family – may worsen MS symptoms. So too can the slow erosion of smaller problems that wear away at the soul. And it’s a two-way street: feeling stressed can lead to relapses, and relapses are associated with feeling more stress.

What can I do about stress?

The cornerstone of stress is a loss of control. If you feel that life just keeps coming at you and you have no control over what is happening – that’s when the stress level goes up. If you’re falling behind at your job or your studies, you have to pick up the kids from soccer practice, make dinner and tidy up the house because your friends are coming over tonight, all on a day when your MS fatigue is making it hard to think (never mind do anything)… No wonder you feel overwhelmed sometimes and find it hard to cope.

So how can you regain control, faced as you are with an illness that is the definition of uncertainty and loss of control? How do you reclaim those positive experiences that’ll make everything easier?

What can give a big boost are the people around you – your spouse or partner, family members, friends and colleagues. They’re your support system and it’s important to feel that they’re listening to your worries and concerns, and they’re in your corner helping you in your fight (Reade and colleagues. J Neurosci Nurs 2012;44:54-63). It can be hard to ask for help – we all like to think we’re self-sufficient and can get the job done by ourselves. But each small act can make a big difference: when your husband cleans the house, your sister watches the kids while you take a nap, your neighbour drives you to the store to get groceries.

There are also some things you can do to re-empower yourself. Many people with MS find that meditation helps them cope with stress (Simmons and colleagues.  Mult Scler 2004;10:202-211). You can also talk to a counsellor about other stress management programs, which have been shown to help heal the brain, reducing the number of lesions visible on MRI (Mohr and colleagues. Neurology 2012;79:412-419).

Techniques such as relaxation breathing and progressive muscle relaxation exercises have also been shown to be effective in reducing stress (and depression) (Artemiadis and colleagues. Arch Clin Neuropsychol 2012;27:406-416).

Exercise as a stress reliever hasn’t been studied in MS. But you may also find that regular exercise takes some of the edge off, improves your mood and helps in your day-to-day coping.

This is the “problem-based approach”, and it’s been shown to be one of the better ways of coping with MS (McCabe and colleagues. J Psychosom Res 2004;56:355-361). Wishful thinking won’t wish MS away. And avoiding the problem – something men with MS may have a tendency to do – won’t really work (Hajhashemi and colleagues. Indian J Psychol Med 2010;32:108-111).

Be kind to yourself. As you face the many challenges of living with MS, one of the worst things you can do is beat up on yourself and a recent study illustrated this point. In looking at what causes the most distress in people with MS, the researchers found that it wasn’t the illness itself, even if the symptoms were severe (Dennison and colleagues. J Psychosom Res 2010;69:353-361). What predicted distress in people was “unhelpful beliefs” about themselves. It’s important to be realistic – but negative thoughts are not necessarily true thoughts. MS will affect your life, but it doesn’t define what your life is about. It doesn’t change who you are. It doesn’t mean that people don’t love you. It doesn’t destroy your dreams. So try to keep things in perspective.

The key is to find what works for you in helping you cope. Each of us has a different way of approaching things, and we often switch from one approach to another depending on the circumstances. There will always be difficulties and problems, and MS will make the process that much harder. But you can overcome problems if you face them. You can figure out solutions. And if you can’t solve a problem yourself, there are doctors, your MS team, family and friends to help you get there.

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