February 25, 2016 | News | Living with MS

Resilience can help you cope with MS

How is it that some people survive adversity and others fall to pieces with the slightest ill wind?

One factor is a person’s resilience – a concept that has received a great deal of attention in recent years by researchers working in multiple sclerosis.

Resilience is a complex idea that has been described in various ways. To some it means “emotional stamina” (Wagnild & Young.  Image: J Nurs Scholar 1009;22:252-255). To others, it’s the personal quality that buffers you from the hard knocks that life throws at you (Rutter and colleagues. Am J Orthopsychiatry 1987;57:316-331). Or it’s that Rocky-like temperament that enables someone to get up and dust themselves off after they’ve been knocked to the ground.

For many years, a person’s resilience was considered just part of their emotional make-up. Some people are survivors; others are not. But recent research has shown that resilience is made up of certain key components, and these building blocks can be supported and strengthened. In other words, resilience can be learned.

According to Wagnild and Young, who developed a Resilience Scale to measure such things, there are the five key components of resilience:

  • Equanimity: This is a sense of balance or stability about yourself and your life, especially during times of stress. (“If you can keep your head when all about you/Are losing theirs, as Rudyard Kipling wrote). Can you take what comes without losing your step? Can you handle the tough times because you know you’ve faced difficult challenges before?
  • Perseverance: This is the ability to hang in there despite setbacks or discouragements. Do you feel determined to struggle on even though there’s a mountain to climb?
  • Self-reliance: This is the sense that you have the resources within yourself to get the job done. Do you tend to rely on yourself instead of others (and do others turn to you)? If you’re in a tight spot, do you believe you can figure        a way out?
  • Meaningfulness: This is the sense that there’s a meaning to your existence – raising your kids, loving your partner, expressing your uniqueness, making the world a better place – so the struggle makes sense.
  • Existential aloneness: This is the sense that you are on a personal journey, that some experiences must necessarily be faced alone, and that your thoughts and actions give you a sense of freedom and uniqueness.

These five factors can be thought of as centred on two key ideas. The first is personal competence: you have the knowledge, experience and sheer grit to cope with difficult situations. And the second is an acceptance of yourself and your life: you have made peace with who you are and what your life is about, your life has meaning, and you are able to maintain your perspective (and can usually manage a good laugh).

This isn’t meant to downplay the challenges that inevitably come – feeling ill and fatigued on those days when you really want to feel well, finding it more difficult to do things that were once effortless, feeling disheartened by the frustrations and setbacks that life has put in your path. But research has shown that there are factors that can erode your sense of resilience, and other factors that buffer you against the hard times.

When a person is first diagnosed with MS, perhaps the greatest challenge is coping with anxiety and depression – the psychological impact of having a chronic illness, wondering how MS will affect your life, the uncertainty about what will come (Tan-Kristanto & Kiropoulos. Psychol Health Med 2015;20:635-645). What makes things worse is avoidance: denying the reality of the diagnosis, leaning too heavily on hope, and not focusing on specific solutions to specific problems. Anxiety can be paralysing. Feelings of helplessness and hopelessness can undermine your motivation and ability to struggle against adversity. If anxiety and depression become too much to handle, it’s important to get the help you need in the form of counselling, therapy and/or medications.

A couple of recent studies have also looked at specific techniques that can build up a person’s resilience as they cope with MS. Mindfulness training is a type of meditation that focuses your attention on the here and now. Studies have shown that mindfulness can relieve stress levels, enable people to cope better, and increase their resilience (Senders and colleagues. J Evid Based Complementary Altern Med 2014;19:104-111). Many centres now offer classes to learn the techniques, which you can then practice at home.

A more mainstream approach is occupational therapy by a licensed occupational therapist (OT). Occupational therapy focuses on the barriers that keep a person with physical or mental difficulties from doing the things they want to do. So an OT will help you identify areas where you’re having problems, provide you with new skills, or teach you how to modify tasks so you can accomplish what’s important to you. Learning how to overcome daily challenges is the first step to rediscovering a sense of mastery in your environment (and your life), and will boost your resilience (Falk-Kessler and colleagues. Int J MS Care 2012;14:160-168). If you need help managing a problem in your daily life, your MS clinic can put you in touch with an OT in your community.

Resilience isn’t a fixed quality and one day’s optimism can become the next day’s despair. There are always new challenges – from MS as it continues on, from life circumstances as they change, from time as we grow older. But there are many resources that can help you overcome adversity – in your family, in and your community, and from the deep wellsprings of resilience within yourself.

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