Emotional Health - National Multiple Sclerosis Society

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Emotional Health

Aaron
Diagnosed in 1995

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In this article

Overview

In the face of a chronic, often progressive illness like MS, people may tend to focus primarily on their physical health and neglect their emotional health—which is an essential component of overall health and wellness. They may assume that being very anxious or depressed is “natural” given the challenges of life with MS. But it is essential to recognize and address significant mood changes for several reasons:
  • Mood changes can be a significant source of pain and distress.
  • Emotional issues significantly impact how one feels physically and functions in everyday life.
  • Significant mood changes affect a person’s ability to adapt to change, problem-solve effectively, and participate actively in his or her own care.
  • Mood changes—particularly depression—can negatively impact cognitive function.
  • Mood changes are difficult for others to understand and live with, potentially causing disruptions in communication and relationships.
  • Depression is the major risk factor for suicide—and the primary reason why the risk of suicide among people with MS is unacceptably high is undiagnosed and under-treated depression

MS can affect mood

MS can have a significant impact on a person’s emotions—not only because MS is a chronic, unpredictable disease that is challenging to live with, but because it affects parts of the brain that control mood. In other words, mood changes are considered to be a symptom of MS as well as a reaction to it.
 
The most common emotional changes include:

  • Grief
  • Depression
  • Moodiness and irritability
  • Anxiety

Grief and sadness are natural reactions to the kinds of changes and losses that MS can cause in a person’s life. These feelings will likely ebb and flow over the course of the disease. Worries and fears are also normal in the face of MS-related unpredictability, and anyone can become a bit irritable when faced with difficult challenges. However, depression, persistent anxiety and extreme irritability are never “natural” or “normal.” Although very common in people with MS, these changes are as deserving of treatment as any of the physical symptoms of the disease.
 
The treatment for emotional changes in MS involves counseling, medication if needed, and exercise. Read more about the diagnosis and management of mood changes in MS.

MS can affect the expression of emotions

Approximately ten percent of people with MS experience uncontrollable episodes of laughing and/or crying known as pseudobulbar affect (PBA) which occurs in other neurologic conditions as well, is caused by damage in the central nervous system. With  PBA, the episodes of laughing and crying are totally out of proportion or unrelated to how the person is actually feeling. The bouts of crying may appear to others as depression, but the two conditions are unrelated.
 
People with more advanced MS, including significant cognitive changes sometimes become euphoric, which means that they appear unrealistically happy, unconcerned about problems, and out of touch with the reality of the situation. This expression of happiness is more related to impairment in cognition than to a mood change.

MS can add to the stresses of daily life

Aside from the normal stresses of everyday life, MS creates stresses of its own, in large part related to the variable symptoms and unpredictable disease course.
 
The important thing to keep in mind is that stress can make any of us feel worse, with or without MS. Many people with MS say they experience more symptoms during stressful times. When the stress abates, their symptoms seem less troubling or less severe. Therefore, learning to relax and manage the stresses of everyday life is essential—but not necessarily easy. You may need to try several different relaxation activities or techniques before finding what works best for you.. Read more about stress and strategies to manage it.

Family members face their own set of emotional challenges

MS affects everyone in the family—with the result that family members are likely to experience their own set of feelings and fears. In particular, care partners are known to be at increased risk of depression and should discuss this with their own healthcare providers.  Young children who have a parent with MS may have questions they do not know how to ask as well as feelings they cannot put into words. Keep S’myelin, a Society magazine for children ages 6-12, provides age-appropriate information about MS as well as guidance for parents on how to talk about the disease and the feelings that kids may be experiencing.

Steps to getting help

Mood changes are not a sign of weakness; dealing with them is a sign of strength.
  • Getting help starts with the recognition that emotional changes significantly impact quality of life and deserve as much attention as physical symptom.
  • Keep in mind that family members, as well as the person with MS, may experience problems with mood.
  • Remember that in MS, mood changes can be a symptom of the disease as well as a reaction to its challenges.
  • Report changes to your healthcare team.
  • Ask your doctor for a referral to a mental health professional who is knowledgeable about MS, or contact an MS Navigator for a referral.
  • Connect with others in person or online for support.

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The Society offers a variety of resources to assist you and your family members in dealing with the emotional aspects of MS, including self-help groups, peer counselors, workshops and other programs. Contact an MS Navigator®, or consult HelpPRO® for help finding therapists, groups and other mental health services