Emotional Health - National Multiple Sclerosis Society

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Emotional Health

Beth
Diagnosed in 2009

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In this article

Overview

In the face of MS, people may focus on their physical health and neglect their emotional health. MS can have a significant impact on a person’s emotions, not only because MS 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.) It is essential to recognize and address changes, because state of mind, emotion and mood:
  • impact how one feels physically and functions in everyday life — they’re essential components of overall wellness
  • affect one’s ability to adapt to change, problem-solve effectively, and participate in personal care
  • can negatively impact cognitive function (particularly depression)
  • are difficult for others to understand and live with, potentially causing disruptions in communication and relationships
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 mood

The most common emotional changes in MS include:
  • grief (and sadness): natural reactions to the type of change and loss that MS can cause in a person’s life. These feelings will likely ebb and flow over the course of the disease.
  • worry, fear, moodiness, irritability and anxiety: normal in the face of unpredictability; anyone can become a bit irritable when faced with difficult challenges.
  • depression: one of the most common symptoms of MS.*
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. Changes in mood can be a significant source of pain and distress in and of themselves.

*Depression is a major risk factor for suicide. The primary reason why the risk of suicide among people with MS is unacceptably high is undiagnosed and under-treated depression.

MS can add to the stresses of daily life

Aside from the normal stresses of everyday life, MS creates stresses of its own. Stress can make any of us feel worse. Many people with MS say they experience more symptoms during stressful times; when the stress abates, their symptoms seem less troubling or less severe.

Learning to 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 emotional challenges too

Each family member experiences his or her 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.  
  • 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.

Getting help

Mood changes are not a sign of weakness. In fact, dealing with them is a sign of strength.
  • Begin with the recognition that emotional changes significantly impact quality of life and deserve as much attention as physical symptoms.
  • 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.

Less common: MS can affect the expression of emotions

  • Pseudobulbar affect (PBA): experienced by approximately 10 percent of people with MS. Uncontrollable episodes of laughing and/or crying (out of proportion or unrelated to how the person is actually feeling) which may appear to others as depression, but the two conditions are unrelated. The condition is treatable.
  • Euphoria: experienced by a small proportion of people with more advanced MS or significant cognitive changes. One appears to be 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.

Additional resources

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Resources

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.