How to Build Resiliency in Multiple Sclerosis

Rebounding From the Adversity of Living With MS

Resiliency in Multiple Sclerosis
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Resiliency means coping well and adapting positively in the face of a life challenge, whether that's a traumatic event, chronic illness, relationship difficulty, financial adversity, or another source of significant stress.

As a chronic, disabling disease, multiple sclerosis (MS), is no doubt a hardship, causing emotional and social distress, as well as debilitating symptoms like fatigue, mobility issues, and pain.

But by utilizing resiliency in adapting to MS, you can improve your quality of life, as well as your daily functioning in activities and life roles.

Barriers to Resiliency in Multiple Sclerosis

According to a study led by researchers at the University of Washington School of Medicine, there are a number of barriers to resiliency in MS.

Some of these barriers include:

Social Isolation and Loneliness

You may feel isolated from friends and/or family members because you believe they do not understand your MS. In this case, you may distance yourself by turning down social engagements. On the flip side, you may feel excluded because of your MS.

MS symptoms like walking or balance problems can also limit social interactions. Besides physical limitations, many people with MS have cognitive difficulties and emotional disabilities like depression and anxiety, which can further perpetuate social isolation.

The unpredictability of your MS also probably plays a role—you may say "no" to social engagements out of worry or fear that you will not feel well.

Stigma

Despite the fact that information about MS is more visible and shared than ever before (mostly because people are diagnosed sooner, and the last decade has seen a surge of new treatments), there are still a lot of misconceptions about the disease.

For instance, many people think that if you have MS, you will automatically require a mobility assistive device.

Others think that MS remission means you feel "normal and well." This is usually not the case, though. For most people with MS, even when not experiencing an acute relapse, they endure symptoms often invisible to others like thinking problems, fatigue, depression, and pain.

Negative Thoughts and Feelings

Research suggests that some people with MS may experience a low sense of self-worth and concentrate on their loss of abilities or the life they once had.

This negative way of thinking counters the concept of resiliency, which entails adopting new or altered life roles and finding meaningful activities in the face of adversity.

Fatigue

While any symptom in MS can be a barrier to resiliency, fatigue seems to be a big one. While fatigue is described uniquely by people with MS (for example, "brain fog," "flu-like," or "weakness"), a common denominator is its overwhelming debilitation, often both mentally and physically.

This draining nature of fatigue can be a big barrier to adopting positive coping strategies.

How to Optimize Your Resiliency

If you are feeling like your resiliency tank is nearing empty, there are strategies to strengthen your spirit and help you to bounce back more easily from MS-related challenges.

Resiliency can be learned or improved—it's not simply a trait that you have or do not have.

Here are some strategies to consider when enhancing your own resiliency:

Find Meaning

One strategy is quite simple: engage in meaningful activities, ones that give you purpose, a sense of accomplishment, or fill your soul.

These activities will be different for each person, but some examples to get your thoughts rolling include:

  • Grabbing coffee or dinner with a close friend or loved one
  • Volunteering
  • Scheduling a treat for yourself—getting a massage or ordering tickets to your favorite musical or play
  • Learning a new hobby like cross stitch or photography
  • Going for a walk or drive in nature
  • Practicing yoga or mindfulness meditation
  • Journaling your deepest thoughts and emotions
  • Going to church or scheduling a visit with a spiritual advisor

Learn About Positive Psychology

Another strategy to improve your resiliency is to learn about positive psychology either online or through a support group, academic course, mental health professional, or book.

You may be surprised to learn that research supports using positive psychology to build resiliency in MS. For example, a six-week positive psychology course called "Everyday Matters," (that was developed by the National MS Society) was found to increase resilience in people with MS by 20 percent.

The course was delivered by teleconference and included telephone-based group meetings every week, as well as videos and readings. People who did not participate in the conference had no change in resilience.

If you do choose to seek out professional help regarding positive psychology, here are examples of factors that will likely be addressed:

  • Developing strong, compassionate, and trusting relationships with others
  • Making realistic goals and navigating the steps to carry them out
  • Being flexible when stress arises
  • Developing self-confidence and identifying your personal strengths
  • Sharpening your communication and problem-solving skills
  • Changing your thinking when it comes to crises
  • Learning healthy ways to manage your emotions and behavior
  • Feeling hopeful and developing a positive outlook on life

Try Occupational Therapy

One small study examined the role of occupational therapy in enhancing resilience in people with multiple sclerosis. In this study, participants completed the Resilience Scale before and after an eight week OT intervention.

The Resilience Scale is a 25-item scale based on five features of resiliency:

  • Self-reliance (for example, "When I am in a difficult situation, I can usually find my way out.")
  • Meaning (for example, "Keeping interested in things is important to me.")
  • Equanimity (for example, "I usually take things in stride.")
  • Perseverance (for example, "Sometimes I make myself do things whether I want to or not.")
  • Existential aloneness (for example, "I can be on my own if I have to.")

The scale is scored on a range from 25 to 175, and the higher the score, the higher the resilience.

The study found that as a group, those who completed the OT intervention had a significant improvement in their resiliency. A small group of participants (out of their own accord) did not participate in the intervention but still completed the Resilience Scale at the beginning and end of the study. They did not show a significant improvement in resilience.

Get Treatment for Depression and Anxiety

Undergoing treatment for your mood problems can build resiliency.

One study of nearly 130 people newly diagnosed with MS found a link between depression and anxiety and resiliency. Of course, a link does not imply that one causes the other, meaning depression does not necessarily cause poor resiliency or vice versa. Rather, a link implies some connection or relationship.

With this finding, there is a possibility that treating depression and/or anxiety can optimize a person's resiliency. On the flip side, implementing strategies to improve your resiliency (like the ones aforementioned), may help you manage your symptoms of depression and anxiety.

In the end, if you are experiencing symptoms of depression (or anxiety), please see your doctor. You deserve to feel well and can with the help of medication and/or talk therapy.

A Word From Verywell

While the humdrum and daily stresses of life can get anyone feeling a bit burned out now and then, throwing in the additional challenge of living with MS can make bouncing back (being resilient) that much harder.

In the end, building resilience is no easy task, and you will likely be filled with emotional discomfort, as you sort out your personal barriers.

But you can do it. In fact, you may be surprised to see just how strong you are—that you can live positively and happily in the face of MS.

Sources:

American Psychological Association. (2017). The Road to Resilience.

Falk-Kessler J, Kalina JT, Miller P. Influence of occupational therapy on resilience in individuals with multiple sclerosis. Int J MS Care. 2012 Fall;14(3):160-8.

Silverman AM, Verrall AM, Alschuler KN, Smith AE, Ehde DM. Bouncing back again, and again: a qualitative study of resilience in people with multiple sclerosis. Disabil Rehabil. 2017 Jan;39(1):14-22.

Tan-Kristanto S1, Kiropoulos LA. Resilience, self-efficacy, coping styles and depressive and anxiety symptoms in those newly diagnosed with multiple sclerosis. Psychol Health Med. 2015;20(6):635-45.

Wagnild G. The Resilience Scale: Users Guide for the US English Version of the Resilience Scale and the 14-Item Resilience Scale (RS-14) Worden, MT: The Resilience Center; 2009.

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