What You Need to Know About Stress and MS

A plan for coping with stress will help you live better with the disease

Frustrated mother rubbing her temples. Credit: JGI/Jamie Grill / Getty Images

A disease like multiple sclerosis (MS) can be so physically overwhelming that we lose sight of the psychological stress it causes. Between getting to and from doctor's appointments, starting on new medications, and adapting to any physical limitations we have, we may not even realize how we feel about all of these major life changes that have been thrust upon us. Ironically, with a disease like MS, negative emotional stress can trigger flare-ups.

It is both a disease that brings tremendous stress into our lives, and one that worsens in the face of that stress. Talk about a conundrum.

Here are some of the emotional, physical and even financial challenges to having MS that contribute to both chronic and acute stress: 

  • The unpredictable nature of MS
  • Appearance of new symptoms
  • Concerns with health insurance
  • Concerns with employment
  • Needing help from others
  • Paying for medications
  • Having less quality time with friends and family 
  • Multiple doctor's appointments 
  • Caring for children while not feeling well 

Every person with MS should develop a proactive system for coping with stress.

Why Does Stress Negatively Affect MS? 

Stress interacts with the immune system, which is why it may trigger a worsening of MS symptoms or a relapse. In a 2006, Australian researchers conducted one of the first studies to seriously examine the relationship of stress and MS relapse.

This study followed 101 people with MS for two years and asked about their stress levels and stressful events every three months. They found that the greater the number of acute stressors that a person reported, the greater their chances of relapse. They also found (not surprisingly) that people who were having a relapse reported more stress.

Chronic stress and stress severity did not predict relapse, only the number of acute stressors. Individuals who used social support (friends and family) to cope with stressors reduced their risk of a relapse.

In addition, during times of stress, certain hormones are released in the brain. These hormones slow down the activity of the sections of the brain responsible for reasoning and decision making. It is logical that for people with MS, this “slow down” would result in an increase in cognitive symptoms. 

Did Stress Cause My MS? 

A study in Denmark used national health registry data to examine if stress could be a cause for MS. This study found 21,000 parents who had a child that died. They compared them to almost 300,000 other parents. In the group that had lost a child, one out of 750 people developed MS. In the comparison group with no child loss, one out of 1300 did. The people who had lost a child were 1.5 times more likely to develop MS. If the child was lost unexpectedly, the risk increased to more than twice as likely to develop MS.

This doesn’t mean that the stress of being stuck in traffic can cause MS. The type of stress the researchers studied was a very specific and deep stress. The loss of child can profoundly impact parents. Researchers were not able to assess how the parents coped with the loss of their child. There was no data on depression, grief duration or coping methods. The interesting finding here is that the emotional impact of the loss of a child increases the risk of MS, illustrating that deeply stressful events may spur the development of chronic disease. It's certainly quite unfair, given that we have no control of these circumstances. 

The Silver Lining: Positive Coping Skills Have Healing Power 

It's easy to feel defeated and angry when we hear this information about stress and MS. But there is emerging research that shows the power of positive coping skills to dramatically improve our quality of life with multiple sclerosis. The way we respond to our stress can influence how fast our disease progresses, and how debilitating or manageable it becomes. A study performed at Northwestern University found that MS patients who received stress management therapy—which consisted of relaxation techniques, problem solving skills, and learning about social support—were able to reduce their risk of new MS lesions. While major negative life events did increase disease activity, positive life events reduced the likelihood of new MS lesions. 

So you see, neither you, nor I, are doomed to a cycle of stress and pain. Yes, stress is an inevitability of life, and even more so with this disease. However, it is how we choose to cope with it that can improve, or worsen, our symptoms. And seeking out positive life experiences can be the counterbalance to the stresses of our disease. 

Stress Reduction Strategies 

There are many ways of coping with stress. Here is a sample of some stress-reduction approaches that people living with MS should consider developing:

  • Social Support: When a relapse occurs or symptoms worsen, you may need help to get to your doctor’s office, fulfill your responsibilities or just make dinner. Cultivate your network of friends and family. Keep close ties with the people you can depend on. Let them know how important they are in your life. When you are feeling good, try to help them.
  • Relaxation: Relaxation is the best way to combat stress in your body. When you are under stress, your body releases certain stress-related hormones. By relaxing, you can reverse this process. A breathing technique known as the relaxation response has been proven to reverse the effects of stress in your body. You can also learn meditation, yoga or gentle stretching. Anything that relaxes you is great – a lukewarm bath, candles, music or whatever works for you.
  • Planning: We don’t like to think about times when symptoms worsen, but having a plan in place will make everything go easier. Think about what would change in your life if you were having a relapse. Who would take you to the doctor? Who would watch the kids? What about work? Go through your typical day and consider how you could deal with each complication. Talk to the people you would need to depend on before you need them. Set aside a little "relapse fund" for takeout, massages and anything else you might need. Creating a relapse plan for MS can make a big difference when things are difficult.

Sources:

 

Brown RF, Tennant CC, Sharrock M, Hodgkinson S, Pollard JD. Relationship between stress and relapse in multiple sclerosis: Part I. Mult Scler. 2006 Aug;12(4):453-64.

Brown RF, Tennant CC, Sharrock M, Hodgkinson S, Pollard JD. Relationship between stress and relapse in multiple sclerosis: Part II. Mult Scler. 2006 Aug;12(4):453-64.

J. Li, MD, MSc, C. Johansen, MD, PhD, H. Brønnum–Hansen, MSc, E. Stenager, MD, N. Koch–Henriksen, MD, PhD and J. Olsen, MD, PhD. The risk of multiple sclerosis in bereaved parents. NEUROLOGY 2004;62:726-729

 

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