MS Mental Health

Managing the Emotional Toll of Multiple Sclerosis

Dealing with the physical limitations of multiple sclerosis (MS) is an arduous task. The changing symptoms influence everything from your walking, strength, energy levels, sleeping patterns, speech and ability to eat and drink. You can never be sure what your MS has in store for you.

As difficult as your physical symptoms are, the emotional impact of MS can seem worse. At times with the physical, there is a comfort or sense of security in the notion that others can see your experience and understand how MS influences you.  The emotional symptoms do not share the same tangible quality. They are more dependent on your ability to notice and identify them. This can lead to self-doubt as your begin to question yourself and conflict with others as they begin to questions you.

MS mental health impacts span a wide range, as they are both a direct and indirect result of the disease. Typically, people with MS report feelings of:

  • Depression – Those with MS experience depression and its symptoms much more than those who do not. Withdrawal from activities, feelings of worthlessness and helplessness, changes in eating and sleep patterns, increased thoughts of suicide or death, low energy levels and sex drive, and difficulty concentrating are all associated with both depression and with MS.
  • Grief and Anger – Those with MS will most likely grieve over their diagnosis, the loss of their previously healthy life, and the potential loss of future dreams. Some are not able to move past the anger stage of the grief process.
  • Anxiety – MS is a highly unpredictable disease that progresses at various rates over time. It is uncertain how someone with MS will feel from one day to the next or even later in the same day. Not knowing what to expect can lead to increased feelings of anxiety or stress.
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  • Mood Swings – The extreme mood swings experienced by some people with MS are often referred to as emotional lability. This moodiness is as unpredictable as MS itself. There are typically no triggers associated with these extreme changes in mood.
  • Pseudobulbar AffectAlso known as PBA, this condition causes uncontrollable bouts of laughing or crying. Like mood swings, these are not triggered by any events so it is unknown exactly why MS sufferers experience this effect, but it is thought to be connected to the damage in the brain MS causes.

Although these impacts may seem far-reaching and overwhelming, good treatment solutions exist for each.

Often in therapy, clients and therapists spend considerable time unearthing the origins and causes of the symptoms. Hoever, with with MS this is not necessarily a valuable use of time or energy, because it is impossible to know the origin. Grief, depression and physiological changes can all result in the same symptoms. Instead, daily management is the most important gosl. Look at your symptoms individually to find effective solutions for each.

MS and Depression

Depressive symptoms are prevalent in people with MS. Finding ways to improve your mood, instead of trying to find all the triggers, is the most beneficial route. Here’s how:

Find Your Strengths

Any chronic medical condition forces you to think about the bad more than the good. This emphasis changes the way you see yourself. MS has not changed your personality or character traits as much as your perceptions of yourself have changed.

Work to reestablish a strong sense of self by listing your favorable attributes. Write down your visible and invisible characteristics. Think about what other people like about you and what makes you a good friend. Look at yourself in the mirror to accept and value your body. Acceptance of yourself reduces depression.

Set Goals

Goals keep you focused and moving forward. A person without goals is as aimless as a boat without a rudder. Set small, relevant, specific goals that build towards a path. Rather than passively assuming that MS will control your life, decide what you want to do with the next days, weeks and years.

Change Your Self-Talk

You are always talking to yourself. That internal monologue is your self-talk. When depressed, your self-talk is more negative and self-defeating.

Challenge your self-talk to be more positive. If your self-talk is telling you that you are a failure or that no one likes you, seek out evidence to the contrary. Negative self-talk is depression working against you. Refute it to shrink depression.

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Get Active

If you are searching for something to improve your depression that's cheap, readily available and without harmful side effects, look no further than exercise. If MS has limited your functioning, look for compromises and modifications.

Increasing your heart rate and warming up your body is beneficial physically and mentally. Finding an avenue to activity crushes depression.

Have Fun

Everybody needs it. Everybody wants it. Have you been having enough fun lately?

When you have MS, fun is not a privilege, it is a right and a necessity. Push yourself to have fun.  Engaging in desirable activities will recharge your batteries more than simply laying on the couch.

Next page: dealing with anger.

Page three: the connection between MS and anxiety and how to cope.

MS and Anger

Anger is another common feeling in those with MS as it is a part of the grieving process.  Many professionals consider depression and anger the same feeling.  When targeted inwards towards yourself, it is depression. When targeted out against certain people or the world-at-large, it is called anger.

If you have been depressed for too long, consider tapping into anger in a preventative, controlled way. Here’s how:

Yell

Yelling at people is usually not productive. People’s feelings get hurt and you say things that you do not mean.

Instead, yell at the wall or into a pillow. Say everything and anything you need or want to say. Hearing the words come out of your mouth provides a sense of relief.

After you complete the yelling, think about what it is you really want to say to MS or someone in your life and more appropriate ways to communicate it.

Break

Waiting until you are fuming to find something to break is not a great idea.  A better idea is to visit a local thrift shop or yard sale to find unwanted dishes, records, vases or anything else that looks like fun to break. Store them and when you feel anger building, seek them out.

Of course, safety is important. Think about wearing safety glasses and gloves. Break the items in a spot where there is no risk of injury to others. The sensation of breaking something can be quite rewarding.

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Hit

Designate what is “hittable" in your home.  Perhaps investing in a punching bag or taking kickboxing classes will be beneficial for you.  Balloons are great options as they are readily available and clean up easily.  Many times, anger comes from feeling powerless or helpless.  Hitting something can inspire a feeling of empowerment that you can use to achieve your goals.

Throw

This is another fantastic way to divert anger desirably.  Throwing a ball against a wall or a chunk of clay against the floor provides relief by releasing energy and stimulating your senses of touch, sight and sound.  Pick up that clay and throw it down harder.

MS and Anxiety

People with MS worry. They worry about how their functioning will change and what their symptoms will look like in a year.

Worry leads to stress and stress leads to anxiety. Anxiety is a chronic worry that can be focused on something specific or generalized to include most aspects of your life. In either case, learning relaxation is the best combatant to anxiety. Here are some relaxation methods to consider:

  • Deep breathing – Deep breathing is the first relaxation technique to learn.  It is the simplest and most basic skill that can be applied to other skills.  Assume a comfortable position either sitting or laying down. Put your right hand on your stomach and left hand on your chest.  As you breathe in, feel your right hand moving while your left stays still.  The goal is to fill your lungs entirely by using your diaphragm to suck in air.

    Most people move their shoulders when breathing deeply but this only partially fills lungs.  Work to extend the seconds inhaling and exhaling.  Five seconds in and seven seconds out is a great goal but three in and five out might be your starting point.  Deep breathing provides access to extra oxygen, which allows your heart to slow down.  Repeat as needed.

  • Autogenic training – Autogenics is a type of self-hypnosis where you repeat a series of phrases to yourself. A quick online search will yield great scripts to use as a guide. Autogenics allows for endless modification and manipulation to obtain your desired effect. These messages work to retrain your thinking to be more desirable while training your body to be more relaxed. Self-hypnosis can help the brain reconnect with the areas of your body damaged by MS.
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  • Guided imagery – Guided imagery involves listening to a script or reading a script to yourself. It often involves thinking about yourself on a tropical island or a relaxing destination from your past and serve as a distraction from your stressors, allowing your mind and body to become refreshed.  Countless examples are available online of both written and audio scripts. Find one or many that work for you.

Conclusion

Embrace rather than denying or ignoring these feelings so that you can improve them. Being active in your treatment is always better than being passive. If you can, complete some or all of the tips listed above your mental health will surely improve. With luck, your physical health will follow and your overall well-being will improve. There is no good reason to wait. Start today.

Next page: fighting back against depression.

Next page: the connection between MS and anxiety and how to cope.

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