Taming Stress in Multiple Sclerosis
by Frederick Foley, PhD with Jane Sarnoff
PART I: CAUSES OF STRESS
Brought to you by evolution ...
When our ancestors were taking a morning stroll and met a tiger, they could run or fight. Either action demanded that their bodies adjust rapidly to meet the emergency, and they experienced stress as part of the process.
Without stress, we would not be able to act in times of danger. In fact, without some stress to get us to focus on a problem we might do almost nothing. Many people perform best while under stress. But sometimes people are immobilized by the pressure that stress creates. Then stress makes it hard to concentrate and stops people from doing what needs to be done.
Stress can be caused by both pleasant and unpleasant demands and changes. People can be just as stressed by getting a promotion as by not getting one.
Stress usually begins with alarm, the modern equivalent of noticing a tiger. However, our options are rarely as simple as running away or fighting. For example, most people are very stressed at the prospect of having to use a cane or wheelchair. Many eventually experience relief or accept the benefits of the aid once the stressor—the idea of using a cane or other assistive device—has been sufficiently worked through.
Stress and MS
Having any chronic illness increases stress. MS is no exception. In fact, there are many stressful situations that are common with MS:
- Diagnostic uncertainties (before the definite MS diagnosis)
- The unpredictability of MS
- The invisibility of the symptoms (which can sometimes cause people with MS to question the reality of their own experience)
- The visibility of the symptoms, particularly newly emerging ones (to which others may react before the person has had time to adjust)
- The need to adjust and readjust to changing abilities
- Financial stress and concerns about employment
- The presence—or possibility—of cognitive impairment
- Loss of control (e.g., coming and going of unpredictable symptoms, or loss of physical control such as bladder dysfunction
- The need to make decisions about disease-modifying treatment and adjusting to the treatment if it is chosen.
Does stress increase the risk of attacks or affect the long-term course of MS? —Many people with MS feel that there is a definite connection between stress and MS. Others believe that controlling stress can have a beneficial impact on MS. And still others believe that neither stress nor controlling stress has any effect on MS. Scientifically speaking, the jury is still out.
A relationship between stress and the onset of MS or MS relapses is considered possible, but hasn't been powerfully demonstrated in studies. Can a stressful event cause nerve damage or lesions? Can nerve damage or lesions increase someone’s experience of stress? More research is needed to answer these questions.
Can stress make MS symptoms feel worse? —Many people with MS say yes. They experience more symptoms during stressful times. When the stress abates, their symptoms seem less troubling or less severe. This could be understood by looking at the stress and coping process.
During times of stress, more energy is required to think, problem-solve, and handle daily life. For example, one’s ability to be patient with family members often wanes after a tough day. At stressful or demanding times, symptoms may be experienced more strongly, because the energy to deal with them and get on with life has been drained.
We all have finite reservoirs of coping ability. At demanding times, our supply may temporarily run dry. Any difficulty, including MS symptoms, is more challenging at these moments.
Stress can’t be—and shouldn’t be—totally avoided. The challenge is to learn to reduce its intensity and to use it to work for, not against, us.