Many people, whether they have MS or not, experience stress. You might experience stress when there is an imbalance between the demands made of you and your ability to meet those demands. This could mean deadlines at work, family difficulties, or having to adapt to new life circumstances, such as your MS diagnosis.
Having some stress isn't necessarily bad, and it is normal to feel anxious or worried from time to time. However, long-term or excessive stress can affect your health and may make the symptoms of MS seem worse. Learning to manage your stress in such a way that it does not make life with MS worse is an important part of taking control of your condition.
How can I tell if I have stress?
Medically speaking, stress causes changes in your blood pressure, heart rate and metabolism. You may not notice these changes yourself. In the short-term, these responses can improve your physical and mental performance to cope with immediate crises - the 'fight or flight' response. However, left unchecked, excessive stress can have negative effects on physical and emotional health, including a direct effect on levels of fatigue.
Everybody reacts differently to stress, but there are common symptoms:
- Physical - increased levels of sweating, muscle tightness, regular headaches, constipation or diarrhoea.
- Emotional - irritability, reduced concentration, feeling overwhelmed, problems making decisions, decreased confidence, low mood.
- Behavioural - difficulty sleeping, changes in appetite, loss of libido, increased drinking or smoking and reduced willingness to socialise.
Can stress cause MS?
Some people with MS feel that they developed MS as a direct result of some stressful event or trauma. The evidence on this connection is mixed. Some studies do see an effect whilst others don't. For example, one study found no link between experiencing a traumatic or stressful life event such as divorce or bereavement of a child or spouse and later developing MS.
Some research does suggest that a prolonged period of stress will increase the risk of having a relapse, in people who already have an MS diagnosis. However, not all studies have found this result. Further research has shown that stress management programmes can slow down new areas of MS damage (lesions) shown by MRI scans. This effect may only be temporary, but it does indicate a link.
Personality type appears to be more relevant than the amount or type of stress in determining the effect it has on your health. This would explain the mixed results from the studies above. Basically, are you the kind of person who reacts well to stress? Some people use stress to push themselves to achieve more, some retreat from challenge and find stress hard to cope with. Do seek practical help with stress-management if you need it.
How can I deal with stress?
Nobody can say what will be stressful for another person, and people have individual ways of dealing with stressful situations.
It might not be possible to remove all of the sources of stress in your life, but it may be possible to manage your own stress by changing the way you think about it, or reducing some of the stressful elements. There are techniques you can learn to help you cope better with stress and develop healthier habits of thinking. These may take time to have an effect.
There are three stages in stress management:
- Recognise the effect stress is having on your health.
- Identify what is causing you stress.
- Take action to remove or reduce the cause of stress.
Ideas to help you deal with stress:
- Keep things in perspective. Focussing on only the bad things that might happen will prevent you from enjoying the good things that are happening just now.
- Recognise your own signs of stress, and take charge of your own emotions, thoughts and actions.
- Keep a positive attitude. Try changing your thinking from "There's no help anyone can give me" to "What can I do improve my situation".
- Be kind to yourself.
- Seek support from other people - discussing sources of worry with others rather than keeping them to yourself can help. Even if they can't directly change the source of stress, another person's point of view can put things in a different light.
- Plan ahead - prioritising activities can create more time for essential tasks and also identify potential areas of stress in advance.
- Stay active and take time out for enjoyable activities - taking a step back from stressful events can change the perspective on problems and relieve the build up of stress to some degree. Physical activity is one of the most effective stress remedies, improving mood and self esteem. It can also act as a safe way to let off steam, or work off anger or frustration which doesn't involve taking things out on other people - a route more likely to increase stress.
- Use relaxation techniques or practise mindfulness techniques. Both relaxation and mindfulness training have been shown to be effective at helping people with long term conditions deal with stress.
- BMC Neurol. 2014; 14: 15. Jan 17 Full article Mindfulness based interventions in multiple sclerosis - a systematic review
- Neuroepidemiology 2011;36(2):109-120. Full article (pdf 232kb) Stress as a risk factor for multiple sclerosis onset or relapse: a systematic review.
- Neurology 2011;76(22):1866-1871. Full article Stress and the risk of multiple sclerosis.
- Materia Socio-Medica 2012; 24(3):142-147. Full article Stress as a provoking factor for the first and repeated multiple sclerosis seizures.
- Archives of Clinical Neuropsychology 2012;27(4):406-416. Summary Stress management in multiple sclerosis: a randomized controlled trial.
- Current Neurology And Neuroscience Reports 2013;13(11):398. Summary Stress in multiple sclerosis: a review of new developments and future directions.
- Journal of Neurology, Neurosurgery and Psychiatry 2014;85(10):1103-1108. Summary Major stressful life events in adulthood and risk of multiple sclerosis.