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Mental health and MS: It's good to talk

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Living with a long-term condition like MS does not only mean facing physical challenges, it can mean overcoming mental challenges too.

So at a time of year when the post-Christmas blues have well and truly kicked in, we’re focusing on the talking therapies that are available to help improve low mood.

Here we look at counselling and cognitive behavioural therapy.

Counselling

What is it?

Counselling provides a safe space for you to open up and talk about any worries, anxieties or difficulties you’re facing in your life. Your counsellor will listen to how you’re feeling and help you find ways to understand those feelings and develop strategies you can use to deal with them going forward. Counsellors are trained to help people who are going through a wide range of difficulties in their life; they can help people learn to cope with depression and anxiety, and long-term conditions like MS.

How is it delivered?

Depending on the service available in your area, counselling sessions can take place face-to-face, over the phone, in a group or online through email or live chat services. NICE guidelines recommend that people with mild to moderate depression should have between six to 10 sessions over a period of two to three months.

How can counselling help?

MS is an unpredictable condition and the uncertainty this brings can lead to feelings of anxiety and low mood. Similarly the challenges that some symptoms can cause may also bring about lower self-esteem and negative thoughts. These are both areas that can be discussed with a counsellor.

Your counsellor won’t tell you what to do, but they can help you to develop coping techniques and adapt to changing symptoms. You might find the first sessions quite difficult emotionally as you begin to talk about upsetting and painful issues in your life. This is completely normal. It may take a few sessions before you start to feel the benefits of counselling. So be patient and try not to feel disheartened if you don’t start to feel better straightaway.

Cognitive Behavioural Therapy (CBT)

What is it?

CBT is mainly used to treat anxiety and depression. It’s all about recognising your thoughts and understanding how they impact on your emotions and actions. When you see a therapist, they will want to understand your thought processes, feelings and behaviours and work out whether any of these are unhelpful or unrealistic. They will then suggest ways of changing how you think, feel and behave which you can practise in your daily life and which may break the cycle of low mood and depression.

How is it delivered?

Sessions can be face-to-face with a therapist or delivered over the phone. There are also computerised CBT programmes which you can go through yourself and a therapist will review your progress as you go along. Group-based CBT is another option. Sessions are usually delivered in groups of approximately eight to ten people. For people with mild to moderate depression, NICE recommends a guided self-help programme which is based on CBT. This involves seeing a therapist between six to eight times over a period of 9–12 weeks and working through a range of self-help materials in between sessions.

There are a number of CBT-based self-help guides available online. Moodzone, an online resource from the NHS, has a CBT-based audio guide for tackling low mood.

How can CBT help?

Being more aware of your thoughts can make it easier to notice how they’re impacting on your mood and other areas of your life. When living with a condition like MS, it can be easy to get frustrated and blame yourself for things that aren’t necessarily your fault and you have little or no control over.

For instance, if leg spasms suddenly come on and all the house cleaning you had planned for the day doesn’t get done, you may start thinking negatively about yourself because you didn’t achieve what you’d hoped to that day. These negative thoughts may affect your emotions – you might start feeling down, angry or upset. By the time the spasms have stopped, all these emotions may have left you feeling exhausted so you no longer fancy going out with your friends that evening and you decide to cancel. See how thoughts, emotions and actions are all interlinked? Maybe this chain could have been broken by changing those negative thoughts at the beginning and being a bit kinder to yourself.

This is what CBT aims to do; it can help you break the cycle by teaching you to be more aware of your thoughts, allowing you to make those positive changes so unhelpful thoughts don’t have a negative impact on your life.

How can I access talking therapy services?

Talking therapies are available on the NHS although we understand that waiting lists can be very long. Your GP can refer you to services in your area. If you're based in England, in some areas you can refer yourself by searching for your local NHS psychological therapies service and contacting them directly. If you find you’re having to wait a long time to access these services on the NHS, there are some other organisations you can turn to for support.

  • MS-UK provides a counselling service for people with MS – see our Q&A with Diana Crowe (below), Head of Services at MS-UK, for more details.
  • MS Therapy Centres provide a range of non-drug therapies for people with MS, usually at a subsidised price. Some centres offer a counselling service. You can search for your nearest centre on our map.
  • Some MS Society groups offer counselling services. You can search for your nearest group on their website.
  • The charity Mind has local groups all over the UK which provide peer support sessions, talking therapies and workshops.
  • Rethink Mental Illness has a range of support groups in England. Find your nearest group here.

If you choose to look for services privately, the websites of the British Association for Counselling and Psychotherapy (BACP) and the UK Council for Psychotherapy (UKCP), allow you to search for private counsellors and psychotherapists near you.

MS-UK Counselling Service

We caught up with Diana Crowe, MS-UK’s Head of Services, to discuss its new counselling service for people with MS.

Can you give a brief overview of the MS-UK Counselling service?

Established in October 2017, MS-UK Counselling is a confidential, national service for people living with MS.

What can people with MS talk to your counsellors about?

Anything that is MS related, that might be affecting your mental health. Counsellors do not give advice but help you to explore your experiences so that you can find your own way forward. Our counselling service is focused on helping you understand yourself in light of your MS and explore its emotional impact on your life.

Why did you decide to set up this service?

Before its launch, we conducted a consultation process with the MS community to identify gaps in MS care. The result informed the charity of a significant need for a counselling service and it continued to engage with them as it shaped what the service should look like. During the research we found 77% of people said they would access a counselling service via a telephone. We felt this mode of delivery would make our counselling service truly accessible to the whole of the UK. MS-UK is a British Association for Counselling and Psychotherapy (BACP) organisational member and its counsellors are BACP registered or accredited. They all have specialist training and experience of MS and the impact it can have on mental wellbeing.

How can people register for counselling?

If you would like to access MS-UK Counselling, simply visit our website and complete an online form, or a health professional can make the referral for you. Alternatively, you can call the MS-UK Helpline on Freephone 0800 783 0518 and an MS Advisor will complete the form for you over the telephone. Once submitted MS-UK will contact you to arrange an assessment, also conducted over the phone. This takes about 30 to 45 minutes. It allows the counsellor to identify what is bringing you to counselling and to discuss any mental health issues you may have. Suitability and availability will be discussed, and a telephone counselling contract will need to be agreed before you are added to the waiting list. Once you have been assigned a counsellor, up to six telephone counselling sessions of 50 minutes will be provided on an agreed regular day and time slot.

Do people have to pay to use the service?

There is no fixed fee, however, a suggested minimum donation of £5 per session helps MS-UK sustain the service in the long term and enables other people with MS access to the service.

Psychological therapies

Psychological therapies

There are a range of talking therapies that can help improve low mood, including counselling and CBT. Read more about them on this page.

Counselling

Counselling

Counselling involves talking to a therapist about your problems and concerns, and developing techniques and strategies to help you live with the unpredictability of MS.

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