At first, it may be difficult to adjust to the diagnosis of a disorder that is unpredictable and has a risk of progressing overtime to levels of physical disability. This can cause great emotional stress for the MS patient as well as their loved ones.
People with MS never know when and if they will get another exacerbation, or exactly how they will feel from one day to the next. The high uncertainty of this disease is the most distressing aspect.
Generally speaking, anxiety is a feeling of fear, unease or worry. A person with MS is almost always susceptible to anxious feelings due to the uncertain nature of the disease. For some, the uncertainty can be consuming which can result in full-blown anxiety attacks.
More often than not, the anxiety associated with MS is caused by the unpredictability of the disease as opposed to actual lesions on the brain. Similar to MS-related stress, the anxieties can be managed with behavioral changes.
High uncertainty in their disease. The loss of certain functions as well as altering their daily lives can also produce anxiety and distress.
1. Professional counseling 2. Support groups 3. Medicinal therapy – Xanax (http://www.pfizer.com/products/product-detail/xanax) & Ativan for example
Grief can be attributed to losses related to the disease, including the ability to work, walk or engage in leisure activities. Grief is typically time-limited and will resolve on its own.
MS patients experience feelings of grief with a new diagnosis. They mourn the loss of their lives before their disease and often some level of independence.
MS patients will often experience the five stages of grief: 1. denial and isolation 2. anger 3. bargaining 4. depression 5. acceptance
Related to changes in self-image triggered by the disease
**Generally resolves with time 1. Supportive counseling 2. Support groups 3. Understanding and supportive environment
This type of behavior is generally beyond the control of the individual and is not a sign of moral weakness or sociopathic tendencies.
MS has a tendency to leave cognitive deficits in patients with the disease. If a person lacks cognition, or the ability to know and perceive, then they could lose the ability to recognize what is an appropriate response in given situations. This may be expressed in patients who do not respond when necessary or simply give responses beyond an appropriate length.
Inappropriate behavior in MS patients is a result of the inability to self-regulate one’s responses. This is a direct result of the damage to the areas of the brain that control cognitive function. However, it is not reflective of the patient’s moral fiber.
Results in part from MS-related damage to the normal inhibitory functions of the brain.
1. Psychiatric medication 2. Psychotherapy 3. Family counseling 4. Individual may require supervision to prevent the behavior from manifesting
These episodes can range from feeling down for a few hours during one day to severe clinical depression that can last for months
For those with MS, feeling very sad or having no interest in the things around them are very indicative of depressive behavior.
It is very important to seek medical assistance when coping with depression.
Chemical imbalance that may occur at any time
1. Psychotherapy & antidepressant medications 2. Support groups 3. Read more on depression (interlink to depression page)
Mood swings can be rapid and unpredictable in MS patients. This symptom can be one of the most challenging to deal with in family life.
Mood swings can be expressed in MS patients as extreme highs and extreme lows. They are characterized by the manic and depressive behaviors which can be results of the disease itself or reactions to medications. Severe mood swings can be classified as variations of bi-polar disorder.
Mood swings or, in some cases, bi-polar disorder, must be treated appropriately. If misdiagnosed as depression or another condition, the patient will not receive the proper medical attention.
It is unclear if mood swings stems from distress related to the disease or if it is caused by changes within the brain.
1. Family counseling 2. Low doses of anticonvulsant medication such as Depakote (www.depakoteer.com)
Patients with MS face significant challenges in coping with a potentially stressful life. Stress has also been said to be a possible trigger to the onset of MS or MS exacerbations. Stress is part of everyday life, and instead of trying to avoid stressful situations, you should focus your efforts on learning how to best manage and cope with it.
Stress is a state of mental or emotional distress caused by adverse circumstances. It can be manifested both physically and emotionally. Emotional manifestations of stress include depression, agitation and a sense of mental paralysis when the two combine, causing an inability to react appropriately to pressure. Physically, stress can cause hair to thin or fall out, gritting or grinding teeth and insomnia.
One must learn how to manage stress because it cannot be wished away. There are behaviors that can be used to cope with different forms of stress. Once new behaviors are learned and turned into regular habits, stress is much more manageable.
Stress can be triggered by any circumstance that presents a threat to one’s normal life balance. Patients with MS find that the disease greatly disrupts their lives posing new and drastic limitations. The overwhelming feeling of loss of control over one’s life brings stress to the surface.
1. Stress-management options 2. Professional counseling 3. Support groups
These episodes are unpredictable and have little or no relationship to actual events or the person’s actual emotions. It is important for others to know that sometimes people with MS may not always be able to control their emotions
Uncontrollable laughter or crying as a result of MS is commonly known as Laughing/Weeping Syndrome. MS can damage the part of the brain that controls emotions. When damaged, a person with MS might laugh or cry at random.
It is very important for those around MS patients to realize that this behavior is involuntary. Likewise, it is equally important for the patient to know that this is a common symptom and can be treated.
Lesions in emotional pathways in the brain.
1. Amitriptyline 2. Levodopa 3. Desipramine 4. Fluoxetine (Prozac) 5. Fluvoxamine 6. Nuedexta (www.nuedexta.com)