Stress and MS / Relaxation

Everyday living
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1

Just wondered what your thoughts are on the links between stress and MS. Do you think anxious people are any more susceptible? I’ve seen suggestions for example that 50% of people with MS suffered from depression at some point (presumably before diagnosis!)

I am someone who is very prone to stress, anxiety, knots in the stomach, increased heartrate. I worry about things a lot. Now that I’ve read that stress is bad for MS, and can worsen symptoms, I don’t know what to do about it! I see that meditation is recommended but even if I had time, I’m sceptical as to whether it would work for me.

What stress-management techniques do you use?

2

Hi,

I reject totally that MS is anything at all to do with personality.

As it happens, I am a bit of a worry-bunny, but I think a quick tour round the forums will show you there are just as many people who are (or were, before getting ill) pretty laid-back and happy-go-lucky.

My bet is that ostensibly high rates of depression in MSers are accounted for by common misdiagnosis. I had been previously diagnosed with depression, but strangely, no anti-depressant helped at all.

I now feel that what I accepted, at the time, must be depression, was in fact the fatigue of chronic undiagnosed illness (MS). I think it’s quite common for people to have MS for a number of years, before it begins to be suspected.

I think early, undiagnosed MS is quite likely to be mistaken for depression, or to cause depression. The person is finding life subtly more difficult, and feels generally cruddy, but has no understanding of why! That would be enough to depress anyone.

I don’t think it’s the other way round - that depressed people are more likely to get MS. I’m not sure any more if I was ever truly depressed, or if it was just a convenient label stuck on symptoms not otherwise explained. I feel that if “depression” hadn’t been such a popular diagnosis these days, I might have been examined for physical causes much sooner. I think I’d already had MS for years, before even being referred to Neurology.

But it’s a bit of a vicious circle, because once you have a mental health diagnosis, NON-psychological symptoms are much less likely to be taken seriously. When you go to the doctor saying: “This hurts, that hurts; I’m starting to worry it may be serious”, you may be told health concerns are a manifestation of your depression and anxiety.

Tina

3

Oh, one thing I forgot to add, though…

I do think stress can cause a reversible increase in symptoms for people who already have MS. During recovery from my last relapse, I’ve even had “jelly legs” from a mildly pushy phone-call (not debts or anything, just an over-persistent friend). I think this is very different from actually causing MS, though.

T.

4

Hi,

A small trial was done recently investigating the effects of stress management on lesion activity in MS. It showed that in the group receiving stress management therapy there was a reduction in active lesions for the period of time the treatment was continued.

Worth having a look at…

http://multiple-sclerosis-research.blogspot.com.au/2012/07/stress-management-on-trial-as-dmt.html

It was only a small trial group and so the results are still open to interpretation but given just HAVING MS is stressful, learning and practicing some stress management techniques can only be beneficial one would think.

As far as the depression statistic goes you said [quote=“Vincere”] 50% of people with MS suffered from depression at some point (presumably before diagnosis!) [/quote]

I am not sure why you made the assumption that the people would have suffered from depression prior to diagnosis. MS can cause depression as a symptom due to lesions as much as it can cause optic neuritis or bladder problems in some people. Other people with MS can develop depression due to social isolation, pain, grief and loss issues etc. So I would suggest that probably the majority of people with MS who also have depression probably develop the depression as a result of having the MS. Although certainly some people with MS may have had a prior history of depression too.

Given you are a self confessed stressy type I would think that you would definitely benefit from stress management. There are lots of different types (not just meditation!) and it may be a matter of shopping around to find the best technique for yourself but I certainly wouldn’t dismiss it out of hand.

It may be as simple as building into your routine a regular walk everyday to get the endorphins pumping… or you may benefit from a more structured approach one on one with a therapist for a while. Or a regular Yoga class. You will know best what works…

Cheers,

Belinda

5

For me, stressy events can worsen existing symptoms temporarily, for sure, in the same sort of way as a hot day or a hot bath can. And I would not be one bit surprised to hear that people under chronic and unpleasant stress tend to have worse health than others across a range of health issues, including, but not limited to, MS (if they happen to have it.)

Managing stress (which is difficult, because life just happens!) and managing one’s responses to stress (which is also difficult, but which is even more important, in my view, and also more do-able) is bound to be a good thing for a person with MS. I’m miles better at it than I was, with a lot of help from counselling and even more help from eventually giving up work, but it’s always work in progress, particularly for a natural worry-bug like me (and you.) But please try not to let anxiety about getting stressed be just another stressor for you! You have enough on your plate. Try to be kind to yourself, and please do not tell yourself you MUST eliminate all stressors from your life right now or you WILL make your MS worse! Try Just take it gently, I would suggest, and don’t force things too much.

Alison

x

6

Hiya

I’m one of those lucky people who doesn’t tend to get stressed, unless it’s an extreme situation and I’ve still got MS which is pretty active even though I’ve been on DMD’s almost since diagnosis. I’ve always plodded quite happily through life and deal with stressful situations by looking at the problem, deciding if I can fix it…if yes, fix it…problem gone no stress involved…if I can’t do anything about it, well it’s not worth getting worked up about as it’s out of my control, so I move on again no stress involved. I know this may seem a very simple view to have but it works for me.

So although stress may play a part for some people, it’s not something that I can ‘blame’ my MS on. If only it was that easy.

Sue

x

7

Hiya

I’m one of those lucky people who doesn’t tend to get stressed, unless it’s an extreme situation and I’ve still got MS which is pretty active even though I’ve been on DMD’s almost since diagnosis. I’ve always plodded quite happily through life and deal with stressful situations by looking at the problem, deciding if I can fix it…if yes, fix it…problem gone no stress involved…if I can’t do anything about it, well it’s not worth getting worked up about as it’s out of my control, so I move on again no stress involved. I know this may seem a very simple view to have but it works for me.

So although stress may play a part for some people, it’s not something that I can ‘blame’ my MS on. If only it was that easy.

Sue

x

8

Hiya

I’m one of those lucky people who doesn’t tend to get stressed, unless it’s an extreme situation and I’ve still got MS which is pretty active even though I’ve been on DMD’s almost since diagnosis. I’ve always plodded quite happily through life and deal with stressful situations by looking at the problem, deciding if I can fix it…if yes, fix it…problem gone no stress involved…if I can’t do anything about it, well it’s not worth getting worked up about as it’s out of my control, so I move on again no stress involved. I know this may seem a very simple view to have but it works for me.

So although stress may play a part for some people, it’s not something that I can ‘blame’ my MS on. If only it was that easy.

Sue

x

9

Yes stress does add to it, I wouldn’t presume to say that it’s what causes it. Stess can bring on MS symptoms though and probably doesn’t help any illness.

I am currently reading some very good books, practising Alexander Tecnique and tai chi to counter my withdrawel from Morphine pain patches and trying to stay chilled by listening to relaxation words and relaxing music as the least bit of stress or excitment seems to give me migraines.

Wendyx

10

Just copied this from another forum, I hope it helps. Pat Depression and MS: This is another very important topic that all of us need to understand. Depression and MS are close companions. Many people with MS will deal with depression at one time or another during their lives. We see depression from four main causes. First, depression is a “primary effect” of Multiple Sclerosis just as vision problems, paresthesias, pain, weakness, spasticity, vertigo and many other things are. Second, there is a depression known as the “depression of chronic illness.” The stress of dealing with all that is involved with MS can cause a situational depression. Finally, many of the medications used in treating MS and its symptoms cause depression as a side effect. The first cause is the most important to understand. DEPRESSION IS A PRIMARY EFFECT OF MS The damage to the brain in Multiple Sclerosis often causes depression, just as directly as it causes optic neuritis or weakness. How this happens is not completely understood. Many researchers believe that the overall slowing of nerve conductions in the brain is mostly responsible for the creation of depression. We know it isn’t just having a serious and incurable disease. The incidence of depression in MS is higher than it is in other much more disabling diseases or even fatal diseases like ALS. Even in the most well-adjusted person MS can cause major depressive episodes. In people genetically predisposed to depression, with a history of severe depression, it is even more likely that they will be affected by this change in the working of the brain. At all points, the treating physician must be watchful for the development of signs of depression. Suicide is a seriously common side effect of this damage to the workings of the brain. It occurs at least seven times more than in people without MS, including those with other chronic illnesses. Families and friends of people with MS need to know about this problem that is peculiar to this disease. The biggest risk of suicide are in those with social isolation, a family history of mental disease, and who are living alone. Depression is so much a part of the disease that many experts in the field are advocating counting a previous and recent Major Depressive Episode as one of the Clinical Attacks need for diagnosis in the McDonald Criteria. They are suggesting if a person is being worked up for MS and has had a Major Depressive Episode within the previous 2 years, that episode should be counted as an both the attack and as the clinical lesion (the abnormality on exam). THE DEPRESSION OF CHRONIC ILLNESS The second cause of depression in MS is the difficulty with the slowing metabolism of inactivity, chronic pain, chronic fatigue, and chronically not “feeling well.” This causes what is called the Depression of Chronic Illness. Some experts would not list this and would say this is part of the next cause, which is situational. Others argue that it occurs too readily in people without a predisposition to depression who have a chronic illness. THE SITUATIONAL DEPRESSION OF LIVING WITH MS The third category is the depression caused by living with the disease. It is hard to cope with the many symptoms of this disease, along with the profound effects MS has on one’s life. Many people with MS are no longer the person they once were. Their current state just doesn’t match the image they have of themselves as a capable, independent and future-filled person. Many lose their careers. This is an expensive disease to have. Not only are the treatments and meds often expensive, but sometimes a person loses their source of income. This is an isolating disease to have. Travel is more difficult and people with MS may become home-bound. This reduces the time that we can spend with family and friends. Social isolation is a potent cause of depression. This disease is hard on relationships. The spouse may suddenly have a caretaking role shoved upon them that they don’t want, are not ready for, or are incapable of handling. Friction can arise over financial problems. The person with MS may feel guilty over this change in roles. The spouse may feel anger at the disease, at the affected loved one, or at the unfairness of it all. There may be intense frustration at not being able to fix it or make things right. We see marriages sometimes break up under the burden of MS. And a major cause of disruption is the uncertainty of MS. What will the future bring? What will TODAY bring? Can we plan for additional children, for a vacation this year, to go see the folks this weekend? Never feeling as though anything is certain causes many people with MS to feel loss of control over the little and big things in their lives. MEDICATIONS CAN CAUSE DEPRESSION AS A SIDE EFFECT Finally, the medications used in MS may cause depression themselves. The first to be aware of is the Interferon-beta drugs; Avonex, Rebif, and Betaserson. Because of their action on the brain functions itself, which may include lowering the production of endorphins, depression must watched for carefully. People with a signifcant history of depessive disease are not the best candidates for these meds. Copaxone does not carry this effect to nearly the same degree, if at all. Another category of meds that have a potential for causing depression as a side effect are the “benzodiazepines” such as Valium (diazepam), Xanax (aprazolam), Klonopin (clonazepam), Ativan (Lorazepam) and there are many others. So, it is clear that the possibility of depression is inherent in the disease of multiple sclerosis. It is also a disease that can cause depression by creating severe stresses in the life and many of the meds used can predispose to depression. How can we tell the difference? Actually, we can’t for the most part. And it is not relevant to say that this depression is caused by the disease and that depression is cause by the stresses. The treatment is mostly the same. Every effort should be made to ease the stresses, relieve the symptoms and reduce meds that can cause the problem. Depression is not shameful in MS, nor in any other setting. It should be approached and treated just as any other symptom of a disease that encompasses almost every part of the body and life.

11

Consultant is always saying that there is no concrete evidence to show there is a link between stress, anxiety and MS. This is seemingly because the study required to do this would be far too extensive, time consuming and costly. However, for me,among other factors, i think there’s a definite link as relapses always link into particularly stressful and / or upsetting times either at work or home. I agree with Wendy that stress can bring on a relapse and probably does not help the illness at all. Depression wise, I’m up and down like a yo yo particularly during and just after a relapse. x

12

Thanks for your replies. My point by the way about that 50% statistic presumably being before diagnosis was precisely because it wouldn’t be news if a lot of MS sufferers have depression AFTER diagnosis because of not only getting such difficult news but because of having a chronic illness. The only reason that statistic would be of any value, in my view, would be if they were saying that 50% of people who later are diagnosed with MS have previously suffered from depression, hence indicating some sort of relationship between the two.

As for stress relief, I don’t really know what to try. I just worry about everything, it’s my nature. I think I have “monkeybrain” (an actual term!) where i just keep running over and over things in my head, either worrying about actions or decisions I’ve already made, or things that are coming up in the future. I tried yoga when pregnant, it did nothing for me.

One thing I don’t really understand yet is this, and maybe you can help me: there seem to be two avenues of treatment, preventing relapses and minimising / avoiding long term disability? I just wonder whether each relapse makes you more likely to suffer long term disability, or if the two are not linked? e.g. I’m not taking any medication, which presumably means I’m not doing anything to avoid relapses. Similarly, stress may bring on relapses. But are these relapses making it more likely I’ll have a worse outcome long term, or are the two linked?

13

i have always been happy go lucky and was in a boring, easy job ob minimum wage until aged 26 i went back to school. got a levels and a degree. oh and had 2 babies whilst i was studying. i remained happy go lucky and enjoyed every minute i spent with my babies.

then started work as a primary school teacher. i loved that job but felt the need to work extra hard.

i started to feel alive when work became stressful.

moved on to an advisory post with a local authority. again i loved that job but again the stress grew and grew.

at the same time my nephew got himself arrested and sent to prison. i spent every evening with my sister who was having a very hard accepting this. we drank lots of wine until late and did a lot of laughing and crying.

whoops - when i wasnt looking i got ms!

i took medical retirement and vowed that i was going to cut out all things stressful. people who caused me stress were to be avoided. places that caused me stress were to be avoided.

i still have some stress but it is manageable.

so i don’t know where i fit into your post. maybe i was always supposed to be happy go lucky in a dead end job?

we’re all so different.

look after yourself, do whatever is needed to get your stress to manageable levels

carole x

14

hi

i have been doing meditation weeky for 2 years-its def not a quick fix but i believe it has helped my recent relapse,

i have not been able to move my right side at all. as if cut in half down the middle. mouth ‘frozen’, limbs just hanging-no power at all.

i know that some talk on here of ‘fighting’ ms. personally i think its stronger than me, it renders me powerless and i only fight in battles i know i can win! i find it it best for me to except whats happening and use my energy to being stronger again.

meditation classes helped me to learn and understand this.

6 weeks ago i started a relapse-i have spent a month in bed unable to move-needed to be fed and washed-whats the point of fighting this?its impossible!

carers are still in my home to assist me but each day i am getting stronger. i use my enery to stretch and excercise.

i tell u this in the hope it gives u reassurance to try meditation for yourself.

ellie x