Multiple Sclerosis

Walking along a country road into strong autumn sunshine with lens flare.

Multiple sclerosis (MS) is a chronic, progressive disease of the central nervous system that disrupts the flow of information within the brain and between the brain and the body. MS, like other chronic medical issues, can affect not only physical wellness, but can also have an impact on an individual’s mental and emotional health.

What Is Multiple Sclerosis?

MS involves damage to the myelin coating around nerve fibers within the central nervous system as well as damage to the nerve fibers themselves. The disrupted nerve signals that result from this damage are what cause the symptoms of MS. There are four disease courses, but a person’s symptoms may be mild, moderate, or severe, regardless of disease type.

Individuals who have MS may experience a wide range of physical symptoms. Some of the most common are fatigue, weakness, vision problems, dizziness, vertigo, sexual issues, bowel and bladder problems, pain, and problems with gait or difficulty walking. Other, rarer symptoms include speech problems, tremors, seizures, difficulty swallowing, headaches, hearing loss, and breathing problems. In addition, MS may cause cognitive and emotional changes. Many people with MS experience difficulties with attention, information processing, problem solving, and perception, for example, and some also experience mood changes.

Currently, there is no single specific test or procedure that can accurately confirm a multiple sclerosis diagnosis. Rather, physicians rely on a thorough medical history, neurological exam, and a combination of various tests such as MRI and spinal fluid analysis. In order to make a diagnosis of MS, a doctor must both find evidence of damage in at least two separate areas of the nervous system that occurred at least one month apart and rule out all other possible conditions that could explain the symptoms.

What Causes Multiple Sclerosis?

The cause of MS is still not fully understood. People in the medical field believe a variety of factors—immunologic, environmental, and genetic—may be responsible for the development of the condition.

The immune system’s involvement can be seen through the attack of certain immune cells on nerve fibers and the myelin coating that surrounds them. Though researchers have been able to identify which immune cells are involved, they do not yet know what sets the process in motion or how to make it stop.

Environmental factors are known to play a role in MS as well. For example, the disorder is more likely to occur in individuals who live farther from the equator. Some believe that vitamin D may have some impact on the development of the condition, as exposure to sunlight and higher levels of vitamin D support immune function and therefore protect against MS.

Smoking is another environmental factor that might contribute to the condition’s development: people who smoke are at greater risk for developing the condition.

Research suggests exposure to certain bacteria or viruses can also increase the likelihood of MS symptoms developing. The Epstein-Barr virus (EBV) is perhaps the virus most often studied in MS research. Studies suggest EBV may interact with environmental and genetic factors to make a person more susceptible to multiple sclerosis. This does not mean that MS is contagious. Most people who get EBV or the measles do not go on to develop multiple sclerosis. Instead, someone with a genetic predisposition for MS is more likely to see symptoms after getting certain infections.

MS and Mental Health

Some of the symptoms of MS are known to have a direct impact on mental health. MS can cause people to experience mood swings and irritability as well as episodes of uncontrollable laughter or crying.

Depression is also commonly experienced by individuals who have been diagnosed with MS: it has been estimated about 50% of people with this condition will experience depression at some point in their life. The mental health effects of MS are likely in part due to the damage to the central nervous system, but they are also likely to occur as a result of the many challenges of living with a chronic disease that can often be debilitating.

How Can Therapy Help?

People who have MS typically require medical treatment to address the disease and its symptoms. It may also often be beneficial for those living with this chronic condition to seek support in increasing their resilience, engaging in fulfilling activities, managing the stress of having a chronic medical condition, and achieving greater overall well-being.

Therapy is one way people can to work on developing ways to experience better health and happiness throughout mind and body. A therapist can often offer support to people attempting to come to terms with a difficult medical diagnosis, as therapy is always a safe place to discuss frustrations and challenges, explore coping strategies, plan for the future, and so on. A therapist can often offer support to people attempting to come to terms with a difficult medical diagnosis, as therapy is always a safe place to discuss frustrations and challenges, explore coping strategies, plan for the future, and so on.

Therapy can also be an effective outlet to deal with the cognitive and emotional symptoms of MS. In therapy, individuals can process their emotions and learn effective ways to manage them. Individuals who experience depression as part of MS, for example, can explore methods of coping and ways to identify and participate in meaningful activities that contribute to well-being in spite of depression’s potential impact on their ability to do so.

Therapy also provides a place where those with MS can learn strategies for compensating for cognitive difficulties with attention, memory, and processing. Finally, a therapist can provide assistance with stress management so individuals with MS can manage their stress more effectively in order to prevent it from exacerbating their symptoms.

Self-Care for MS

Self-care is considered an important aspect of well-being for everyone, but especially for individuals with chronic conditions such as MS. Doctors may recommend a certain type of nutritional plan specific for those who have MS, and following this recommended dietary intake may help reduce symptoms and improve well-being. Beyond this, managing stress and taking time to adequately care for mental and physical well-being can help relieve some of the symptoms of MS.

Exercise, when it is possible, can help to improve strength, muscle tone, and coordination, things that are especially important for those with MS, as the condition often negatively impacts strength and movement. Relaxation techniques such as deep breathing, yoga, massage, and meditation can help reduce stress, which is known to worsen symptoms of MS.

Individuals who continue to participate in hobbies they enjoy, avoid isolation, and pursue typical daily activities as much as possible may also be able to alleviate some negative impact of the condition.

References:

1. Definition of MS. (n.d.). Retrieved from http://www.nationalmssociety.org/What-is-MS/Definition-of-MS
2. Diagnosing MS. (n.d.). Retrieved from http://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-MS
3. Emotional health. (n.d.). Retrieved from http://www.nationalmssociety.org/Living-Well-With-MS/Health-Wellness/Emotional-Health
4. Guan, Y., Jakimovski, D., Ramanathan, M., Weinstock-Guttman, D., & Zivadinov, R. (2019). The role of Epstein-Barr virus in multiple sclerosis: From molecular pathophysiology to in vivo imaging. Neural Regeneration Research, 14(3), 373-286. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30539801
5. Hind, D., Cotter, J., Thake, A., Bradburn, M., Cooper, C., Isaac, C., & House, A. (2014). Cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: A systematic review and meta-analysis. BMC Psychiatry, 14(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890565
6. Multiple sclerosis: Self-management. (2015, October 1). Retrieved from http://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/manage/ptc-20131886
7. MS symptoms. (n.d.). Retrieved from http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms
8. What causes MS? (n.d.). Retrieved from http://www.nationalmssociety.org/What-is-MS/What-Causes-MS

Last Updated: 07-30-2019