Stress Management and Multiple Sclerosis

 Many people with Multiple Sclerosis say that they experience more symptoms (or that they notice a worsening of old symptoms) during times of stress.

What is Stress?
Stress is anything that challenges or threatens our sense of well being. Something may feel like it is just “too much” for us to handle, we may feel overwhelmed, or overloaded. Too many bills, not enough money, not enough time to finish a project for work or school, problems in a relationship, the death of a loved one, or health problems… Those are just a few common sources of stress and Multiple Sclerosis can cause all sorts of stress on it’s own in addition to the stress that just comes with life!

When all of a sudden you can’t do something that you have always been able to do, that frustration causes stress. Not being able to walk properly, see, feel something on your skin, or realizing you are no longer strong enough to lift just a gallon of milk? That causes all sorts of emotional disturbances which “changes your sense of well being”, that is stress. Even if you have lived with Multiple Sclerosis for years and have long accepted the debilitating disease and all the lifestyle changes that comes with it,  it can still cause you stress. Pain, discomfort, not being able to “keep up”, or occasionally looking back at your past and wishing things were a little like the way they used to be can all add to your stress!

Even good things can cause stress! Maybe you would not call it stress but let’s say you got a new job, that feeling of excitement? That can be a form of stress depending on how much it effects you emotional state!

I know that I stress out at the smallest of things. What people don’t always understand is that stress does not have to always stem from something major like work or school. If someone followed you around all day and randomly poked you wouldn’t that make you feel stressed?  Small things stress me out like having 6 tabs open on my web browser, messes, clutter, sound, it all overwhelms me which causes stress. The way I look at it is like this; Our capacity for stress is like a cup, some of us can hold a lot more liquid (stress) than others but when our cup overflows that is when our stress is out of control. In my case, my cup is constantly at the verge of overflowing because it is much smaller than most people’s! So adding just a tiny amount of liquid into it causes it to spill over. When we loose control of our stress that is when it really starts to effect our health… So the key here is to learn how to properly manage your stress and avoid “your cup overflowing”.

What happens when we are stressed?
When we become stressed how does our body respond? It’s not just in our head, it’s physiological, it’s in our physical brain and it’s in our body! When we become stressed our heart rate increases, our blood vessels dilate, we produce cortisol (a stress hormone produced by the adrenal glands), our bodies stop producing sex hormones, and our metabolism decreases causing extra glucose to pump throughout our body. So as you can see, simply being stressed out causes all sorts of changes in our body!

How Stress Effects MS
Though many people with MS say that stress makes their symptoms worse and that it can even push them into an exacerbation, there is actually no scientific evidence on how stress effects MS! With all the physiological changes we undergo, it’s very likely that stress effects our immune system, but just how is not yet known. But that doesn’t take away from it’s reality, it’s kind of like how the disease modifying therapies work, in that, we don’t actually know how they work, we just know that they do.

The Importance of Managing Stress
So we don’t know why stress makes MS worse (for most people) we just know that it does. This is why it’s important to learn how to manage our stress. When living with MS our goal is to not relapse, to manage our symptoms, and to reduce the long term disability effects of the disease and if stress can make any part of MS worse, then stress is a major obstacle in the way of those goals. If stress can cause our symptoms to flare then stress can basically be responsible for some of our relapses. I am not saying stress alone is the cause of all or even some of our relapses, I am simply saying that stress may be a contributor. I know that for me personally, stress is a major contributor. When I feel stressed I immediately see my symptoms flare up, especially my spasticity. When I become angry or upset the first thing I notice is how my legs just tighten up!

How to Manage Stress
Let me just say this, because I am so sensitive to stress I have been constantly trying to learn how to deal with it since I was diagnosed with MS, I am finally starting to learn how to handle it better but I think it is going to be one of those things that you constantly learn about. New management techniques may come up, new triggers, or new limits may arise. Here are some things that I have learned about dealing with stress as well as things that have shown to help others.

Prevention
That is right, the best thing I have learned so far is to avoid stressful situations (stressors) when ever possible. If I know that something like a noisy kitchen stresses me out then I simply avoid the kitchen when it is in use. I have also had to cut people out of my life because they simply added to my stress levels. I suggest evaluating your life and all the stressors that’s in it and try to come up with ways to cut those stressors out if possible.

Attitude
Having a positive outlook towards life won’t eliminate your stressors but it might help you look at them more positively and handle them better. If you are happy with yourself then when a stressor hits you out of nowhere then it is more likely to roll off you like water off a duck because hey, your happy, it’s not so bad right? You’ll figure it out! But if your dwelling in negativity it will feel like the end of the world…

Talking/Venting
Don’t keep it bottled up! Empty that cup out! This is probably one of the easiest ways to try to cope with a stressful event, talk about it to someone! A friend, family member, or even a therapist. Can’t talk about it to someone in person? Join an online support group where you can post anonymously or join a private group on Facebook, if it’s a private group, what you post won’t appear in people’s news feeds and your friends won’t even see that you joined.

If talking to people about your problems is not your thing try writing about what is bothering you in a journal. This might sound dumb but it really does help people, sometimes it feels good to just get that negativity out of your head and onto a piece of paper (or a word document that is). Both of these options helps keep me sane so I really do recommend it. If you don’t want to (or can’t) write in a physical journal, try making a personal blog by joining blogger.com for free. You can change the privacy settings so that no one can read your posts but you. I have several “journals” on blogger that are for this purpose alone.

Prioritize
Look at everything you may need or want to do everyday and ask yourself how important each of these things may be. Do you have to mow the lawn today or can you do it every other week? Maybe you don’t have to be so strict about everything in your life. If something is pushing your limits learn to let it go if you can. Some things like “picking the kids up from school” can’t be forgotten about but maybe you can find a trustworthy friend or family member to help you on certain days of the week to give you a little brake? You might even feel stressed over something you want to do. Maybe your trying to make sure you work out, read, and practice guitar everyday but your just feeling so tired! Loosen it up! Maybe work out every other day, practice playing guitar on the opposite days, read a little less, and then spend some of that extra time resting. Is doing everything everyday really as important as you might think it is? Prioritize.

Ask for Help
I just mentioned maybe asking someone to pick the kids up from school, we don’t all have kids, but the idea is the same. It is OK to ask for help to try to reduce your stress load. Simple things like asking for help with dinner, cleaning, or playing with the dog can really help relieve some of the stress. Maybe you have the energy for it but you are trying to do something that is now beyond your abilities, for example, sometimes I can’t do little things that I used to be good at because my fine motor skills are just not happening. That stress of not being able to screw that tiny screw in with a screw driver can cause a lot of stress! “Stop shaking hands!” Maybe just put down the screw driver, take a deep breath, and ask someone to help you, even if you don’t want to.

Extend Your Mornings
I like this one. A lot of people hate mornings, they hate getting up, and they hate rushing to work or school. Extend your morning. Go to bed a little earlier so you can wake up a little earlier even if it’s just by 15 minutes. That can be the difference between 5 minutes late and 5 minutes early! Also, try to get what ever you can ready the night before even if it’s picking your clothes for the next day so they are laid out an ready. I always try to prepare for a doctor’s appointment the day before by making a list of everything I want to talk about that way I am not rushing to try to make this list 5 minutes before I leave and I am not stressing out about the little things I may have forgot to mention. I like to have way more time than I need in the morning so that getting ready for something is not down to the second.

“Just Relax”
“As if it’s just that simple” you say before smacking someone across the face. OK, now you need to relax, but how?.. Relaxing is not something you just decide to do, it is something you have to learn to do. What works for one person may not work for you and what works for you may not work for someone else. Everyone has their thing whether it is reading, listening to music, painting, gardening, cooking, meditating, working out, going on walks, doing yoga, taking pictures, or doing puzzles. You have to experiment with doing things that you enjoy, specifically, things that you can loose you thoughts in. You want to reach a state where you are thinking of nothing but your activity so that you can use it as an escape from all your worries.

Deep Breathing
This is probably one of the easiest stress relief techniques and it can be done anywhere, anytime, and only take a few minutes.  You can do this several times a day and you can find different exercises out there but here is a simple one:

  • Sit back strait and try to be comfortable.
  • Place your hand on your stomach so that you can feel yourself breathe.
  • Take a deep breath through your nose, breathe in slowly, and concentrate on the feeling of the air moving into your body.
  • Draw in as much air as you can and let your stomach expand beneath your hands.
  • Hold your breath for a few seconds and don’t count unless you find it helps you relax.
  • Slowly exhale through your mouth using your lips to control the speed of your exhaling (try to shape them as if you were going to whistle)
  • Concentrate on the feeling of every bit of air leaving your body as your hands feel your stomach contract.
  • Sit quietly for a moment an reapeat 4-5 times.
  • When done sit for a couple of minutes before getting up. 

Meditation
I personally can not meditate, when I try to meditate, my mind fills with thoughts and this just adds to
my stress but many people really like this. Of course, it takes practice either way, so you kind of have to try it out for yourself. There are many meditation techniques online!
 
Progressive muscle relaxation
I remember trying this in physical rehab but I can’t say I ever mastered it. Basically, it involves laying down and slowly tensing each muscle in your body and then releasing it. Your suppose to closely observe the feeling of that “release in tension” that you feel when you stop clenching a muscle. It is also supposed to help you become more aware of your body. Though I am not sure I ever mastered this I do like it and recommend looking into it.  CLICK HERE to check out a page I found with instructions on performing this technique but I do want to add that it should take about 15 minutes, anything less than that means your are moving too fast which won’t help you relax.

Bottom Line
There is no set way of reducing stress, we all have different stressors therefore we all have different solutions. Some people will find that one thing helps reduce their stress and another person might find that same thing stresses them out even more! What you need to do is experiment and really try to listen to your body and figure out what it is that causes your stress. Figure out what it is that make you feel good. This is probably not easy to do during the peak of a stressful situation so maybe try some deep breathing first and once you feel calm start trying to identify your stressors. Once that has been done start thinking about how you can eliminate them, keep a list, when eve you have an idea? Add it to the list. We may not know how, but stress definitely seems to effect MS so learning how to manage it is very important for our health!

2 Responses to Stress Management and Multiple Sclerosis

  1. Minakitty says:

    For me, stress can trigger those pesky "MS hug" attacks. Of course, they tend to show up whenever they want to, but I can pinpoint instances when stress was the cause.

    Yoga! I took 9 weekly classes this past spring of "gentle" yoga (it was still hard!), and my daily neuropathic pain disappeared for a few days afterwards, and NO MS hugs!

    It's the little victories 🙂

  2. Wow, yeah, a lot of people say yoga help a lot of things with MS, I don't like it, i wish i did. Stupid hug….. I can't even tell when I have it anymore but sometimes when I get really stressed I do notice myself thinking "hmmm, my chest feels kind of tight"

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