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The Connection Between Stress & Multiple Sclerosis

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Discover the main types of stress, how it can impact symptoms of MS, and what stress management techniques to try when stressful situations arise. 

Multiple sclerosis (MS) is a disease that affects the brain and spinal cord (central nervous system). For people living with MS, their immune system attacks the myelin (a protective sheath that covers the nerve fibers), which then causes communication problems between the brain and the rest of the body. With disease progression, patients may experience deterioration of their nerve fibers causing memory issues, numbness, vision issues, and muscle weakness. 

While a certain degree of short-term stress is normal for everyone, those with MS may experience added stressors due to the many ways in which the disease can affect work, friendships, relationships, parenting, and more. Below, we’re diving into the main types of stress, how it can impact symptoms of MS, and what stress management techniques to try when stressful situations arise.

Types of stress

Emotional Stress

An emotional stress response results in feelings of sadness, frustration, anger, or worry. Symptoms may include:

  • Dizziness
  • Fatigue
  • Anxiety and/or depression 
  • Shortness of breath 
  • Memory impairment
  • Increased chest pain 
  • Increased heartbeat

Mental Stress

Mental stress occurs because of a person’s perception of events in their external or internal environment causing them to experience distress or anxiety. Symptoms may include:

  • Difficulty making everyday decisions 
  • Worrying 
  • Expecting the worst 
  • Easily distracted 

Physical Stress

Physical stress affects the body. When a person undergoes physical stress for a long period of time, it can result in health problems such as increased blood pressure, low immune function, and susceptibility to alcohol and substance abuse. Symptoms may include:

  • Headaches 
  • Muscle tension 
  • Constipation 
  • Diarrhea
  • Heart palpitations 
  • Cramps or knots 
  • Nausea 
  • Dry mouth 
  • Stomach ache 

Long-term or prolonged stress can increase the prevalence of disease.

The connection between stress & MS

Can stress cause an onset of MS? 

MS is an autoimmune disease that affects the nervous system. While stress can interfere with the immune system, it isn’t clear what severity or duration of stress could trigger an autoimmune condition like MS. The effect of stress is also dependent on other contributing factors such as mental health symptoms and negative life events.

In a 2020 study with 3000 MS patients, researchers evaluated via a questionnaire whether stressful life events influenced patients’ MS diagnosis. According to self-reported data, they found that major life events such as divorce, sickness, accidents, and major conflicts increased risk of MS by 17% to 30%

So while stress does not directly result in MS development, it may increase the risk of MS onset. 

Can stress cause more or worsening MS symptoms? 

Long-term or excessive stress may be a risk factor for MS exacerbations like pain, fatigue, and depression. 

Can stress trigger an MS relapse? 

MS relapse is the occurrence of new MS symptoms or the worsening of symptoms at least 30 days after a flare-up and lasting for at least 24 hours. This relapse is usually caused by an acute inflammation in the central nervous system which damages the protective myelin. A relapse can be confirmed by the detection of one or more enhancing lesions on the brain or through a spinal cord MRI scan.

Research has found that major negative stressful events can increase a person's risk for lesions. Another prospective study similarly suggests that a high number of stressors increases the risk of relapse. The symptoms experienced during a relapse vary from person to person, with some experiencing mild sensory disturbances while others experience new disabilities. MS patients may experience just one symptom or several new symptoms at the same time. Relapses can last as long as several days to weeks to months. 

5 stress management techniques 

  1. Surround yourself with strong social support

    Lacking a supportive social network can make you more vulnerable to the effects of stress on your body. A 2022 study found that having strong social support makes it easy for you to push through stressful situations. Another study found that social support might affect the release of hormones like oxytocin, which is associated with social bonding and can help reduce stress. Social support may also affect other hormones like Dehydroepiandrosterone (DHEA) and Neuropeptide Y(NPY), which could help regulate the systems in the body that respond to stress.

    When you’re experiencing a relapse or worsening of disease activities, a strong social support system can help improve emotional wellbeing in daily life — not to mention the very practical benefits of helping you get to your healthcare provider’s office for treatment.

    READ MORE: How To Find MS Support Groups (Online & In-Person)

  2. Practice relaxation techniques like yoga

    Yoga is a form of exercise, but it can also be a great form of relaxation. It has been found to decrease stress and anxiety while boosting overall well-being. 

    READ MORE: Yoga For MS: Benefits, Poses & Tips

  3. Hone your positive coping skills

    Your stress response can determine the effect that stress has on you. With positive coping strategies, you can lower the impact of stress. Some positive coping skills include: 

    - Reaching out for help if you need it 
    - Trying to shift perspective 
    - Focusing on positive memories. 

    If you’re finding this difficult, it may be beneficial to speak to a mental health professional or licensed therapist who can help you learn and develop effective ways of approaching challenges.

  4. Learn new breathing techniques

    Breathing techniques can help you manage the effects of stress and improve overall quality of life When you’re focused on breathing, there’s little room for other thoughts to infiltrate your mind, thus reducing levels of stress. Here are some breathing techniques to try:

    - Deep breathing: focus on breathing in slowly through your nose and exhale slowly through your lips
    - Belly breathing:  close your eyes and place one hand on your belly and the other on your chest. Breathe in through your nose and feel your belly rise more than your chest. Then exhale through your nose. 
    - Box breath: inhale for four seconds and then hold your breath for the following four seconds. Next, slowly exhale through your mouth for another four seconds and then pause and hold your breath for four seconds before restarting the cycle.  

  5. Sleep 

    One of the most effective ways to manage stress is to get enough sleep — which we know is easier said than done. To help make things easier, try establishing a nighttime routine, keeping your bedroom cool, and avoid looking at your devices 30-60 minutes before bedtime (or using blue light blocking glasses if that’s impossible).


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