Stress

Most people experience stress, whether they have MS or not. It’s normal to feel anxious or worried from time to time. Experiencing some low-level stress isn’t always bad for you, but long-term or excessive stress can affect your health. It may make your symptoms of MS, such as pain, fatigue and depression, seem worse. Learning to manage your stress is an important part of taking control of your condition.

There are lots of different factors that can lead to stress. Some of them are internal to us, others are external, and some stressors are down to our environment.

Internal stressors are the sources of stress inside us which are shaped by our beliefs, attitudes, values and expectations. Internal stressors include fear, worry, negative thoughts, anxiety and depression.

External stressors are the sources of stress that we’re aware of around us. This might be day-today issues such as time pressures, money worries or the expectations of others. Or it may be a stressful life event or trauma such as illness, changes in a relationship, job loss or the death of a loved one.

You might experience stress if you feel you can’t meet the demands being made of you. This could be deadlines at work, family difficulties, or having to adapt to new life circumstances, such as your MS diagnosis.

The third type of stressors are environmental. These are aspects of your surroundings that might affect you mentally or emotionally. Some examples are extremes of noise or temperature, pollution and crowded areas.

Everybody reacts differently to stress, but there are some common symptoms.

• Physical signs – such as increased sweating, muscle tightness, regular headaches, constipation or diarrhoea.
• Emotional indicators – include irritability, reduced concentration, feeling overwhelmed, problems making decisions, decreased confidence, low mood.
• Behavioural changes – sleep problems, changes in appetite and sex drive, drinking or smoking too much, not wanting to socialise.

Stress causes changes in your blood pressure, heart rate and metabolism. You may not notice these yourself. In the short-term, these responses can improve your physical and mental performance. This can help you cope with the immediate situation – known as the 'fight or flight' response. But, left unchecked, excessive stress can have negative effects. It can impact on your physical and emotional health, including affecting fatigue levels.

Some people with MS believe they developed MS as a direct result of a stressful event or trauma in their life. But the evidence for any link isn’t clear cut. Some studies do suggest an effect whilst others don’t. 

For those with an MS diagnosis, research has also looked to see if there is a relationship between stress and MS relapses. Some studies do suggest that a prolonged period of stress can increase your risk of having a relapse. But again, not all studies have found this effect. 

Why is it that the results vary so much between studies? One explanation could be that everyone reacts to and deals with stress differently. Some people use stress to push themselves to achieve more. Others find stress hard to cope with. So, it may not be the amount or type of stress you’re dealing with that affects your MS. Instead, it could be how you deal with stress that is more relevant to the effect it has on your health.

Some research has shown that stress management programmes can slow down new areas of MS damage. The effect may only be temporary, but it does suggest a link. So do seek practical help with managing stress if you need it.

Only you know what makes you feel stressed, and you’ll have your own ways of dealing with stressful situations. It’s not possible to remove all the sources of stress in your life. But maybe you could change the way you think about it or try to reduce some causes of stress. 

There are techniques you can learn to help you cope better with stress and develop healthier habits of thinking. You could try different strategies to find what works best for you. Be aware they may take time to have an effect.

• Recognising the effect stress is having on your health.
• Identifying what is causing you stress.
• Taking action to remove or reduce the cause(s) of stress.

Firstly, you need to be kind to yourself. Take charge of your own thoughts, emotions and actions. It can be helpful to keep a positive attitude. Rather than thinking “No-one can help me”, instead consider “What could I do to improve my situation?” It’s also important to keep things in perspective. If you only focus on the bad things, you won’t be able to appreciate the good in your life.

The following are some strategies you could try to help achieve the above.

• Talk to someone. Don’t keep things to yourself. Discussing your worries can help. It could be a family member, friend or colleague. They may not be able to change the situation, but another point of view could put things in a different light.
• Try to take stay active and make time for things you enjoy. This allows you to take a step back from the source of stress and perhaps change your perspective on the problem. Being active can help in a variety of ways. It improves mood and self-esteem. It can burn off nervous energy. Exercise can be a safe way to let off steam and work off your anger or frustration. This means you’re less likely to take things out on other people which could increase stress.
• Plan ahead. This can identify potential stressors in advance. To-do lists can help you prioritise activities. Also, breaking tasks down into more manageable chunks can help reduce stress.
• Self-help techniques can be effective at helping people with long-term conditions manage stress. This includes relaxation or mindfulness techniques. Some people find cognitive behavioural therapy (CBT) useful to help find new ways to work through problems.
• Try keeping a gratitude journal. Jot down three things you’re thankful for, or that went well, everyday no matter how small.

There’s no quick fix for stress and no single coping strategy will work for everyone. If you’ve tried some of these techniques and they’re not helping, speak to your GP or MS team.

• Dealing with stress – from the NHS every mind matters website
• 10 stress busters – from the NHS website
• What to do if you’re struggling with stress – from the NHS inform website
• Stress – information from the Mental Health Foundation website
• Stress – information from the Mind website