Can Stress Make MS Symptoms Worse?

Learn what research says about the connection between stress, MS, and overall health.

Medically reviewed in March 2020

Multiple sclerosis is a disease of the central nervous system, where the immune system attacks myelin, a delicate later of tissue that covers and protects nerve tissue. MS can cause a wide variety of neurological changes and impairments, impacting the way a person moves, thinks, feels, and what they are capable of doing day by day.

Stress is often a part of the discussion about MS. Patient education materials often discuss ways to reduce stress. A number of studies have made the claim that stress can trigger MS relapses or worsen disease progression, but the relationship between stress and MS is unclear and not fully understood. Here, we look at what is known about the connection, and why reducing stress is important to your health and wellbeing.

What the research says
Much research has looked at the impact that stress might have on MS. Some studies have looked at the role stressful life events can play in the onset of MS. Others have looked at whether stress can trigger flare-ups or relapses. Others have looked at the impact that mindfulness and stress management have on disease progression. There are a number of challenges researchers face in producing consistent results. MS is unpredictable and affects everyone differently. A wide range of people have MS, people with different backgrounds, personalities, coping mechanisms. And stress can be difficult to quantify and measure.

The impact of stress
While the relationship between stress and MS remains unclear and more research is needed, it is well-established that MS is a stressful condition to live with. People with MS must cope with a great deal of uncertainty—not knowing when the disease will relapse or progress, what new symptoms will emerge, what life will be like a year from now, or even what they will feel like tomorrow.

It is also well-established that stress can be harmful to a person’s body, mood, and behavior. People who are experiencing unmanageable levels of stress may experience headaches, pain, fatigue, loss of sex drive, and difficulty sleeping. They may also feel anxious, angry, irritable, and depressed. They may avoid socializing, consume too much alcohol, smoke, exercise less, and not eat well.

For some people, chronic stress can lead to health problems, including hypertension and heart disease, and disorders like anxiety and depression. Anxiety, depression, and substance abuse or misuse are more prevalent among people with MS, and can have a negative impact on treatment adherence, functionality, and quality of life. It is important to remember that these disorders are more than just passing moods and require treatment from a healthcare provider.

Managing stress
Taking care of stress is an important part of overall health and wellbeing, and is something you should discuss with your healthcare provider. Additionally, there are many steps you can take in your everyday life to help reduce stress and cope with stress, including:

  • Keeping a record of how you feel each day, including your mood, how you slept, your energy level, and anything you are struggling with.
  • Getting some exercise each day. Although MS can make it difficult to exercise, any amount of physical activity can help both mood and health.
  • Keeping in touch with friends and loved ones.
  • Engaging in a mindfulness activity like deep breathing or meditation.
  • Making time for hobbies and activities that are important to you. Pay attention to what you need. If you find that your usual activities and interests are too difficult or time consuming at the moment, try to find new activities or interests.

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Frederick Foley, PhD with Jane Sarnoff. "Taming Stress in Multiple Sclerosis." National MS Society, 2016.
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Laia Briones-Buixassa, Raimon Mila, et al. "Stress and multiple sclerosis: A systematic review considering potential moderating and mediating factors and methods of assessing stress." Health Psychology Open, July 2015. Vol. 2, No. 2.
Jasminka Djelilovic-Vranic, Azra Alajbegovic, et al. "Stress as Provoking Factor for the First and Repeated Multiple Sclerosis Seizures." Materia socio-medica, 2012. Vol. 24, No. 3.
Senders A, Bourdette D, Hanes D, Yadav V, Shinto L. "Perceived stress in multiple sclerosis: the potential role of mindfulness in health and well-being." Journal of Evidence-Based Complementary & Alternative Medicine, 2014. Vol. 19, No. 2.
Artemiadis AK, Vervainioti AA, Alexopoulos EC, Rombos A, Anagnostouli MC, Darviri C. "Stress management and multiple sclerosis: a randomized controlled trial." Archives of Clinical Neuropsychology, June 2012. Vol. 27, No. 4.
Mayo Clinic. "Stress symptoms: Effects on your body and behavior."
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Chwastiak, Lydia A, and Dawn M Ehde. “Psychiatric issues in multiple sclerosis.” The Psychiatric Clinics of North America, 2007. Vol. 30, No. 4.
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