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Can Stress Make MS Symptoms Worse?

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

Young woman meditates with a group.

Multiple sclerosis (MS) is a disease where the immune system attacks myelin, a delicate layer of tissue that covers and protects nerves, including nerves in the central nervous system (the brain and spinal cord). MS can cause a wide variety of neurological changes, impacting the way a person moves, thinks, and feels, and what they are capable of doing each day.

Stress is often part of the discussion around MS. Patient education materials frequently discuss ways to reduce stress. Some research has found that stress is associated with MS relapses, 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

Stress is a topic of interest in MS research. 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 many challenges researchers face in producing consistent results. MS is unpredictable and affects everyone differently. Stress can be difficult to quantify and measure. And many different people have MS—people with different backgrounds, personalities, and coping mechanisms.

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 use are prevalent among people with MS, and can have a negative impact on treatment adherence, functionality, and quality of life. It’s 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.
Article sources open article sources

MedlinePlus. Multiple Sclerosis.
National MS Society. Taming Stress in Multiple Sclerosis.
Mayo Clinic. Multiple Sclerosis.
Maddalena Sparaco, Giuseppina Miele, et al. Association between relapses, stress, and depression in people with multiple sclerosis during the COVID-19 pandemic. Neurological Sciences, 2022. Vol. 43, No. 5.
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, 2015. Vol. 2, No. 2.
X. Jiang, T. Olsson, et al. Stressful life events are associated with the risk of multiple sclerosis. European Journal of Neurology, 2020. Vol. 27, No. 12.
Susan Agland, Amanda Lydon, et al. Can a stress management programme reduce stress and improve quality of life in people diagnosed with multiple sclerosis? Multiple Sclerosis Journal—Experimental, Translational and Clinical, 2018. Vol. 4, No. 4.
Mayo Clinic. Multiple Sclerosis.
MS Society. Anxiety, Stress and MS.
Mayo Clinic. Stress symptoms: Effects on your body and behavior.
American Psychological Association. Stress effects on the body.
Celeste Silveira, Renato Guedes, et al. Neuropsychiatric Symptoms of Multiple Sclerosis: State of the Art. Psychiatry Investigation, 2019. Vol. 16, No. 12.
National Institute of Mental Health. I’m So Stressed Out! Fact Sheet.

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