If you’re living with other health conditions in addition to multiple sclerosis (MS), you’re not alone. The Centers for Disease Control and Prevention estimates that 40 percent of adults in the United States live with two or more chronic conditions. When someone has more than one disease occurring at the same time, the conditions are known as comorbidities.
While it’s difficult to estimate exactly how many people with MS live with another chronic condition, a 2015 study from the Multiple Sclerosis Journal found that depression, anxiety, high blood pressure, high cholesterol, and lung disease were the most prevalent comorbidities among people with MS. Living with MS and additional health problems can create challenges and increase the risk of hospitalization. You can take proactive steps to support your wellness by learning about common MS comorbidities and identifying ways to manage them or even prevent them.
Common Conditions Related to MS
For the most part, it is unclear why people with MS seem to have a higher risk for developing specific health conditions. Some diseases may have the same genetic risk factors inherited from parents as MS. In others, the inflammation and autoimmune attacks involved in MS may cause damage to other parts of the body besides the myelin sheathing that protects the nerves. For each of the conditions discussed below, the relationship with MS is complex and only partly understood.
Depression and MS
Depression is common among people with MS. Studies have found that as many as half of people with MS will experience depression in their lifetime. There are many possible reasons people with MS develop depression. Some people experience depression when they’re first diagnosed with MS. Even after people adjust to their MS diagnosis, they may continue to experience episodes of depression when they encounter new symptoms or if their MS advances to a progressive type of MS.
People with MS may also experience depression due to the physical effects of MS. For example, depression may be related to damage to the central nervous system, changes in brain chemistry, and fatigue that can occur with MS. Depression can also be related to side effects of medications used to treat MS.
You can take control of your mental and emotional wellness by being familiar with some of the symptoms of depression, including two weeks or more of:
- Feeling hopeless or worthless
- Loss of pleasure in previously enjoyed activities
- Uncontrolled crying
- Sleeping problems (insomnia or sleeping too much)
While it can be worrisome that depression is common among people with MS, it’s important to remember that depression is treatable with therapy, medication, and lifestyle support. Talk to your doctor if you experience any of the symptoms of depression. You can also take proactive steps to support your mental health. The National Multiple Sclerosis Society offers resources for improving your emotional well-being.
Anxiety and MS
People with MS may also experience anxiety. A study of approximately 265,000 Canadians found that anxiety was 58 percent more prevalent among people with MS than the general population. Anxiety was more common in women with MS than men with MS, which is also true in the general population.
Anxiety among people with MS may be triggered by the unpredictability of the condition, the onset of new symptoms, or fears about future disease progression. Similar to depression, anxiety may also be the result of MS-related neurological changes. Familiarizing yourself with anxiety symptoms can help you better support your emotional well-being. Symptoms of anxiety include:
- Feelings of nervousness or tension
- Sense of impending disaster or danger
- Difficulty sleeping or concentrating
- Elevated heart rate
- Hyperventilation (rapid breathing)
Hypertension (high blood pressure) and MS
A study of approximately 1,500 people with MS found that individuals with MS are 48 percent more likely to have ever had hypertension (high blood pressure) than people without MS. High blood pressure forces your heart and blood vessels to work too hard. Hypertension can cause significant health problems for anyone, whether or not they have MS. Some common complications from high blood pressure include heart disease, stroke, and kidney disease. For people with MS, there is some evidence that hypertension may accelerate disability progression. A study of nearly 2,400 Israelis with MS found that those with a history of hypertension were at greater risk for disability progression than those without a history of high blood pressure. High blood pressure can be managed with various medications and with lifestyle changes like exercise, eating a healthy diet, quitting smoking, and managing stress. Your doctor can help you determine the best treatment plan for you.
Hyperlipidemia (high cholesterol) and MS
Hyperlipidemia, more commonly known as high cholesterol, occurs when the levels of fats in your blood are too high. High cholesterol can cause blockages in the arteries which can increase the risk of heart disease or stroke.
A review of 13 studies conducted between 1984 and 2010 found that nearly 11 percent of people with MS have high cholesterol. This estimate includes studies of people in North America, Europe, Australia, and Asia. The same review of studies found mixed evidence about the prevalence of high cholesterol among people with MS compared to the general population - some studies found higher rates among the MS population and some found lower rates. While there isn’t conclusive data indicating if people with MS are at greater risk for hyperlipidemia, a study from the Multiple Sclerosis Journal found evidence that unhealthy levels of fat in the blood are associated with higher levels of disability and MS disability progression. Like high blood pressure, high cholesterol can be treated with medication and lifestyle changes like modifying your diet, exercising, and quitting smoking. Talk to your doctor about the best treatment plan for you.
Chronic Lung Disease and MS
A study of more than a quarter million Canadians found that chronic lung diseases asthma and chronic obstructive pulmonary disease (COPD) are more common among adults with MS under 44 than adults without MS. A study of more than 50 million Americans found that asthma was three times more common among people with MS than those without.
The precise relationship between lung disease and MS is not fully understood. A 2008 study from Sweden found that MS and COPD may be caused by similar inflammatory responses. Inflammation is one of the immune system's main methods for responding to injury or infection. When the immune system is working correctly, inflammation helps fight the infection or protect and heal the injury. In people with multiple sclerosis and COPD, inflammation is chronic and directed at the body's own tissues. MS, COPD, and asthma also share smoking as a common risk factor. However, not everyone with these conditions has smoked, and not everyone who smokes develops an illness. COPD can be treated with various types of medications, oxygen therapy, surgery, and lifestyle modifications. Asthma is usually treated using inhalers or nebulizers. Your doctor can help you determine the best options for your lung condition and your MS.
Managing MS and Other Chronic Conditions
Managing MS and any other health conditions you may have is critical to maintaining your overall wellness. In addition to adopting healthy lifestyle habits and supporting your mental and emotional health, strategies for managing relationships with multiple health care providers can help support your well-being. Below are some proactive steps you can take to help coordinate your health care.
- Prioritize your own goals: Be proactive about deciding what is most valuable for you. Is it important that you can travel? Play the piano? Spend time with family? Live independently? Tell your physicians and ask how you can tailor your treatment to meet these goals.
- Keep a list of your medications and treatments: Be sure you have an up-to-date list of all your medications, including vitamins or herbal supplements, and any other treatments to bring to your medical appointments. Reference the document if you’re discussing a new treatment with your health care provider and ask if there are any potential interactions. Your provider can consult a pharmacist or the doctor who prescribed an existing treatment to further discuss how other medications may interact with your current routine.
- Get all the information you can: Don’t be shy about asking lots of questions. How should you expect a new medication to affect you? What are the benefits and risks? How and when should you take it? When should you start feeling the effects? Write the questions (and answers) down so you can refer to them later. Think about bringing a friend or family member who can help you remember all the details.
- Seek out a “quarterback”: Ask one of your doctors – likely your primary care physician or the specialist you see the most – to keep an eye on the big picture and help coordinate your care across all physicians you see.
- Speak up if something doesn’t seem right: Tell your doctor immediately if a treatment doesn’t seem to be working or is causing problems. Also, speak up if your treatment plan is too complicated for you to manage. Your physician can help you find ways to make it work better for you.
On MyMSTeam, the social network and online support group for those living with MS, members talk about a range of personal experiences. Living with multiple conditions is one of the most popular topics.
Do you live with health conditions in addition to multiple sclerosis? Share your experiences in the comments below or on MyMSTeam.
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