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Fear After MS Emergencies: 4 Trauma Coping Mechanisms

Posted on March 6, 2023

Experiencing a multiple sclerosis (MS) emergency, such as a relapse (flare-up) requiring a hospital stay, can be traumatic and affect your emotional state for some time afterward. Recognizing and addressing the emotional fallout of a health emergency is important because excessive stress can make you feel irritable and worried.

It’s normal to feel afraid after going through a severe MS relapse that interferes with your daily functioning. Taking time to look after yourself and develop trauma coping skills is not an indulgence — it’s a vital part of your health care.

What Does an MS Emergency Look Like?

An MS relapse qualifies as an exacerbation — another term for relapse or flare-up — if the symptoms last for 24 hours or longer and occur at least 30 days after a previous relapse. In addition, the symptoms shouldn’t be related to another cause, such as an infection.

Exacerbations can occur when inflammation in the central nervous system damages the myelin covering that protects your nerves. The damage makes it hard for messages to flow between your brain and other body parts, which can cause MS symptoms.

A severe MS exacerbation might involve losing your vision or becoming extremely weak. Doctors usually treat flare-ups like these with a short course of high-dose corticosteroids.

One MyMSTeam member described their flare-up: “I’m back in the hospital. Second attack of the year that’s landed me in hospital after nine years of no stays. Frustrated — paralysis, spasticity, legs just plumb don’t work.”

Feeling like you’re losing control of your body can understandably cause a spike in anxiety, and afterward, you may be afraid another one will occur. If you have relapsing-remitting MS (RRMS) — the most common form of MS — the prospect of characteristic relapses that follow times of remission (improvement) may have you especially on edge.

Making space for self-care after experiencing trauma such as an MS emergency is important for managing both your physical and mental health.

How Might an MS Emergency Affect Mental Health?

After an MS emergency or another distressing life event, people may develop post-traumatic stress disorder (PTSD) or experience other symptoms of anxiety.

Post-Traumatic Stress Disorder

People who’ve been injured during a traumatic event or have ongoing trauma are more likely to develop PTSD. According to Cleveland Clinic, symptoms of the disorder include:

  • Feeling the need to avoid situations that remind you of the traumatic event
  • Having the jitters or feeling generally anxious
  • Experiencing negative thoughts and feelings, such as anger, sadness, distrust, guilt, or even numbness
  • Flashing back to or dreaming about the traumatic event

This is not an exhaustive list of symptoms — PTSD can have many different effects on health and well-being. It’s important to talk to a mental health professional if you think you might have PTSD. Usually, a diagnosis requires that symptoms have lasted more than a month and disrupt your day-to-day life.

Anxiety

Whether or not you have post-traumatic stress, you may experience anxiety in the aftermath of a traumatic medical event. When you’re living with MS, it’s natural to feel worried after a drastic event such as a hospitalization or trip to the emergency room. With an anxiety disorder, however, you may feel a prolonged sense of extreme or unrealistic worry.

According to Cleveland Clinic, physical symptoms of anxiety include:

  • Sweaty hands
  • Nausea
  • Shortness of breath
  • Racing, pounding, or fluttering heartbeat

Additionally, you may experience some mental and behavioral symptoms such as:

  • Panicky feelings
  • Obsessive thoughts
  • Troubled sleep
  • Constant restlessness

Whether you’re diagnosed with PTSD or an anxiety disorder or simply looking for ways to cope in the aftermath of an MS-related medical emergency, here are several trauma-coping mechanisms that may help.

1. Try Mindfulness, Meditation, or Other Relaxation Techniques

When you feel constantly worried or fearful, it may seem like your thoughts control you and not the other way around. Relaxation techniques such as mindfulness and meditation can help you calm your mind and regain a sense of control.

Mindfulness

The goal of mindfulness is to stay in the present moment, focusing on details of what you’re doing or how you’re feeling right now. Mindfulness practices include breathing deeply and purposefully, listening to guided imagery (focusing on a positive mental picture), and other techniques to calm your body and mind.

However, you shouldn’t worry about interpreting or judging your thoughts. The goal isn’t to avoid negative thoughts — it’s to notice them when they arise but not let them take over your mental state.

According to Mayo Clinic, simple ways to practice mindfulness include strategies such as:

  • Paying attention to your environment using each sense (sight, sound, smell, taste, and touch) — You might concentrate on one sense at a time to help you stay grounded in the moment and pause racing thoughts.
  • Sitting still and taking deep breaths, even if for only a moment — Pay attention to each slow inhale and exhale.
  • Doing a structured body scan — Lie on your back with your legs straight and your arms next to your sides, palms up. Starting at your head and moving slowly down to your toes, deliberately think about each part of your body and how it feels to you.

Meditation

The everyday mindfulness techniques discussed above are forms of meditation, but you can also practice longer-form relaxation techniques such as visualization, transcendental meditation, or yoga. Meditation can be helpful for people with a variety of health conditions, including chronic pain, heart disease, and sleep problems.

Meditation might also help you cope with mental health symptoms after an MS emergency. In one small study, people with MS who followed an eight-week meditation program initially reported having a higher quality of life and fewer problems with anxiety, depression, and sleep compared with people who followed an exercise regimen. After six months, both groups had similar results. The study authors noted that an online mindfulness-based intervention, like what participants used, might help improve well-being in the short term.

MyMSTeam members have described their experiences with mind-body practices like mindfulness and meditation. “I do guided meditations and try hard to follow mindfulness. … It helps a lot,” one member said. “I do guided mindfulness meditations from YouTube. There are also guided meditations on Overcoming MS.”

2. Focus on Eating Well and Being Active

When you’re living with MS, healthy eating is essential to overall wellness — there is a connection between your mental health and physical health. Your diet can affect your gut microbiome (the microorganisms that live in your digestive tract), which in turn can have an impact on how your mood is regulated.

Eating foods with anti-inflammatory properties can be beneficial to your mental health. Inflammation-fighting foods include those that are:

  • Plant-based, such as fresh and frozen vegetables
  • Fermented, such as yogurt with live active cultures
  • Rich in omega-3 fatty acids, such as avocados and olive oil
  • Good sources of vitamin D, such as salmon and fortified milk

In addition to eating mood-boosting foods, you might find that getting consistent exercise helps with your mental health after an MS emergency. When you’re active, your brain releases chemicals that can make you feel more relaxed and less anxious. Exercise can also help you sleep better.

You can adapt “physical activity” to mean whatever feels most manageable, comfortable, and helpful for you. Commonly suggested forms of exercise for people with MS include yoga, stretching, swimming, and water exercises. (Avoid swimming in water warmer than 84 degrees Fahrenheit because it can worsen your symptoms.) Even simply going for a walk can yield positive mental health benefits.

One MyMSTeam member wrote of their goals to stay healthy: “Real plans made today … (1) daily positive visualizations … and (2) put manageable exercise into my week, like those machines that you sit/lie on to do leg exercises and chair tai chi.”

Be sure to check with a health care professional before starting a new exercise routine. If you have trouble with balance or coordinated movements because of your MS, a physical therapist can adapt exercises to help you get the most out of your physical activity.

3. Tap Your Social Support Networks

Your network of family members and friends can be an important resource when you’re going through a crisis, such as after an MS emergency. Having a social support system can have positive health outcomes. One MyMSTeam member wrote of their support system: “My hubby, my hero, without him and daughter I’d be lost.”

However, mental health symptoms such as anxiety or irritability can lead to strained relationships, so don’t feel discouraged if you find it difficult to communicate in a calm manner with the people around you.

People who have been through a traumatic incident can become withdrawn and isolate themselves from the people around them. Although wanting to avoid others is a normal response, isolating yourself for too long can also prolong your stress response, according to the American Psychological Association.

Try your best to communicate with your loved ones — whether your family, friends, partner, caregivers, or someone else — about what you’re going through emotionally if a stressor comes up. If you’re reliving the traumatic event or reexperiencing negative emotions associated with a trauma — such as a medical emergency — communicate this to the people you trust so that they can better understand your emotional responses.

After the imminent physical danger has passed and your symptoms are not as apparent, people might not understand the effects of an MS emergency. By telling your friends and family about your lingering difficulties, you can help them understand where you’re coming from.

4. Seek Professional Support

Don’t hesitate to contact a mental health professional if you feel your anxiety after an MS emergency is interfering with your daily life. Treatments such as the following may help you cope:

  • Psychological first aid (PFA) — Originally designed to help people who’ve been through natural disasters, this form of treatment has been adapted to work with all forms of trauma. PFA aims to reduce your distress both in the short and long term.
  • Cognitive behavioral therapy (CBT) — CBT can help you adjust your thinking patterns to a more helpful outlook. It can be focused on a traumatic event to best help you cope with your personal experience.
  • Solution-focused brief therapy (SFBT) — This is a goal-oriented way to learn specific problem-solving skills. SFBT can help you cope with anxiety and depression in the wake of an MS emergency.

Feelings of anxiety are normal in the aftermath of a health crisis like an MS emergency. Even if a lot of time has passed, traumatic experiences can make you fearful of what might lie ahead. A number of psychological and lifestyle techniques can help you cope with and eventually reduce post-traumatic stress reactions.

Whether you could benefit from a short-term coping mechanism or a longer-term approach, getting support to cope with difficult life experiences can improve your health and quality of life.

Talk With People Who Understand

On MyMSTeam, the social network and online support group for people with multiple sclerosis and their loved ones, members discuss the chronic nature of the disease. Here, more than 196,000 members from across the world come together to ask questions, offer advice and support, and share stories with others who understand life with multiple sclerosis.

Have you experienced an MS emergency? If so, what coping strategies have you used to deal with fear in the aftermath? Share your experience in the comments below, or start a conversation on your Activities page.

    Posted on March 6, 2023
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    Luc Jasmin, M.D., Ph.D., FRCS (C), FACS is a board-certified neurosurgery specialist. Learn more about him here.
    Anika Brahmbhatt is an undergraduate student at Boston University, where she is pursuing a dual degree in media science and psychology. Learn more about her here.

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