The stress from living with a chronic disease like multiple sclerosis (MS) can be difficult to manage. Stress affects nearly everyone. However, people with chronic and oftentimes unpredictable illnesses like MS may have increased feelings of stress due to their illness.

Since many people with MS have noted that their MS symptoms worsen during times of stress and decrease when the stress goes away, learning how to manage stress could be a powerful tool for living with MS and coping with its symptoms.

MS as a Source of Stress

Aside from stressors of daily life like paying bills, taking care of yourself and your family, and household chores, people with MS experience stressors specifically from MS. These might include:

• Uncertainties around the diagnosis of MS (before receiving a definitive diagnosis)
• The unpredictability of MS symptoms
• The invisibility of some symptoms, and having to communicate those symptoms to people who may not understand
• The possibility, or presence, of cognitive impairment
• Financial and employment-related stress due to having MS
• Decisions about a course of care for MS

The Relationship Between MS and Stress

Many people with MS find that there is a connection between stress and MS, and that stress may cause worsening of symptoms or MS relapses. One study found that people with MS who experienced distressing events had an increased risk of relapse as compared to people with MS who didn’t experience those stressful events.

Another study examining people with different neurological disorders found that people with MS were more likely to report stressful life events prior to their first symptoms of MS compared to people with other neurological disorders or healthy control subjects.

“I think I need to be reminded that stress does not do my body good. MS and stress do not play well together,” noted one MyMSTeam member. Another wrote, “I know that stress triggers my MS symptoms.”

People with MS may have less energy in general, and fatigue is one of the most common symptoms of MS. When a person experiences stress, they have even less energy to perform everyday activities. For people with MS, stress may affect their ability to cope with other symptoms of MS. This could make them feel worse than they do during times of low stress.

While it’s impossible to eliminate stress from your life, there are many ways to better manage it and possibly reduce stress-related MS symptoms.

Recognizing Symptoms of Stress

There are various ways stress manifests physically and mentally, and they differ from person to person. Recognizing your personal signs of stress is a great first step to managing stress.

With MS, it may be difficult to differentiate symptoms of MS from symptoms of stress. Keeping a journal of your symptoms with details about co-occurring life events may help you discern which symptoms are due to MS or stress.

These are some common physical signs of stress:

• Headaches
• Heart palpitations
• Clammy hands or sweating
• Faintness
• Too much or too little sleep

These are some common emotional and thought-related signs of stress:

• Feeling chronically irritable or resentful
• Experiencing excessive nervousness or anxiety
• Feeling overwhelmed or demoralized
• Being easily distracted
• Expecting the worst to happen
• Worrying daily

Understanding your unique signs of stress will help you to be better equipped to manage stress when you feel it coming on.

Techniques for Managing Stress

In addition to treatments for MS, incorporating different stress management techniques into your life will help you to cope with symptoms of MS and any subsequent feelings of stress which may occur.

Identify Stressors

Identifying your sources of stress is important for stress management. If you understand what events and tasks cause you to feel stress, you can be proactive and take steps to manage the stress you know that event will cause you.

Implement Daily Coping Strategies

There are many strategies for stress management that could be incorporated into your daily life with MS. The following are some of the techniques recommended by the National Multiple Sclerosis Society:

• Plan ahead for daily situations that may cause stress.
• Do unpleasant tasks earlier in the day to get them out of the way.
• Make a three-fourths rule. For example, refill medication when three-fourths is gone, fill your car’s gas tank when it’s three-fourths empty, and restock groceries when they are three-fourths gone. This will help you avoid a situation where you are out of important items.
• Try to do something you enjoy every day.

Undertake Relaxation Techniques

Relaxation techniques aim to calm your body and mind in response to stress and also help you to be more equipped to handle stress when it arises. There are several practices that can help you to relax.

Meditation

Meditation can be a powerful tool for clearing your mind and bringing about a sense of peace. Even just five minutes of meditation can go a long way in reducing stress levels and improving mental health. There are many online resources to help you get started with meditation, including free videos on YouTube and mobile apps.

“It's great healing guidance,” noted one MyMSTeam member on meditation. “I enjoy its peacefulness and how it helps me to let go.”

Deep Breathing

Deep breathing is another relaxation technique that can be done almost any time and anywhere. Try it at the beginning of your day or before stressful events, like doctors' visits. The National Multiple Sclerosis Society offers a step-by-step deep breathing exercise for releasing tension.

Progressive Muscle Relaxation

Another great way to relax is through a technique called progressive muscle relaxation. With this practice, you tighten and release each muscle group in your body for intervals of 10 to 15 seconds. This practice will help you let go of tension in your body and mind. The National Multiple Sclerosis Society offers in-depth instructions for progressive muscle relaxation, and also warns that if you are prone to muscle spasms you should speak with a health care provider before trying this practice.

One study assessed the effects of a stress management program that people with relapsing-remitting MS participated in twice a day. This program consisted of deep breathing exercises and progressive muscle relaxation. The study found that the people who practiced the stress management program had lower levels of perceived stress and symptoms of depression after eight weeks.

Try Physical Activity

Physical activity has been found to provide many different benefits, including stress reduction. It may also help to relieve different MS symptoms. However, physical activity and finding the energy for exercise may be difficult if you have MS. Speak with your health care provider about potential options for physical activity that are suited to your needs.

“I found that exercise helps my MS and luckily found a health club near me that offers MS-specific classes,” one MyMSTeam member wrote. Another commented on how daily activities can also be exercise, “All movement is exercise, additional movement is more exercise! Even tiny things — going up and down stairs an extra time, ironing, vacuuming the house — absolutely anything.”

Tai chi is a good option for physical activity for people with MS as it involves slow, deliberate, and gentle bodily movements. The practice incorporates movement, deep breathing, and mindfulness, which could all contribute to lower levels of stress. A review of the research on tai chi even found improved quality of life and functional balance for people with MS.

Speak With Your Health Care Provider or a Counselor

Your health care provider can be a great resource for managing stress. They can suggest stress management techniques that are suitable for you and your health status, and they may also provide other resources and referrals for stress management. It is also important to discuss your levels of stress with your doctors because some medications and treatments won’t be as effective if you have high levels of stress.

If your stress levels start to feel unmanageable, you might also seek counseling or therapy. Therapists and professional counselors can provide a place to voice your frustrations and also offer you suitable coping tools. The National Multiple Sclerosis Society can work with you and provide referrals to counselors in your area.

Talk About Stress

Another great tool for managing stress is building social support by talking about stress and MS, and connecting with others who understand. Joining an MS support group, whether in-person or virtual, can help address your stress levels and improve your well-being.

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 167,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Are you living with MS and want to share your tools for managing stress? Share your experience in the comments below, or start a conversation by posting on your Activities page.