Everyone experiences mood swings or “moodiness” from time to time. But some people experience rapid, uncontrollable changes as one of the emotional symptoms of multiple sclerosis (MS). You may hear something negative and start laughing, or begin crying when you actually feel happy.

Some people diagnosed with MS also experience pseudobulbar affect (PBA), a condition in which a person bursts into tears or laughter without any situational or emotional trigger. Changes in mood can also happen again as symptoms change, and as relapses or remissions occur.

These emotional reactions might seem to come out of nowhere and may not be proportionate to the situation that triggered them. Emotional reactions may also feel out of control — like you cannot stop them or like your emotions are taking over your life. Understanding your mood changes and what you can do to improve the situation can help you feel better and improve your quality of life dramatically.

Effects of Mood Changes With MS

MS-related mood swings can be challenging. These emotional changes can make relationships with family members and friends difficult. Sometimes, these new emotional challenges can feel overwhelming and discouraging. It can feel as though your mood swings are out of your control.

Most people with multiple sclerosis do not enjoy their mood swings — but they do learn how to live with them. Some people with MS accept that mood swings may come as part of the diagnosis and are reassured to know they are not being unreasonable.

What Causes Mood Changes in MS?

Multiple factors can cause or contribute to mood swings with multiple sclerosis.

Changes in the Brain

In people with MS, the body’s defenders (white blood cells) attack the central nervous system, stripping the nerves of their protective coating (myelin) and causing inflammation. This process, known as demyelination, can occur in locations in the brain that produce and manage emotions. When nerves in those regions are stripped of their protective coating and inflammation occurs, you may experience changes in your mental health, including mood swings.

Grief

Receiving a diagnosis of multiple sclerosis can trigger many intense emotions, including sadness and feelings of loss as your everyday life begins to change. Together, feelings of sadness and loss can result in feelings of grief. As MS progresses, you may experience changes that cause further grieving. Grief can both cause emotional changes and intensify mood swings.

Stress

Being diagnosed with multiple sclerosis can add stress to your life and to the lives of your loved ones and caregivers. As you modify your lifestyle to accommodate the symptoms of MS, you also learn to manage medications, deal with the ways the condition changes over time, and handle difficult conversations with loved ones. This can be very stressful.

Some doctors believe that stress can aggravate the mood swings that come with MS. Managing that stress well may alleviate mood swings and other symptoms of MS. Stress management techniques may provide help to some people.

Medications

Certain medications used to manage MS can cause mood swings and other behavioral changes. Not all people experience the same side effects from the same medications. Additionally, some mood changes may be caused by a combination of different medications.

It is important to work with your doctor to find out how your medications may be affecting your mood. If you experience any emotional changes or if you notice an increase in mood swings after you start a certain medication or medications, talk to your doctor right away to determine the cause.

Managing Mood Swings Associated With MS

There are many things that you can do to help manage the mood swings associated with multiple sclerosis.

Talk To a Therapist

If you believe that your mood swings are caused mostly by stress or grief, talk to your doctor about finding a therapist. They may be able to recommend a practitioner who specializes in helping people diagnosed with chronic diseases such as MS. These practitioners, including cognitive behavioral therapists and talk therapists, will be able to help you work through your grief and find healthy ways to deal with your stress. They may also help improve your overall sense of well-being.

You may also choose to join a support group led by a psychotherapy expert. These groups will allow you to meet people who are in similar situations and find support. If it is helpful to you, therapy can become a component of your health care.

Occupational Therapy

Occupational therapists can relieve some of the stress brought on by changes you may have had to make due to MS. Occupational therapists can help make certain tasks more manageable, so that you can still do them on your own. They may help you get more sleep, manage your energy throughout the day, increase your confidence, and improve your wellness.

Medications

There are many options when it comes to medications that can help regulate mood swings brought on by MS. A drug called Nuedexta (dextromethorphan HBr and quinidine sulfate) can help with episodes of uncontrollable laughing or crying. Antidepressants may also be beneficial, even if you are not diagnosed with depression, as they may help your brain make chemicals needed for optimal regulation. However, these medications can have serious side effects. These medications should only be taken if all other options have failed and your symptoms remain a major burden to your everyday life.

Your neurologist will be able to give you medical advice and help you try different medication options until you find one that works for you.

If you are experiencing mood swings associated with MS, talk to your doctor today. Your neurologist or another medical specialist should be able to help you find the solution you need to stabilize your mood and feel better soon. Different people diagnosed with MS will find that different solutions work best for them, so do not be afraid to try different options until you find what works for you.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis 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 mood changes? Share your experience in the comments below, or start a conversation by posting on your Activities page.