Thursday, June 16, 2011

Stress and Multiple Sclerosis

By Julie Stachowiak, Ph.D.,

Stress and MS Relapses

While there have been few studies examining the relationship of stress and MS symptoms, MS patients often report that stress causes their symptoms to worsen. Because stress interacts with the immune system, it could be possible that stress may trigger a worsening of MS symptoms or a relapse.

In a 2006, Australian researchers conducted one of the first studies to seriously examine the relationship of stress and MS relapse. This study followed 101 people with MS for 2 years and asked about their stress levels and stressful events every three months. They found that the greater number of acute stressors that a person reported predicted relapse. They also found (not surprisingly) that people who were having a relapse reported more stress. Chronic stress and stress severity did not predict relapse, only the number of acute stressors. Individuals who used social support (friends and family) to cope with stressors reduced their risk of a relapse.

Stress and MS Symptoms

Many people with MS note that their symptoms seem to worsen during times of stress. This makes sense from a physiological viewpoint. During times of stress, certain hormones are released in the brain. These hormones slow down the activity of the sections of the brain responsible for reasoning and decision making. It is logical that for people with MS, this “slow down” would result in an increase in cognitive symptoms. However, no researchers have proven that this is true.
Stress from MS
While there isn’t clear proof that stress can cause MS symptoms, there is no doubt that having MS is stressful. There are many emotional, physical and even financial challenges in having MS that contribute to both chronic and acute stress. Some examples are:
• The unpredictable nature of MS
• Appearance of new symptoms
• Concerns with health insurance
• Concerns with employment
• Needing help from others
• and many more
Every person with MS should develop a proactive system for coping with stress.
Coping with Stress from MS
There are many ways of coping with stress. Here is a sample of some stress-reduction approaches that people living with MS should consider developing:

• Social Support: When a relapse occurs or symptoms worsen, you may need help to get to your doctor’s office, fulfill your responsibilities or just make dinner. Cultivate your network of friends and family. Keep close ties with the people you can depend on. Let them know how important they are in your life. When you are feeling good, try to help them.

• Relaxation: Relaxation is the best way to combat stress in your body. When you are under stress, your body releases certain stress-related hormones. By relaxing, you can reverse this process. A breathing technique known as the relaxation response has been proven to reverse the effects of stress in your body. You can also learn meditation, yoga or gentle stretching. Anything that relaxes you is great – a lukewarm bath, candles, music or whatever works for you.

• Planning: We don’t like to think about times when symptoms worsen, but having a plan in place will make everything go easier. Think about what would change in your life if you were having a relapse. Who would take you to the doctor? Who would watch the kids? What about work? Go through your typical day and consider how you could deal with each complication. Talk to the people you would need to depend on before you need them. Set aside a little ‘relapse fund’ for takeout, massages and anything else you might need. Creating a relapse plan for MS can make a big difference when things are difficult.
Stress as an MS Cause

A study in Denmark used national health registry data to examine if stress could be a cause for MS. This study found 21,000 parents who had child that died. They compared them to almost 300,000 other parents. In the group that had lost a child, 28 people (or 1/750) developed MS. In the comparison group, 230 people (or 1/1300) did. The people who had lost a child were 1.5 times more likely to develop MS. If the child was lost unexpectedly, the risk increased to more than twice as likely to develop MS.

This doesn’t mean that the stress of being stuck in traffic can cause MS. The type of stress the researchers studied was a very specific and deep stress. The loss of child can profoundly impact parents. Researchers were not able to assess how the parents coped with the loss of a child. There was no data on depression, grief duration or coping methods. The interesting finding here is that the emotional impact of the loss of a child increases the risk of MS. There is something more complex than simple physiological mechanisms impacting MS risk.

Brown RF, Tennant CC, Sharrock M, Hodgkinson S, Pollard JD. Relationship between stress and relapse in multiple sclerosis: Part I. Mult Scler. 2006 Aug;12(4):453-64.
Brown RF, Tennant CC, Sharrock M, Hodgkinson S, Pollard JD. Relationship between stress and relapse in multiple sclerosis: Part II. Mult Scler. 2006 Aug;12(4):453-64.
J. Li, MD, MSc, C. Johansen, MD, PhD, H. Br√łnnum–Hansen, MSc, E. Stenager, MD, N. Koch–Henriksen, MD, PhD and J. Olsen, MD, PhD. The risk of multiple sclerosis in bereaved parents. NEUROLOGY 2004;62:726-729

I think the article should be called Stress and Disease or Stress and Health.

All of us, whether ill or not should develop coping mechanisms.

I personally try to reduce the stress in my life by simply avoiding what causes me stress.

I always need order around me; so slowly and steadily, everything in my life has been organized and arranged the way I want it. When things are not in order, my stress levels are heightened. Therefore, as much as possible, I am surrounded by order and the lack of chaos.

I avoid bad news. My day starts by listening to the classical station on the radio. It is on through out the day and even in my car. I used to listen to the news talk stations but found that I got too wound up in the debates and discussions. I do not read newspapers and do not listen to the news. There is too much bad news and negativity in them.

Meditation , yoga and spiritual therapy are of the greatest help to maintain a calm, sane mind. I do my yoga and breathing exercises every morning as soon as I wake up and meditate soon after I have finished with my yoga. During the day, I am constantly praying or having a conversation with the Divine (whatever that may be, whoever that may be),
It is important to feed the spirit so that the spirit can help carry the burdens of the world. I should say volunteer work and the fulfillment that comes with it, falls under this category.
I cannot do as much volunteer work as I would like to but I still do my share while a keeping my limitations in mind.

Retail therapy, which is one of my favorite therapies, also helps. I love browsing and sometimes I will just go into a store and go around browsing. I do not have to buy, I just enjoy looking. This takes my mind of everything else that is bothering me. It really is like a meditation!

Reading and music also play a huge part in keeping my stress level to a minimum. Whether it is spiritual music, classical or New Age, the genre does not matter. It just relaxes me. I read short stories because my attention span is short. Writing that make me think and ponder are of great help in keeping me sane. Puzzles help keep my mind alert. I enjoy sitting in my back yard and reading while listening to classical music. The birds, squirrels and the light rustling of leaves, the chimes, all help keep my sane.

Finally, there is the happiness therapy. I surround myself with love and laughter. I watch TV shows that make me laugh, I read jokes in the Reader's Digest when I am in the bathroom (there is nothing else to do there anyway).
I am lucky to be surrounded with people who love me, be it friends or family. A hug here, a kiss there and a gesture of kindness, all help.
Talking to my loved ones keeps me from constantly pondering on thoughts that would otherwise, increase my level of stress.

It is important to find what heps reduce the stress in your life and keep these close to you, always. Do not become a victim of circumstances. Change the circumstances where and when you can.

The only limits in our life are those we impose on ourselves.
- Bob Proctor

Gratitude is an attitude that hooks us up to our source of supply.
And the more grateful you are, the closer you become to your maker,
to the architect of the universe, to the spiritual core of your being.
- Bob Proctor

We come this way but once.
We can either tiptoe through life
and hope we get to death without being badly bruised
or we can live a full, complete life
achieving our goals and realizing our wildest dreams.
- Bob Proctor

Choose today to break through whatever limits that are holding you back from living your greatest life.
Whether you live with MS, another illness or any other mental, physical, emotional or spiritual challenge, you can introduce small changes to your lifestyle to learn to live with pride, joy and acceptance. It is these small changes and coping mechanisms that will be intrumental on your journey toward healing.
I know they were and continue to be for me

If for any reason you falter and fall off your wagon, get on it again and again and again.