Symptom Management

Taking Care of Your Emotional Wellness

By Tiffany Malone, MSW, MSCS
Living with MS can definitely take a toll on your mood and emotional health. Often, people living with MS experience the loss of the person they were prior to the diagnosis, their social/familial/professional roles, and physical ability. Frustration can become a recurring feeling when faced with the daily reminder of physical and cognitive challenges or the changes that have occurred over time. Questions about the future cause worry about what will happen next.

Grief, anxiety, depression, anger, and fear are common emotional reactions to the diagnosis of, and life with, MS. These feelings are natural, and they should not be dismissed or ignored. Depression, for example, affects 20 percent of the general population; that number more than doubles for people living with MS. The prevalence of depression for people living with MS is also typically higher than in other chronic conditions. Therefore, it
is widely believed that depression is not just due to coping with the changing disease process, but may also be linked to a neuro-inflammatory or neuro-degenerative process. Depression can also exacerbate MS symptoms, causing increased difficulties with fatigue, pain, sleep, concentration, and memory. This can all contribute to increased feelings of negativity, frustration, and anger. It is when these feelings become constant over long periods of time that they should be properly addressed. Over time, this can lead to declining emotional health.
There are some things you can do on your own to build a more positive environment for yourself, which can lead to a more positive mood and improved emotional health:

Sleep – Maintaining healthy sleep hygiene can significantly improve the quality of your sleep, which can positively affect your mood. Consider keeping electronics turned off, including cell phones, tablets, and television, to calm the mind and avoid distractions from restful sleep. Additionally, maintain a comfortable temperature when sleeping by using fans and 100 percent cotton bedding. Changing pillows frequently can also offer a more comfortable sleep environment. If sleep continues to be restless for you, talk with your
healthcare provider; a sleep study may be advised to further assess for sleep disorder.

Gratitude – Often, people find it very easy to focus on all the things that did not go well throughout the day or how MS has negatively affected life. It can become a habit to place emphasis on the negativity. Practicing mindfulness, or paying attention to the moments of your day, can allow you to notice all the good things as well. Small things, such as a stranger opening a door for you, can easily be missed if you are not paying attention to that act of kindness. Recognizing and appreciating the good moments can help you find gratitude throughout your day, rather than focusing on everything that did not go well or as you had planned.

Journaling – How many times have you arrived to your medical appointment and forgotten everything you wanted to share with your physician? Journaling can be used for tracking symptoms, frustrations, concerns, mood, and sleep to discuss with your healthcare team or for documenting questions to ask at your next appointment. Your journal can also be a place to document your gratitude, and when you are feeling down, revisiting that list can remind you of all your grateful memories.

Schedule something you look forward to – Your calendar does not have to be saturated with medical appointments, lab work, and MRIs, nor does it need to only include the ‘I have to do’ list. Planning to meet a friend for coffee, joining a book club, or going to a movie with the family can get you excited about your plans and be the motivation you need to get out of bed and ready for the day. Allow your life to be balanced by fun, meaningful activities, or the things ‘I want to do’.

Exercise – Keep moving! Find some physical activity that you enjoy, or are willing to do, and
make it a habit. This can improve fatigue, pain, and physical discomfort. Exercise also releases endorphins which can improve mood. If you are having trouble getting started, find
an exercise partner to keep you accountable, take a class at the local gym, use DVDs and
online programs to workout at home, or take your dog out for a strollÄroll around the park.

Sometimes, it takes some additional assistance to manage depression and other mental health challenges. Medications and/or talk therapy may be helpful in balancing your emotional health. Consider adding one or more of the following professionals to your support system:
  • • Counselors
  • • Clergy
  • • Social Workers
  • • Psychologists
  • • Psychiatrists
Starting with your primary care physician or neurologist can be helpful in identifying the best option for you and your needs. Additionally, they can assist you with any referrals that are required.

If you are unsure about how your emotional wellness is affecting your daily life, ask yourself these two questions: During the past two weeks, have you often felt down, depressed, or hopeless? During the past two weeks, have you had little interest or pleasure in doing things?

If you answered yes, probably, or maybe to either/both of those questions, reach out to someone from your healthcare team. Know that mental health challenges are treatable and can be managed.