Stress is a daily fact of life. It keeps us focused. In response to situations perceived to be potentially dangerous, stress hormones, such as cortisol, adrenaline, and epinephrine, are released by the adrenal glands. This is part of the “fight or flight” response which helps keep us safe.
For example, a driver zooms past you on the highway and cuts you off. You don’t time to think about it, but your body releases stress hormones and gives you the mental and physical boost you need to react quickly and steer out of harm’s way. Your heart is pounding and extra oxygen is pumped to the brain. Extra glucose is released to fuel your muscles and resources are diverted away from your immune, digestive, or reproductive systems. Once out of danger your bodily functions return to normal.
When living with MS we may experience additional kinds of physical stress, emotional stress, social stress, economic stress and cognitive distress.
The physiological changes caused by MS, such as weakness, spasticity, imbalance or loss of coordination, can increase physical demands on the body. It is important to be aware of physical changes caused by MS and to work to combat them so that the changes themselves do not create additional problems. Staying active and working with a physical therapist or trainer are ways you can reduce the physical stress caused by MS.
Regular exercise reduces the effects of stress hormones on the body and can help prevent physical de-conditioning. Strength training helps to build and maintain muscle strength which is necessary when you live with MS. Working with a healthcare provider to learn how to adjust to changing abilities and how to properly use assistive devices can be invaluable.
Emotional stress can be caused by the uncertainty and unpredictable nature of the disease. It can also result from physical changes occurring in the brain due to neurological damage. Common symptoms of MS include depression, anxiety, and cognitive dysfunction. When you are feeling emotionally stressed, it doesn’t take much to trigger a physical reaction. However, there is no clear evidence that stress can trigger exacerbations.
Working with a mental health professional or neuropsychologist can help you deal with many different types of stressors, recognize and express emotions, and develop productive coping and problem-solving skills. I have been working with a licensed clinical social worker (LCSW) who is helping me to communicate more effectively with my family members and to identify my own personal triggers for anxiety.
Note that depression is more than just a reaction to emotional stressors. Depression is a condition best treated with a combination of pharmaceutical and cognitive-behavioral therapies under the guidance of a professional. Common symptoms of depression which overlap with signs of emotional stress include chronic irritability or resentment, feeling down in the dumps, boredom, excessiveness nervousness or anxiety, feeling overwhelmed, nightmares, or feeling numb or detached.
Thought-related signs of stress include excessive worrying, distractibility, difficulty making decisions, and expecting the worse to happen much of the time. Physical signs of stress include muscle tightness, clammy hands or sweating, dry mouth, fatigue, headache, irregular heartbeat, shallow breathing, a lump in the throat feeling, stomach aches, constipation, diarrhea, or nausea, and sleeping too much or too little.
Social relationships and obligations can also cause stress when you live with a chronic illness. Examples of social stressors may include not feeling accepted or understood by those around you. Although MS is primarily an invisible disease, the use of assistive devices might make one feel conspicuous, isolated and insecure. Tell members of your health care team and your family how you feel and together you can find a way to make social interactions less stressful.
Holidays can be particularly stressful with a multitude of social obligations which are scheduled for folks to “have fun and socialize.” These events can be extraordinarily stressful for people with MS who experience fatigue and are sensitive to overstimulation. Planning an exit strategy ahead of time may make attending events more enjoyable when you know that if it gets to be too much, you can remove yourself to a calmer and quieter environment. It’s an opportunity to strategize with your partner and to discuss how various social stressors affect you.
As with the uncertainty of the disease, MS can likewise affect one’s ability to maintain gainful employment and MS can be expensive. Workplace accommodations may help as your physical needs change, but note that not all employers must abide by ADA laws. Research the law carefully to know your rights. Making sure that your financial matters are in order will help to alleviate some economic stressors. Work with financial, tax and retirement professionals to help maximize your resources.
Reducing stress is not as simple as taking 10 slow, deep breaths. It may require working with a number of professionals to address specific aspects of a stressful life. In fact, you may not even realize the source of some stressors until someone else helps you get to the bottom of the ocean of stress you may experience from time to time.
In the meantime, try these eight simple stress reducers to help release the hold stress may have on you. If taking 10 deep breaths doesn’t work today, try again tomorrow; it may have greater effect with repeated efforts. Included in the National MS Society’s downloadable booklet, Taming Stress in Multiple Sclerosis (pdf), are several excellent physical and visualization exercises you can try to help reduce stress.