Guided Imagery May Reduce Depression and Fatigue in MS

Patient Expert

Complementary and Alternative Medicine (CAM) therapies include a wide variety of interventions — from diets and supplements to meditation and tai chi — aimed at improving health and well-being. CAM therapies may be used alongside (to complement) or instead of (as alternative to) conventional therapies. Many patients with multiple sclerosis may incorporate CAM therapies into their self-care without realizing it. If you meditate, do yoga, or take certain vitamins or supplements to reduce MS symptoms or improve quality of life, you are using CAM.

In 2014, the American Academy of Neurology (AAN) released guidelines for the use of CAM in MS, classifying therapies into three groups: mind-body medicine, biologically-based practices, or manipulative and body-based practices. The National Center for Complementary and Alternative Medicine (NCCAM) defines mind-body therapies as those that integrate the brain, mind, body, and behavior, with the intent to use the mind to affect physical functioning and promote health; examples include meditation, yoga, tai chi, relaxation techniques, biofeedback, and hypnosis.

Guided Imagery (GI) is a traditional mind-body technique that is considered a form of hypnosis. The term ‘guided imagery’ can be found scattered throughout the literature examining the use of CAM therapies in MS. However, a systematic review of mind-body medicine used in MS identified only a single study (Maguire, 1996) that examined the use of GI in MS producing mixed or inconclusive results.

A recent small pilot study conducted at the University of California San Diego (UCSD) examined the effect of a novel guided imagery modality developed by a person living with MS as compared to guided journaling. This study measured the quality of life, fatigue, and depressed mood in 11 patients with MS over the course of 10 weeks. Participants were randomized to weekly 1-hour guided imagery sessions (n=6) or an at-home journaling program focusing on topics of gratitude or positive self-image (n=5).

Results of the unpublished study showed that Healing Light Guided Imagery (HLGI) led to improvements in depressed mood (p<0.05), fatigue (p=0.05), and physical (p=<0.15) and mental (p<0.05) quality of life as compared to journaling in people with MS. Depressed mood decreased by 76 percent in the HLGI group compared to a 10 percent increase in the journaling group. Fatigue decreased by 28 percent in the HLGI group compared to no change in the journaling group. Physical quality of life increased by 29.7 percent and 4 percent, respectively, while mental quality of life increased by 12 percent and 5 percent, respectively.

Dr. Revere (Rip) Kinkel, UCSD's MS Center Director is hopeful and suggests the need for a larger study, he said, "This open-label pilot suggested modest but potentially meaningful benefits that require confirmation with larger controlled studies prior to dissemination and adoption by other MS clinics."

Read more about Healing Light Guided Imagery (HLGI) in an interview with the developer, Paula Marie Jackson, a certified hypnotherapist and person living with MS since 1999.

More helpful information:

Better Balance and Brain Connections Through Playing Video Games
Exercise, Education, or Medication: Which is Better for Fighting MS-Related Fatigue?

A Guided Imagery Intervention May Offer Multiple Sclerosis Patients Some Respite From Two Of Their Worst Symptoms, Depression and Fatigue [press release]. October 9, 2015. University of California San Diego.

Senders A, Wahbeh H, Spain R, Shinto L. Mind-body medicine for multiple sclerosis: a systematic review. Autoimmune Dis. 2012;2012:567324. doi: 10.1155/2012/567324. Epub 2012 Nov 22.

Yadav V, Bever C Jr, Bowen J, et al. Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: report of the guideline development subcommittee of the American Academy of Neurology. Neurology. 2014 Mar 25;82(12):1083-92. doi: 10.1212/WNL.0000000000000250.