The MS Personality: Fact or Fiction?
If you have ever perused the literature on Multiple Sclerosis you may have come across a term used to describe the temperament of someone who has MS called, "the MS personality." I began to wonder if MS could ultimately change personality and if so, what sort of personality are we supposed to morph into? I would like to think that I am pretty much the same person as I was before this disease. But is this really true?
Do you believe there is such a thing as an "MS personality"?
Recently I went to Wikipedia (which is not always the most reliable source of information) and they made reference to the fact that some Multiple Sclerosis patients have paranoid delusions as a result of having this disease. My response was to be skeptical of this information. Yet I found more references to this potential symptom of MS. On McFox's Multiple Sclerosis web site for example, the author cites a statistic that,
"Approximately 10% of patients with Multiple Sclerosis will suffer severe psychotic disorders such as Manic Depression (Bipolar Disorder) and paranoia."
Of course I wonder which came first, the psychiatric disorder or the Multiple Sclerosis. In some cases the patients Multiple Sclerosis is misdiagnosed as a psychiatric condition. On the web site, Wrong Diagnosis, the authors give examples of this misdiagnosis:
"Multiple sclerosis often misdiagnosed as mental disorder: The early stages of multiple sclerosis may cause various general feelings of wellness, happiness, euphoria, or manic-type symptoms in some patients. These symptoms may lead to a misdiagnosis of bipolar disorder, hypomania, cyclothymia, histrionic personality disorder, or similar disorders."
Again, it is unclear as to whether a patient who has MS can also have a psychiatric disorder such as Bipolar Disorder and if so, how does one differentiate MS from the mental disorder or are they one and the same?
Certainly having symptoms of a psychiatric condition would cause one's personality to change. How is it possible that MS can have such an impact upon personality? And are there more subtle ways in which Multiple Sclerosis can affect someone's personality?
When someone is told that they have a chronic illness such as MS, there will most understandably be an emotional reaction. Most go through the grief stages of shock, anger, and sadness. The nature of this disease is unpredictable and so there is also fear of the future to deal with. If you have MS, you also have to deal with changing your self concept of what you can and cannot do. All of these changes can affect how you deal with the world and including your friends, family, and loved ones. It is unlikely that others will not notice some part of your emotional struggle. Some might even say that the disease has changed your personality.
In addition to the emotional, social, and interpersonal challenges of having this disease, there may also be changes to one's cognition. Patricia Daily, L.C.S.W, who is the author of an excellent article entitled, "MS and Personality," gives an estimate that as many as 60% of the population who suffers from MS also suffer from cognitive problems. Some of these cognitive impairments include problems with memory, planning, processing language, and problem solving. Daily feels that these cognitive issues impact the way we organize, integrate, and understand our experiences. And these new limitations can affect our personality and how we relate to the world.
There may be physiological changes to our emotions as well. Daily shares that:
"Sometimes people with MS have difficulty controlling their emotional responses. A mild stimulus can set off a response that far exceeds what the person feels. For example, sometimes people find themselves crying when they aren't sad or laughing uncontrollably at something that is only mildly funny."
Other reactions may include having more of a short fuse, becoming more easily irritated, and being more impulsive. Emotional volatility and instability can change the appearance of one's personality.
So getting back to my original question...Is there such a thing as an MS personality and is there any proof of such a thing? Vicki Hinson-Smith who wrote "Does "MS personality" exist?" believes that it may be difficult to prove such a thing. However, she does cite reference to what medical professionals use in correlating Multiple Sclerosis with personality changes:
"The Diagnostic and Statistical Manual (DSM), which is used by mental health professionals, describes the effects of MS in its discussion of chronic and organic brain syndrome and organic personality syndrome: abnormal mood shifts, anxiety, affective instability, outbursts, aggression, rage, suspiciousness, and paranoia."
The evidence seems mounting that it is possible for Multiple Sclerosis to alter one's personality. In looking for research, I found one study which was cited multiple times with reference to this topic. Benedict, Priore, Miller, Munschauer, and Jacobs (The Journal of Neuropsychiatry and Clinical Neurosciences 2001; 13:70-76) attempted to discover if there is any correlation between MS and Personality Disorder. And indeed, they found such a correlation.
These researchers preface their study with recognition that personality change has historically been noted in Multiple Sclerosis patients:
"Changes in personality and affect have been recognized in multiple sclerosis (MS) for more than a century, and recent investigators delineate three primary affective disorders: depression, pathological laughing/crying, and euphoria."
What did these researchers find?
"Abnormalities were found among MS patients indicating elevated neuroticism and reduction in empathy,agreeableness, and conscientiousness."
What does this mean? Basically friends and relatives perceived these individuals as being more emotionally overreactive, more irritable, and more tense than usual. They were also felt to be less outgoing and thoughtful of the other's feelings. It seems these traits are also found in Alzheimer's patients and seems to denote a personality profile of someone suffering from dementia.
What did they suspect as the cause? Neurogenic frontal lobe syndrome (damage to that part of the brain). Cognitive impairments or greater cortical atrophy resulted in a more adverse affect upon the MS patient's personality. The more an MS patient suffers from cognitive impairments, the more likely they are to also suffer changes in personality.
So what are your thoughts? Do you feel that your personality has changed due to having Multiple Sclerosis or do you think this is all a bunch of bunk? Have friends or family told you that you seem different in temperament since your diagnosis? What aspects of your personality have changed and what things have remained the same? Please do share your experiences here. Your thoughts and opinions are important to us and can ultimately help someone else who is coping with similar challenges.