Stress & MS




	Stress & MS By Laurie Long 9/04 You’ve heard that stress is bad for people with MS. Even the most conservative doctors and researchers would agree to that. The real question is: Do stressful life events trigger exacerbations? Doctors and researchers can’t give a definite “yes” or “no” to that question yet, but here is what they can tell you… There have been numerous studies and papers over the last 20 years about the effects of stress on MS symptoms, and while the methodology and focus of the studies varies greatly, the vast majority agree that the risk of exacerbation after a stressful life event is significantly increased. It has been a struggle to achieve even this much consensus, because of the vague nature of the term “stress” and the difficulty in singling out its effects. Most studies decided to focus on particular events that are viewed as stressful, such as illness in the family, job stress, death of a relative or friend, problems in a relationship or marriage, etc. When we are in stressful situations such as these, our body produces “stress hormones” - adrenalin and glucocorticoids. Adrenalin raises blood pressure and heart rate, making more energy available. Glucocorticoids enhance memory and immune function. While these responses can be helpful in the short term, continuing high levels of these hormones may have adverse affects on health. According to a panel of experts speaking at Experimental Biology 2004, the body’s hormonal response to stress alters immune system function and influences susceptibility, onset and exacerbation of mental and physical diseases, including autoimmune diseases such as multiple sclerosis.¹ Dr. William Malarkey, while speaking to the panel, described how the perception of stress activates the interaction between the endocrine system and the immune system, initiating a cascade of physiological events. If the stress is short-term, these hormonal changes fade away. But if the stress persists, the resulting dysregulation of the immune system initiates an inflammatory state that, if not stabilized, leads to symptoms and then established disease processes.² A new study by David C. Mohr et al that combines the findings of 14 studies on stress and exacerbations in MS from 1965 to 2003 concluded, “There is a consistent association between stressful life events and subsequent exacerbation in multiple sclerosis.”³ Another study completed in 2003 by D. Buljevac et al and reported in the British Medical Journal showed that, “occurrence of stress was associated with a doubling of the exacerbation rate during the subsequent four weeks.”⁴ How to Deal With Stress The signs and symptoms of stress cover a broad spectrum including irritability, headaches, anxiety, fatigue, worrying, distractability, feeling overwhelmed, stomach aches or nausea, clenched muscles, feeling demoralized, constant worrying and more. Doctors and researchers say that stress can be helped by preventative strategies such as regular exercise, good social support and stress coping behaviors. Some of these include deep breathing exercises, visualization exercises and meditation, yoga, tai chi, chi gung, stretching exercises or physical therapy, regular exercise of any kind such as walking, swimming or gardening, and by eating a healthy diet. Recent studies have also found that certain drugs used to treat depression can also help protect the brain against the effects of stress.⁵ If you think that you are suffering from the effects of ongoing stress, consult with your doctor on ways of relieving and coping with it. The National MS Society also has a booklet “Taming Stress in Multiple Sclerosis” which covers causes of stress and how to cope with it. Remember that there are many different coping strategies. Find the approach that works for you to evaluate and manage your stress. Was this information helpful? Then please consider making a donation. We are a small, independent nonprofit agency and are dependent on donations from our supporters. Thank you from all the staff at the MSA. New Research Shows How Chronic Stress Worsens Neurodegenerative Disease Course Endnotes & Bibliography ^1,2 Rabin, Dr. Bruce S. et al, PsychoNeuroImmunology Research Society, Alteration of Health by the Hormonal Response to Stress. Experimental Biology 2004. ³ Mohr, David C, et al, Association Between Stressful Life Events and Exacerbation in Multiple Sclerosis: a Meta-Analysis. British Medical Journal, Vol. 328, March 27, 2004. ⁴Buljevac, D. et al, Self Reported Stressful Life Events and Exacerbations in Multiple Sclerosis: Prospective Study. British Medical Journal, Vol. 327, Sept. 20, 2003, 646-9. ⁵ Ackerman, Sandra J., New Research Stresses the Response to Stress. BrainWork – The Neuroscience Newsletter, Vol. 14, No.2, March-April 2004. Goodwin, Sarah, Hormonal Response to Stress Alters Immune System Function and Alters Mental and Physical Disease. Federation of American Societies for Experimental Biology, April 18, 2004. Ackerman Dr. Kurt, et al, Stressful Life Events Precede Exacerbations of Multiple Sclerosis. Psychosomatic Medicine, 64:916-920 (2002). Mohr, David C., et al, Psychological Stress and the Subsequent Appearance of New Brain Lesions in MS. Journal of Neurology, 2000;55:55-61. Nisipeanu P, Korczyn, AD, Psychological Stress as Risk Factor for Exacerbations in Multiple Sclerosis. Neurology 1993;43:1311-2. Foley, Dr. Frederick and Sarnoff, Jane, Taming Stress in Multiple Sclerosis. National Multiple Sclerosis Society, 1996.
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