In relation to MS, anxiety can present itself, owing to the fear of the effects of MS as it progresses, and the challenges, losses, or adjustments that may be necessary as a result of MS. This fear usually comes as a threat to your sense of normal self. A sense of self refers to how you feel about yourself normally, including the way you feel about unique personal qualities that define you.
How Anxiety Happens
The human body consists of a mechanism responsible for a response to perceived threats. When fear or tension sets in, it triggers the automatic production of adrenaline which results in physical effects like facial expressions, faster heartbeat, sweating, dry mouth and throat, and other feelings which the body experiences.
Naturally, it is important for the body to respond in this manner because it is then armed to deal with what seemingly lies ahead. On the other hand, when this state persists for an overly long period of time, it becomes a health risk.
Why Is Anxiety Common in MS Patients?
Owing to the unpredictable and chronic nature of MS, it is quite understandable that individuals are likely to suffer from anxiety and depression thanks to the reality of having to live with this condition. It is estimated that anxiety affects 43% of MS patients, especially women, yet only 1/3 of them receive proper treatment.
Managing MS in itself can be yet another cause for anxiety given that in the most advanced stage of MS, patients are likely to be disabled in one way or another, leading to what seems like overdependence on others followed by feelings of frustration, helplessness, self-pity and other feelings that affect emotions. In addition, the most common fear in people with MS as reported by physicians is the fear of how disabled they might be in the future, especially if diagnosed with Progressive-Relapsing MS (PRMS).
Studies show that anxiety is common among people with MS and other chronic diseases, only differing in severity and frequency depending on several factors. However, it is important to note that anxiety is not directly correlated to MS, rather it is a psychological reaction to the effect of this condition in patients. It is also thought that the fact that MS affects normal brain function, this could be a cause of anxiety and other psychologically related conditions like depression, irritability, and mood swings that you may suffer from in the course of the disease.
Another cause of anxiety in MS patients is the side effects of medications like corticosteroids, although this is not common.
Challenges Associated with Anxiety
Anxiety in itself comes with some challenges as far as intervention is concerned. Some of these challenges include:
- Detection: Apart from the difficulty of diagnosing anxiety, sometimes patients will exhibit symptoms of anxiety which eventually disappear as they become acquainted with their MS diagnosis. Secondly, some MS symptoms are similar to symptoms of anxiety; therefore, it poses a challenge to point a specific symptom either to anxiety or MS.
- Management with the aim of reducing it
- Coping with it
- Concentration on treatment and management of physical symptoms, overlooking anxiety
Both depression and anxiety can affect MS patients. However, because depression is normally the more prominent of the two, anxiety can go unnoticed and ultimately untreated or undertreated, unless symptoms of depression reduce, and those of anxiety become evident after treatment.
In normal cases, anxiety will present itself during certain specific situations connected with fear of the unknown. However, this soon disappears with time. If anxiety persists for a long period of time, it becomes a condition worth bringing to your doctor’s attention.
Signs of Anxiety
The symptoms of anxiety can be categorized into two groups.
Physiological symptoms which include:
- Faster heartbeats and short breaths
- Profuse sweating
- Trembling and restlessness
- Dryness in the mouth
- Tensed muscles
- Inability to fall asleep
- Frequent urination
Psychological symptoms which include:
- Persistent sadness, worrying, or guilt
- Feelings of anger and irritability
- Racing thoughts
- Negative thoughts, especially concerning the future
- Inability to decide accompanied by thinking over something repeatedly without being settled
- Rigidity or inflexibility when it comes to changes
- Feeling inadequate, embarrassed, or having low self-esteem
- Excessive worrying about health
If you find yourself continuously exhibiting the above symptoms over a long period of time, chances are you are suffering from anxiety. The following tips should help you deal with anxiety as you receive your MS medication for more effective results.
Tips on Dealing with Anxiety in MS
If you are experiencing signs of anxiety, it is best to start looking for ways to address it. Here are other tips to help you manage anxiety.
Talk about it. The best approach to emotional problems is communication. Start by telling the people close to you about the feelings that you have. It may be through them that you will discover you are actually suffering from anxiety. With their recommendation or your own, you may decide that it is time to seek professional help.
Professional intervention. Your doctor should be the next person to consult about your feelings. An early diagnosis for any condition is vital so that symptoms are addressed before they become worse. Part of treatment could involve specialized counselling and joining support groups because, as we had mentioned in the previous point, communication, particularly interacting with people going through the same challenge, will help you deal with challenges associated with MS. Remember that the best health professional to deal with MS is one with a background in psychiatry, particularly in line with MS cases.
Mind relaxation exercises. Some exercises like meditation, yoga, and deep breathing have been found to work for most people. These give them the calmness they need and divert their attention from worrying. Regular relaxation exercises actually train you to keep calm, which is an important step when dealing with anxiety.
Address negative thoughts.Negative thoughts include:
- Living in the past, for instance dwelling on what you did in the past and forgetting any positives you may have in your present condition. This way, you will not even have the enthusiasm to use your present positive aspects for your own good.
- Feeling remorseful about the things you feel you should be doing yet cannot do only adds to your guilt and anxiety.
Negative thoughts can be addressed effectively through an interruptive mechanism such as exercise, involving yourself with the things you love doing, and a refocus on your positives and using them to solve your present challenges, but after breaking them down into step-by-step manageable sessions. In addition, if you can go through grieving and come out of it, then you will be better prepared to handle the anxiety that comes with MS.
Deal with all-or-nothing thinking. All-or-nothing thinking, also known as black-and-white thinking, is a type of thinking bordered on the extremes; for example, “I’ll never or I’m ever”. Usually, such thinking blinds a person so that he or she will never see an alternative or any possibility finding solutions to the challenges he is going through. He may settle with the fact that he is either a total failure or a total success, with the former being more common among MS patients.
If you notice that this is your pattern of thinking:
- Learn or practice how to spot the absolute terms in your thinking and speech and try replacing them with more realistic terms. For instance, instead of “I’ll never get to do it right,” you could say “I could try again and see how it goes”. The second statement represents a grey area in your thought pattern which gives you room for problem-solving.
- If you find that you are struggling with quitting the all-or-nothing thinking pattern, identify and join a support network. Hanging around realistic thinkers eventually helps you rise above absolute thinking to problem-solving targeted thinking.
Studies have found that such negative thinking is closely linked with depression-related or anxiety-related panic, which can be traced to extreme emotions. In this case, learning how to be calm will go a long way to sober up your thinking and help you think more realistically.
Have worry time. Setting apart some little everyday worry time, about five minutes or so, and strictly adhering to it can help you reduce anxiety. This is because after you are done worrying, you will be ready to focus on more important issues of the day.
Plan your day. Planning your day is a sure way of maintaining a sense of purpose. This way, you will set goals and work towards achieving them and when you have, the feeling of self-fulfillment will be another great way to keep on the positive side of life. Planning also helps you move towards a more productive direction and keeps you more in charge of your life and your feelings.
Pursue anxiety treatment options.Several tools have been put forward towards the treatment of anxiety caused by multiple sclerosis. The three common screening tools used to determine the severity of anxiety include:
- Hospital Anxiety and Depression Scale
- The Hamilton Anxiety Scale
- State Trait Anxiety Inventory
As you interact with your doctor, he or she should be in a position to recommend the most appropriate tool for you. If you are suffering from both anxiety and depression, you may benefit from SSRI, which addresses both conditions.
Other medications available for anxiety include antidepressants and anti-anxiety drugs. Therapies have also been used widely, including CBT (Cognitive Behavioural Therapy) and ACT (Acceptance and Commitment Therapy), which are geared towards reducing levels of anxiety.