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Understanding and Managing Multiple Sclerosis Mood Swings

Overview

You might be happy one minute and angry the next. A television commercial might bring you to tears. Or maybe you're suddenly snapping at other people for no reason. These are all examples of mood swings, which are common in some people with multiple sclerosis (MS).

In MS, your immune system attacks your myelin, the protective covering that coats the nerves of your central nervous system (CNS), creating lesions or scars. Your brain, spinal cord, and optic nerve all make up your CNS. Depending on what part of your CNS is involved, a wide range of symptoms can result.

Mood swings are a common symptom of MS. But the connection between the disease and emotions often goes unrecognized. It’s easy to see many of the physical effects of MS, such as problems with balance, walking, or tremors. In comparison, the emotional impact of the disease is less visible from the outside.

MS can raise your risk of emotional instability, which may lead to uncontrollable laughing, crying, or even euphoria. However, therapy, medication, and frank communication may help you manage your mood swings.

Common causes of MS-related mood swings

Causes

MS mood swings can strike without warning and leave you feeling frustrated and overcome by your seeming lack of emotional control. It’s important to try to understand what you’re feeling and the reasons for your mood swings. Being as honest and observant as possible can help you determine the cause of your emotions.

Some common causes of MS-related mood swings include:

  • stress
  • anxiety
  • depression
  • pent-up frustration
  • inability to cope
  • grief

Mood swings from grief typically resolve with time. They often last anywhere from a few weeks to a few months. It’s especially common to experience grief-related mood swings when you’ve been recently diagnosed with MS. It can be very difficult to learn that you have the condition.

Besides grief and other emotional responses to external factors, the disease itself may play a role in your mood swings. Two parts of your brain are involved in emotion. One part forms emotional responses, while the other allows you to control them. MS lesions can form in the part of your brain that allows you to control emotions.

This might lead to difficulties with self-control. It can also cause unbalanced expressions of sadness or happiness. Your emotional responses can even be scrambled, causing you to laugh at sad news or cry at something funny. Many patients report a worsening of their emotional symptoms during an MS attack.

You can have mood swings, no matter how severe your MS is. It may seem like they come out of nowhere and end just as quickly as they began. If your mood swings are linked to nerve damage, they may become more frequent as your condition progresses.

Managing and coping

Coping

The first step in taming your MS-related mood swings is speaking with your doctor. Your family doctor, neurologist, or mental health specialist can give you tools to help you escape the emotional roller coaster.

For example, they may recommend:

  • counseling sessions with a trained mental health expert
  • mood stabilizing drugs
  • antianxiety medications
  • antidepressants

Depending on the other medications you take to control your MS symptoms and the progression of your condition, you may be unable to use antidepressants and mood stabilizing drugs. In this case, cognitive behavioral therapy may be your only option.

In addition to therapy and medications, you can take several proactive steps to help control your moods. Getting support from others is key. For example:

  • Delegate: If you’re overwhelmed by your daily routine, reduce your stress levels by delegating some tasks to other people. Free yourself from burdens to give yourself more time to relax and focus.
  • Turn to a friend: Confide in a trusted family member or friend about your frustrations, fears, and other feelings. Talking to others can help release your pent-up emotions and stop them from boiling over in the form of a mood swing.
  • Find additional support: Join an MS support group to talk about your thoughts and feelings with other people who are going through a similar experience. Your fellow group members and group leader may also share tips and resources to help you cope.
  • Tell others about your mood swings before they happen: Sometimes worrying about what others think about you can cause enough stress to bring on a mood swing. Letting others know that it’s part of your MS may help ease your mind.

You can also try to increase your sense of calm and peacefulness to reduce your mood swings. For example:

  • Practice yoga or mindful meditation. The calming effects of these activities can help you unwind and and focus.
  • Practice deep breathing. It can help calm you down and give you an extra moment to take back control when you find yourself in a stressful situation.
  • Think your feelings through. If you pause and examine your feelings objectively, you may be able to reclaim control and realize what's triggering your emotions.

Finally, staying mentally and physically active may help regulate your mood swings. Physical exercise has been shown to have a positive effect on mental well-being. Besides being good for your body, the time you spend engaged in exercise is a great opportunity for personal reflection.

What you can do

Outlook

While mood swings are common in people with MS, you shouldn’t ignore them. Reach out to your primary care doctor or neurologist. Let them know that you’re experiencing anxiety, depression, sadness, inappropriate bursts of laughter, or other emotional challenges.

They can refer you to a mental health specialist who can help you manage the emotional mood swings that often accompany MS. Therapists and counselors are trained to help you understand what flips your emotional “switch.” They can also offer tips and tools to help you take emotional control. If your relatives are affected by your mood swings, family counseling may also be beneficial.

If your doctor thinks medications may help, you can weigh the risks and benefits of different options together to find one that’s right for you.

With all of the help available to treat the emotional symptoms of MS, there’s no need to struggle with mood swings alone. The right combination of medication, counseling, social support, and healthy lifestyle habits can help you feel like yourself again.

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