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

In MS, the immune system attacks the protective covering (myelin) that coats the nerves of the central nervous system (CNS), creating lesions or scars. The brain, spinal cord, and optic nerve all make up the CNS. Depending on what part is involved, a wide range of symptoms can result. Mood swings are one of the many symptoms common to MS, but the connection between the disease and emotions often goes unrecognized.

While it’s easy to see the physical effects of MS, such as balance, trouble walking, or tremors, the emotional impact of the disease is not so apparent. MS can involve various types of emotional instability, including uncontrollable laughing and crying or even euphoria. However, you can manage your mood swings with treatment, therapy, and frank communication.

Pinning Down the Cause

MS mood swings can strike without warning and leave a person with MS feeling frustrated and overcome by their seeming lack of emotional control. It’s important to understand what you’re feeling and try to understand the reasons for emotional swings. You might benefit from talking about your feelings with others. Being as honest and observant as possible will help in determining the cause.

Some common reasons for MS-related mood swings include:

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

Besides external factors, the disease itself may play a role in mood swings. Many patients report a worsening of their emotional symptoms during an MS attack.

There are two parts of the brain involved in emotion. One part forms emotional responses, while the other allows you to control them. MS lesions can form in the part of the 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.

Emotional responses can even be scrambled, causing you to laugh at sad news or cry at something funny.

Dealing with Cognition Changes

The first step in taming MS mood swings is to communicate with your neurologist. A neurologist or mental health expert can give you tools to conquer your emotional rollercoaster. Some people find counseling helpful, while others manage their emotions with mood-stabilizing drugs, anti-anxiety medication, or antidepressants.

In addition to therapies, you can take these proactive steps to control your moods:

  • Delegate. If you’re overwhelmed by your daily routine, reduce stress by delegating some tasks. Free yourself from burdens in order to relax and focus.
  • Turn to a friend. Find a friend to confide in about frustrations or fears. Just talking can help release pent-up feelings. This can keep your emotions from boiling over in the form of a mood swing.
  • Find support. Join an MS support group. Talking things out with others who are going through a similar experience can help. The group leader can also provide resources to find experts who can help.
  • Practice peace. Practice yoga or mindful meditation. The calming effects of yoga and meditation can help your brain settle down and focus.
  • Explain. Tell others about your mood swings before they happen. Sometimes the worry of what others might think can cause enough stress to bring on an event. Letting others know it’s part of your disease will ease your mind.
  • Breathe. Deep breathing can calm you down and give you an extra moment to take back control when you find yourself in a stressful situation.
  • Think it through. If you pause and examine your feelings objectively, you may be able to reclaim control. Realizing what is triggering your emotions can also help.
  • Exercise. Physical exercise has been shown to have a positive effect on mental wellbeing. Besides being good for your body, the time you spend engaged in exercise can be a great time for personal reflection.

There Is Help

Remember that mood swings are common in MS. They shouldn’t be reason for shame or embarrassment, but they shouldn’t be ignored either. Reach out to your neurologist or primary care doctor and let them know that you’re experiencing anxiety, depression, sadness, or even inappropriate bursts of laughter. They can refer you to a mental health specialist who is trained to identify and help you manage the emotional mood swings of MS.

Therapists or counselors are trained to recognize and help you see what flips your emotional “switch.” A mental health professional can give you tools to take emotional control. If your relatives are affected by your mood swings, family counseling can also be beneficial.

If medication is in order, you can work together with your doctor to weigh the risks and benefits of each and find the one that’s right for you.

With all the help available to treat the emotional symptoms of MS, there is no reason for you to suffer in silence. The right combination of counseling and medication will help you feel like yourself.