Multiple sclerosis (MS) can profoundly affect your physical health, but it can also take a serious toll on your mental health. Depression, stress, anxiety, and mood swings are all common in people with advancing MS, but it’s possible to manage these emotional changes. Here are some ways to reduce stress, create a healthier mindset, and maintain a better quality of life.

If you have MS, you know that each day brings new challenges and questions. Constant uncertainty and worry can cause almost anyone to feel anxious, stressed, or fearful.

According to the Cleveland Clinic, the most common emotional changes you may experience with MS include:

Your experience of the disease may lead to depression. For example, your changing body and mind may affect how you feel about yourself and your life. The disease itself may also cause depression: As MS attacks the myelin, your nerves may no longer be able to correctly transmit the electrical impulses that affect your mood.

The good news is that depression can be treated. In most cases, doctors prescribe a combination of therapy and antidepressant medication. Talk therapy may be one-on-one with a licensed professional, or your doctor may suggest meeting in group therapy sessions with other people who also have MS.

Learn more: Understanding and managing multiple sclerosis mood swings »

Stress can be healthy in small doses. It promotes faster responses to situations which require them and can even boost immunity.

Prolonged and unresolved stress can have the opposite effect, however. You may begin having new or worsened MS symptoms because of how stress affects the disease and your body.

MS is unpredictable, which can add to stress. The disease can change and get worse without warning. Other stressful factors include the invisibility of symptoms, financial concerns about covering treatment, and the constant adjustments needed to address the progressing disease.

Stress can be treated, though. In fact, a 2012 study found that people with MS who followed an 8-week stress management program of relaxation breathing and muscle relaxation techniques experienced less stress and fewer symptoms of depression.

Regular exercise can also help reduce stress. Talk with your doctor or physical therapist about ways you can be active without aggravating your symptoms or setting back progress.

Learn more: Nine exercises for advancing MS »

In moments of great stress, you may simply need to let it out. Expressing your anger or frustration can often help you relieve stress. However, it shouldn’t be your primary form of anger reduction.

When you’ve had a few moments to calm yourself, ask yourself:

  • Why was I so angry?
  • What caused me to feel so frustrated?
  • Was this something that I could have prevented?
  • What can I do to keep it from happening again?

Develop a game plan in case you find yourself experiencing similar feelings in the future.

There’s no one right way to relax. Relaxation may mean something different to everyone. Reading, listening to music, cooking, or any number of other activities may help you feel calm and in control.

Deep breathing is one activity that can reduce tension, relax your body, and help your mind feel more at ease. Try using deep breathing when you anticipate a stressful period — for example, if you’re nervous about going out in public, being around a lot of people, or getting back test results. Deep breathing only takes a few minutes, doesn’t require special equipment, and can be used at any point when you need to feel calm.

Yoga combines breathing and gentle stretching to help release mental and physical tension. If MS hinders your physical range, you may still be able to practice modified poses to help you stretch, relax, and let go of stress. Talk to your doctor or physical therapist before you begin yoga.

Read more: The benefits of yoga for people with MS »