Multiple sclerosis (MS) can be unpredictable. About 85 percent of people with MS are diagnosed with relapsing-remitting MS (RRMS), which is characterized by randomly recurring attacks of new or heightened symptoms. These attacks can last anywhere from a few days to several months and, depending on their severity, may be disruptive to your day-to-day life.

Beyond sticking to your treatment plan as prescribed, there’s no proven way to prevent an MS attack. But that doesn’t mean you can’t take action. These six strategies may help you to manage your symptoms and reduce your stress levels during a relapse.

The first step to coping with an attack is to be prepared for the fact that one might occur. A good place to start is to make a list of important information like emergency contact numbers, medical history details, and current medications. Keep your list in an easily accessible place in your home.

Since MS attacks can affect your mobility, consider making transportation arrangements with trusted friends or family members in the event that you can’t drive due to the severity of symptoms.

Many public transit systems offer pickup and drop-off services for people with reduced mobility. It’s worth contacting your local transit service about the process for booking a ride.

If you think you feel an MS attack beginning, take care to monitor your symptoms closely over the first 24 hours. It’s helpful to make sure that what you’re experiencing is actually a relapse, and not a subtler shift.

External factors like temperature, stress, lack of sleep, or infection can sometimes exacerbate symptoms in a way that feels similar to an MS attack. Try to stay mindful of any day-to-day fluctuations you’ve been experiencing in those areas.

Although the symptoms of an MS attack vary from person to person, some of the most common ones include:

  • fatigue
  • mobility issues
  • dizziness
  • trouble concentrating
  • bladder problems
  • blurry vision

If one or more of these symptoms is present for more than 24 hours, you may be having a relapse.

Sometimes a relapse has more severe symptoms. In some cases, you may need to go to the hospital. Seek emergency care if you experience symptoms such as significant pain, vision loss, or greatly reduced mobility.

However, not all relapses require a hospital visit or even treatment. Minor sensory changes or increased fatigue may be signs of a relapse, but the symptoms can often be managed at home.

If you believe you’re having a relapse, contact your doctor as soon as possible. Even if your symptoms seem manageable and you don’t feel like you need medical attention, your doctor needs to know about every relapse to accurately monitor any MS activity and progression.

It’s helpful to be able to answer key questions about your symptoms, including when they started, which parts of your body are affected, and how the symptoms are impacting your daily life.

Try to be as detailed as possible. Make sure to mention any major changes to your lifestyle, diet, or medication that your doctor may not know about.

If the intensity of MS attacks has increased since your initial diagnosis, it may be useful to talk to your doctor about new treatment options.

More severe relapses are sometimes treated with a high-dose course of corticosteroids, taken intravenously over a period of three to five days. These steroid treatments are typically administered in a hospital or infusion center. In some cases they can be taken at home.

While corticosteroids can reduce the intensity and duration of an attack, they haven’t been shown to make a difference in the long-term progression of MS.

Restorative rehabilitation is another option that’s available regardless of whether or not you pursue steroid treatment. Rehab programs aim to help you restore functions that are essential for daily life, such as mobility, fitness, work performance, and personal care. The members of your rehab team may include physiotherapists, speech pathologists, occupational therapists, or cognitive remediation specialists, depending on your symptoms.

If you’re interested in trying a rehab program, your doctor can refer you to other health professionals for your specific needs.

Once you’ve contacted your doctor, consider letting your friends and family know that you’re experiencing a relapse. Your symptoms may mean that you need to change some of your social plans. Making people aware of your situation can help to alleviate the stress of canceling previous engagements.

If you need assistance with any household tasks or transit accommodations, don’t be afraid to ask. Sometimes people feel embarrassed about asking for help, but your loved ones will likely want to support you in any way that they can.

It can also be useful to inform your employer that you’re experiencing a relapse, especially if your performance at work might be affected. Taking time off, working from home, or restructuring your break times may help you balance your career responsibilities with your health.

An MS attack can be a source of stress and complicated emotions. People sometimes feel angry about the situation, scared for the future, or worried about how the condition affects relationships with others. If you’re experiencing any of these responses, remind yourself that the feelings will pass with time.

Mindfulness exercises like deep breathing and meditation can be effective ways to manage stress and anxiety. Local community centers and yoga studios often offer classes, or you can try guided medications through podcasts or smartphone apps. Even taking a few minutes to sit quietly and focus on your breathing may help.

Your doctor can also direct you to counseling services if you start to feel overwhelmed by your emotions. Talking about your feelings with someone impartial can provide a new perspective on things.

Although you can’t predict an MS attack, you can take steps to be ready for changes in your condition. Remember that you’re not alone. Aim to build a trusting relationship with your doctor so that you feel comfortable discussing any changes in your condition right away.