Does Stress make MS worse? This is a question without a simple and straightforward answer. However, the research I have done and my own personal experience has led me to believe that there is most definitely a correlation between stressful periods of life and disease progression. This may not be something directly related to your MS diet, but is just as important to monitor and control.
[blockquote width="250" align="right"]Learn to know when you are stressed and what to do when it happens[/blockquote]
Looking back on my MS journey, the onset of my symptoms has nearly always been preceded by a stressful time in my life. My very first episode of numbness occurred during the end of my first year of teaching. I had a very busy timetable and had been desperately trying to finish off the year's work with my classes. I had also been expected to compile over ten separate examinations for the subjects I was teaching. For an experienced teacher this would have been an ordinary, run of the mill task but for a first year teacher who needed to prove herself, this was a highly stressful event. I had probably been under pressure for about 2-3 weeks when the numbness struck half my face. Luckily it was a minor attack that only lasted a few days.
Stress is a Subjective Experience
The story of my first noticeable attack highlights that stress is a highly subjective experience. Each person will interpret an event differently. Take, for example, moving to a new house. For some people, this is an exciting and stimulating experience. They don't really mind packing hundreds of boxes. They love trying to find a new place for their belongings and are not too bothered when they can't find their essentials for days on end. However, for others, it is their worst nightmare. They can't handle the disorder it brings to their lives and find the adjustment to a new home highly stressful. Stress depends on the person and this can make it very difficult to measure.
You may find it easier to manage your MS diet - controlling what you eat to defend against MS. But with stress, its more intangible and not something you can plan out on a piece of paper.
Stress can, therefore, be seen as the result of the interaction between an event (the stressor) and the person's perception of the event, their personality and their current psychological and physical health. People with MS are often already feeling overwhelmed by their condition and it's unpredictable nature. They may also be experiencing symptoms such as fatigue, depression or physical symptoms preventing them from doing what they usually can. In this situation they are less likely to cope effectively with a challenge that life may present them. In this way, a stressor can exacerbate current symptoms, even if you are following your MS diet very strictly.
Stress and the Immune System
Stress induces certain hormones and enzymes which have an unbalancing effect on the immune system. The immune system is a delicate balance between causing inflammation (usually to foreign agents) and dampening down inflammation to bring healing to an area of the body. When this balance is upset, the immune system may be more prone to cause inflammation, which is the exact opposite of what your are trying to achieve with a healthy MS diet.
The research done on this link certainly seems to confirm that stress does have a negative effect on the immune system. Swiss researchers conducted a study in fourteen healthy medical students, to see whether a psychologically stressful event, in this case the students’ final examination, could modify hormone levels associated with the immune system. They showed a significant increase of the hormone TNF-alpha, starting the next day. This suggests that stress can precipitate MS relapses by its effect on the immune system.
In another study, thirty seven women with multiple sclerosis were regularly seen every four weeks, for one year. They kept diaries of events they considered stressful. These events were ranked according to the Holmes and Rahe Social Readjustment Rating Scale. Their anxiety levels were also monitored. A total of 291 stressful events, 37 episodes of infection, and 48 relapses, were registered. High levels of anxiety were strongly related to the number and the severity of reported stressful events during the preceding period and with the advent of a relapse in the following period. The conclusions were that the anxiety associated with a stressful event plays an important role on the course of the disease and relapse rate.
The stress of finding out I was pregnant with my second child, a big surprise, also preceded one of my worst episodes. I wasn't quite ready to be pregnant again, as my first child had only just turned one. I lost some sensation and coordination in my right hand and had terrible itching on one side of my neck. This lasted for a month or so. I actually had a great pregnancy but a few weeks after giving birth to him, I had a minor return of symptoms. He is now almost a year old and feel that I am still recovering from this significant life change. My most recent episode involved numbness in my legs and a stiff feeling when I walked. I am almost a hundred percent convinced that this was brought on by a stressful week I had looking after four children in my home, as funny as that sounds.
[blockquote width="250" align="left"]Managing your stress takes practice[/blockquote]
The point is that stressful situations are a normal part of life. They are pretty much unavoidable unless you go and live in a simple beach shack on a quiet island in the Caribbean. Even then, stress will probably find you! The trick is to learn how to cope with these challenging situations in a positive way. These are some of the things that have helped me:
Do something you enjoy: Do it regularly. This must be something you REALLY enjoy doing. It could be going into town and seeing movie or a theatre production. It could also be taking an art, ballet or cooking class. I know that finding the time to do these things is often difficult but the key is to schedule them in and then stick to the plan and do them! Think about something right now that you want to do and set a date.
Make time for yourself: For me, this is so important. I spend my whole day doing things for other people. It is sometimes difficult to even find time to make myself some lunch. I'm sure other mothers can relate to the fact that there is always so much to do that you could be running from pillar to post the whole day without actually achieving everything you set out to. If I make just a little bit of time for myself whether it is to make some good food, update my facebook status or read a chapter of a good book, I feel I can take on the rest of the day.
Spend time with good friends: See your good friends regularly. Studies have also shown that being to to share our lives with people we trust and can really connect with, helps us feel supported and reduce feelings of stress and anxiety. Friends share our burden and a burden shared is a burden halved. I have only told a few of my good friends about my MS. These are the friends I know will help and support me at any time and never judge me if I'm going through a bad patch.
Exercise: It is preferable to get out of the house when exercising. Fresh air, the feeling of the wind on your face and a change of environment will all help to reduce that tense feeling that stress often creates. Getting your blood pumping and those endorphins floating around your body also makes you feel great! It takes a little effort to get yourself out there but at the end of my work out sessions, I always think 'Why, the heck don't I do this everyday?'. Another nice way to exercise is to take a class with a friend. My neurologist recently told me to start doing Pilates. I love Pilates! I really need to investigate this option.
Breathing techniques: This is for those moments when you really get yourself into a state. Yes, you know what I'm talking about. Your face feels hot, and your head feels like it might explode. You feel confused about what to do next and the volume of your voice gets a little louder. When this happens to me, I stop whatever I am doing, sit down and take a few slow breaths. Perspective seems to return after a few minutes and then I can start thinking clearly about how to handle the situation.
Stick to your MS Diet: Usually, when you are stressed, you give yourself an excuse to be undisciplined. Don't allow yourself to slip and indulge on foods that you really shouldn't be eating. Maintaining your MS diet is vital, especially when you are stressed, as our body will already be dealing with stress-induced inflammation - don't add to this by the breaking rules of your MS diet.
I hope that helps you in some way this week, remember, your perception of an event is the major contributor to stress in your body. Try and see things positively and you are half way there to keeping stress under control.