Emotional Turmoil: An Unseen Symptom Of Multiple Sclerosis

Multiple sclerosis (MS) can have a profound impact on a person's emotions, and it is not uncommon for those diagnosed with the disease to experience a range of powerful emotions. The emotional and cognitive effects of MS are often the greatest challenges for those living with the disease. While many people with MS experience depression or anxiety at some point, some people rarely experience changes to their emotions or behaviour that don't seem to make sense or that they can't control. This phenomenon is known as emotional lability or emotionalism, and it can manifest as very sudden and intense periods of emotion that seem disproportionate or unrelated to the trigger. These emotions can build up quickly and may be challenging to control.

Emotional lability, or emotionalism, can cause very sudden and intense periods of emotion

Emotional lability, or emotionalism, and its effects on people with MS

Emotional lability, or emotionalism, is a symptom of MS that can cause very sudden and intense periods of emotion. Emotionalism can be characterised by very sudden, intense periods of emotion that seem out of proportion or unrelated to whatever triggered them. For example, a person with MS may easily burst into tears or suddenly get very angry. These emotions may build up very quickly, and the person may have no control over them.

Sometimes, these emotions are related to what the person is actually feeling. At other times, the emotions displayed may not reflect their true feelings. For instance, they may react to hearing some bad news by laughing hysterically, or they may start crying when they are feeling happy. In some cases, they may swing rapidly from one emotion to another with no warning.

Emotionalism is believed to be caused by MS-related nerve damage in the areas of the brain that control emotions. However, as with any emotional symptom of MS, there may be several different factors involved. The extra stress brought on by MS, as well as neurological changes, are also thought to contribute to emotional lability.

Emotional lability can be a challenging symptom of MS, affecting the way people feel about themselves and their self-esteem. It can be difficult to cope with the unpredictability of these intense emotions and the feeling of a lack of control. Additionally, the emotional impact of MS is often less visible to others compared to the physical effects, such as problems with balance, walking, or tremors.

There are treatments available to help manage emotional lability in people with MS. Drug treatments, such as antidepressants, can be prescribed to help stabilise mood. Talking therapies can also be beneficial, either in combination with medication or on their own. Additionally, lifestyle changes, such as practising relaxation techniques, mindfulness, or meditation, can help to reduce stress and improve emotional well-being.

MS-related nerve damage in the brain can cause emotionalism

Multiple sclerosis (MS) can cause a range of emotional changes, including feelings of sadness, anxiety, and irritability. These emotional shifts can be unpredictable and may not always be linked to external triggers. While many people with MS experience depression or anxiety at some point, some individuals may also exhibit emotionalism, a symptom characterised by sudden and intense periods of emotion that seem disproportionate or unrelated to the trigger.

Emotionalism, also known as emotional lability or pseudobulbar affect, is often caused by MS-related nerve damage in the areas of the brain that govern emotions. This nerve damage can disrupt the normal functioning of emotions, resulting in uncontrollable displays of emotion. Individuals with emotionalism may find themselves laughing hysterically in response to bad news or crying when they are actually feeling happy. These emotions can build up rapidly and may not reflect the person's true inner feelings.

The impact of MS on emotional regulation can be complex and multifaceted. In addition to nerve damage, the extra stress and neurological changes associated with the disease can also contribute to emotionalism. Moreover, the unpredictable nature of MS can make it challenging for individuals to process their emotions effectively. The condition can affect any part of the brain, leading to a wide range of cognitive and emotional changes that can impact daily life.

Managing emotionalism in individuals with MS often involves a combination of medication and talking therapies. Antidepressants, such as amitriptyline, fluoxetine, or citalopram, can help stabilise mood and reduce the severity of emotional outbursts. Talking therapies, including counselling and cognitive behavioural therapy, can provide individuals with tools to understand and manage their emotions more effectively. Joining support groups specifically for people with MS can also be beneficial, as it allows individuals to connect with others who are navigating similar challenges.

Depression and bipolar disorder are more common in people with MS and require professional attention

Emotional Changes in People with MS

Overview

People with Multiple Sclerosis (MS) often experience a range of powerful emotions, especially at the time of diagnosis, and it may take time to come to terms with having the condition. The changing nature of MS means that people living with the condition may also experience challenging feelings at other points in their lives.

Depression and bipolar disorder

Depression and bipolar disorder are more common in people with MS than in the general population. Depression affects around half of all people with MS at some point, and bipolar disorder is also a recognised symptom. Both conditions require professional attention and effective treatments.

Causes

The causes of depression and bipolar disorder in people with MS are believed to be the extra stress brought on by the condition, as well as neurological changes. For example, in the case of depression, inflammatory processes and unhelpful thoughts such as feelings of guilt, worthlessness, or hopelessness may be more frequent.

Treatment

Depression and bipolar disorder can be treated with a combination of antidepressants and cognitive behavioural therapy or talking therapies. Amitriptyline, an antidepressant, is recommended by the NICE guideline for MS, which outlines how MS should be treated on the NHS in England and Wales. Other antidepressants such as fluoxetine or citalopram may also help.

Self-help

In addition to medication and therapy, there are several self-help strategies that can be employed to manage depression and bipolar disorder. These include:

• Reflection on what might be causing emotional responses and whether there are any changes that can be made to improve things.
• Prioritising what is most important in life and focusing energy on these things.
• Learning to say no and setting realistic goals to avoid feeling overwhelmed.
• Finding a new hobby or challenge as a positive distraction.
• Looking after physical and mental health through healthy eating, exercise, and relaxation techniques.

MS can cause feelings of uncertainty, stress, and anxiety

Uncertainty, stress, and anxiety are common feelings for people with MS, not just at the time of diagnosis, but throughout the course of the disease. This is due to the extra stress and neurological changes brought on by MS.

The emotional impact of MS is less visible from the outside, but it can be one of the disease's greatest challenges. The unpredictable nature of MS can make it difficult to work through your emotions. You may feel angry, anxious, or upset. You might feel relieved, especially if you've spent a long time trying to find out the reason for what you've been experiencing. You may be in shock, especially if the onset of your symptoms was sudden and you were diagnosed almost immediately. You may feel numb, like it's unreal or happening to someone else. You may also experience a complete lack of emotion.

It is important 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. For example, you might feel uncertain about the future and what MS may mean for you in the long term. This is a natural and common response to diagnosis or when things change. You might have had an episode of new or worsening symptoms, a relapse, or a medication is no longer helping. Learning to live with the unpredictable nature of MS and the uncertainty it brings can be challenging.

You may also feel apprehensive about the impact of MS on your family, especially if you feel that MS is intruding in your relationships or intimate moments. MS might mean you see yourself or your partner in a different light, especially if your roles within the relationship change. You may worry that some symptoms, such as fatigue, pain, or continence issues, may impact these relationships.

There are several ways to manage these feelings. Talking things through with family, friends, or in online or face-to-face support groups can help with low mood and anxiety. If you continue to feel down or anxious, consider seeking professional advice about treatment options, such as counselling or medication, from your MS nurse or GP.

It can also be helpful to reflect on what might be causing you to feel emotional and whether there's anything you can do to improve things. For example, could you start or change medication, or learn some management or relaxation techniques? Would improving your bedtime routine give you a better chance of a good night's sleep?

MS can affect self-esteem and self-image

The emotional and cognitive effects of MS are often the greatest challenges for those living with the condition. The changes that people may experience in terms of their cognition and emotions can affect the way they feel about themselves and alter their cognitive functions.

The initial diagnosis of MS can provoke strong emotions. You may feel angry, anxious, upset, or relieved, especially if you've spent a long time trying to find out the reason for your symptoms. Many people say that adjusting to the diagnosis of a long-term condition, such as MS, is similar to the grieving process after a bereavement. You may grieve for your life before MS, and it may take time for your self-image to adjust to having MS.

The unpredictable nature of MS can make it challenging to process your emotions and come to terms with the changes and losses it has led to in your life. Physical symptoms may be distressing if you're very active or have a physical job, while cognitive difficulties may be upsetting if your job is mentally demanding or you enjoy brain-power-reliant activities.

MS can affect your ability to fulfil roles that are important to you, which may lead to a stronger sense of loss. However, it's important to remember that symptoms may resolve or improve with treatment, and you may find strategies to manage them, such as reducing fatigue, so you can continue doing the things that are important to you.

The emotional symptoms of MS can include feelings of sadness, anxiety, irritability, and euphoria. In advanced cases, MS can increase the risk of emotional instability, leading to uncontrollable laughing and crying, or euphoria. These emotional changes can be caused by MS-related nerve damage in the areas of the brain that control emotions.

Uncertainty, stress, and anxiety are common emotional responses throughout the course of the disease, not just during diagnosis. Depression and bipolar disorder are also more common in people with MS than in the general population and require professional attention and treatment.

The impact of MS on self-esteem and self-image can be significant. There may be times when it's difficult to do everything you're used to doing, or you may have to make adjustments to your usual activities. Focusing too much on the negative aspects can feel overwhelming, so it's important to seek support and treatment for managing these emotional challenges.

Frequently asked questions