Group Project – Final Draft
Multiple Sclerosis – The Physical and Behavioral Effects

Multiple Sclerosis, also known as MS, or Demyelinating disease; a disease that not many are aware of. It is “an autoimmune disease that affects the brain and spinal cord (central nervous system).” (A.D.A.M. Inc, 2011) The symptoms vary depending on the individual affected by the disease, and it also differs in duration for each symptom. In this paper, we will discuss the definition of Multiple Sclerosis, review the main symptoms affecting Multiple Sclerosis patients and their loved ones, its risk factors, how to recognize potential symptoms, the tests available, and support groups that can provide more information on this disease as well as how to cope with it.

Depression is one of the main side effects Multiple Sclerosis patients have; it is unfortunately very common for someone with Multiple Sclerosis to experience depression. To learn more about the disease, we have to understand what MS is. Multiple Sclerosis, or MS, is an auto-immune disease that affects your brain’s nervous system; the “T-Cells” attack your neurons which function is to send signals to your brain. Each nerve cell control different parts of your body and emotions; having the T-cells attacking your emotional nerves can impact your way of living. If these T-cells damage the nerves of the brain that are involved in emotional expression and control; it can create a variety of behavioral changes resulting in depression. “People living with MS can experience a wide range of emotions including anxiety, fear, anger, frustration, worry, grief, guilt and stress;” (MS Life Lines) which are all components of emotional feelings. Depression caused by Multiple Sclerosis may destroy the insulating myelin surrounding the nerves transmitting signals and therefore affecting mood. Physicians discovered three different types of depression relating to Multiple Sclerosis; Reactive or Situational Depression, Organic Depression, and Medication Side Effect. This can affect several things alone, or in combination. The reactive or situational depression is a new set of symptoms that never happen to you before; these symptoms will limit the patients’ ability to do normal things such as cleaning, moving, walking, or even talking. This will only occur as a reaction to something happening to a friend, or family and might trigger something in the brain to react. Patients with Multiple Sclerosis might feel fear or sadness without even noticing it; the Organic Depression happens within certain part of the brain; but studies haven’t been able to pin point the exact source in the brain affected by this type of depression. Studies say that this could also be unrelated to Multiple Sclerosis, especially if there is a history of depression in the family; but at this time, it is still uncertain since there is hardly any study on Organic Depression. This type of depression only affects 15 percent of patients with Multiple Sclerosis, and may also be linked to depressive experiences in their lifetime. The medication side effect is related to the drug use in order to treat Multiple Sclerosis, and is very common for its patients to experience that type of depression.
Other symptoms of depression include sadness, loss of energy, feeling of hopelessness or worthlessness, difficulty concentrating, uncontrollable crying, difficulty making decisions, irritability, increased need for sleep, inability to fall or stay asleep at night, unexplained aches and pains, stomachache and digestive problems, decreased sex drive, sexual problems, headache, a change in appetite causing weight loss or gain, thoughts of death or suicide, and attempting suicide. We will discuss suicidal thoughts, depression, and energy level more into details throughout the paper. “Life is full of stress MS generally adds a hefty dose of disease-related stress to the mix. MS is unpredictable and just anticipating the next exacerbation can be a significant source of stress. MS can also lead to some major life changes such as loss of mobility and interference with work. Thus the person with MS faces significant challenges in coping with a potentially stressful life.” (National Multiple Sclerosis Society) About 50 percent of people with Multiple Sclerosis have symptoms relating to depression; it can affect some of them in a more minor way than others. Only 14 percent of people with this disease are depressed at any time; bottom line is that depression with Multiple Sclerosis can be severe which can lead to suicidal. Studies show that people with the Multiple Sclerosis disease are two to eight times more likely to commit suicide. A very high rate among the population and the studies show no known cause except that the T-cells in the brain are attacking certain nerves in the brain triggering that episode. Physicians and Nurses found a way to handle depression while on Multiple Sclerosis from identifying that most of it is related stress in our daily lives. Even though stress is very hard to handle; it can still be manageable but you have to take the steps to allow yourself to do that.
Major depression within Multiple Sclerosis patients can lead to something more serious such as suicidal thoughts; “Suicidal thoughts are common in people with multiple sclerosis (MS), especially in those who live alone, have major depression or abuse alcohol.” (My Dr, 2002) Even though patients who abuse alcohol and patients who live alone are more susceptible to thoughts of suicide; the severity of those symptoms, length patient have had the condition, and level of impairment has no increase in the risk of suicide. Suicide is a very serious issue that can affect anyone, not the just the person that is having those thoughts but also the people around them. So it could directly or indirectly reflect on others’ lives and how they cope with it; it could lead to a vicious cycle if left untreated. There is an article relating to MS and suicidal thoughts on Montel Williams where “he reveals hard truths about the disease that nearly drove him to take his life” (Silverman, 2004), and that is just one out of many examples of people going through this thought process.
Suicidal thinking within Multiple Sclerosis patient is different than anyone else; “studies demonstrate that suicidal ideation (SI) is greater in persons with multiple sclerosis (MS) than in the general population. SI may offer some MS patients a mechanism for feeling in control of their lives, in the face of a daunting, unpredictable disease. In this study, we determined what specific mental constructs or perceptual themes occur for MS patients experiencing SI, while also examining the construct of 'control' as a central theme.” (Gaskill A, 2011)
Multiple Sclerosis affects each person differently; for example, one patient may have severe physical problems while another has severe cognitive problems. While there is no relation between the two types of problems; it affects each person differently. Around 45 to 65 percent of people with Multiple Sclerosis have cognitive problems. This includes problems with memory, attention, word-finding and problem-solving. These problems are more difficult for others to relate to MS. Family members, friends and employers may think that the person if forgetting on purpose when it is really a symptom of Multiple Sclerosis. The person experiencing these problems may just think they are going crazy.
Multiple sclerosis also affects a person’s semantic memory, or the memory for events, words, or things. This means that the person will not necessarily forget how to do something; but rather, they will just forget that something needed to be done. The memory of past events in their life leading up to being diagnosed with Multiple Sclerosis is normally not an effect, but people with Multiple Sclerosis tend to forget things about their own lives since being infected with the disease. It could be a denial phase or trauma that the person is going through with accepting the disease.
Adjustment to having Multiple Sclerosis can take an emotional toll on a person. A person that once viewed himself or herself as strong and invulnerable has to adjust to living with a life-long and deadly disease. Self-image can change dramatically as the disease progresses. Physical changes like loss of mobility, fatigue and change in appearance can be the worst to deal with. How others view a person with Multiple Sclerosis can affect the person. Going out in public people will often stare, be patronizing or just avoid them all together. If symptoms are not visible to others and they do not know a person has Multiple Sclerosis some people will think the person is being lazy or ignoring them on purpose.
After being diagnosed with Multiple Sclerosis, people tend to isolate themselves from family and friends. Most of the time it is the fear of being treated differently or judge by others soon after the other people are told that someone has Multiple Sclerosis. It is also for the same reason why others don’t share they have Multiple Sclerosis because they fear it will put an unneeded burden on people around them. This can lead to isolation, loneliness, and depression as the disease progresses. To refer back to depression and its different type; it is defined as “a term commonly applied to a wide variety of emotional states in Multiple Sclerosis. These may range from feeling down for a few hours on a given day to severe clinical depression that may last for several months.” (National Multiple Sclerosis Society - Depression) For people with Multiple Sclerosis it is even harder to maintain relationships with loved ones as it might be for other people because of the additional challenges brought by Multiple Sclerosis. Relationships can be anything from partners, parents and children, employee and employer; all of those relationships affect our everyday lives differently but they all are as important as one another for the role they play in it. Just as with anything, there are steps to finding out someone is affected by Multiple Sclerosis and how to deal with it.
The first step to dealing with Multiple Sclerosis within a personal interaction setting would be to identify and recognize the effects of the disease and work from there to find a solution. Sometimes, you might not even know you have a disease until it is too late. It is usually because you think you know who you are and have been ignoring symptoms, whether they were clear as day or minor ones that just weren’t as obvious. Knowing who you are as a person and how you react to things can help anyone identifying when and if anything is different than usual. The earliest anyone can see that they have Multiple Sclerosis the better it is for them and the people in their lives; because all those symptoms could lead to lives being ruined. Once you have identified the existence of Multiple Sclerosis in your life or in someone you know; the next step will be to expose the disease to people so that they understand what you are going through and how it affects you and the relationship with them. It is hard to explain something to others especially if you are not familiar with it yourself; so as you move toward the third step of dealing with MS, it is always good to find a professional or support group that specialize in the disease. It will allow you to find information about the symptoms, how to deal with them, things you can do to improve yourself, and groups you can join to share your experience and maybe help others that have just learned about Multiple Sclerosis. Finally, acceptance is the final step which is when you have come to terms with the idea of making room for Multiple Sclerosis in your personal and professional relationships as well as your life. It is hard to admit to having a disease, but when you do realize that a lot of the struggles you were dealing with can be reduced or eliminating by knowing how to cope with those challenges; it can only make you live a better life. Finding ways to manage and “deal with the ups and downs that come with living with MS are to talk openly about your feelings so those close to you can learn how best to support you, to allow for two-way communication - regular family meetings are a good outlet for communication, to reach out to the loved one if you need help, to spend time with other, to get connected to others with Multiple Sclerosis, to get involved in the community, to find time to relax, to laugh as much as possible, to try to focus on the positive, and to use exercise as an outlet.” (MS - Symptoms: Depression or Mood Swings)
Multiple Sclerosis or “MS” is a slow progressing disorder; many don’t know how much energy it takes away from us. Energy healing has many ways in which a person can maintain a good balance of energy. The greater mental positive attitude someone has, the greater immune system response he or she will have. Although stress is unhealthy when its level is too high for anyone; people with MS tend to drain out their energy level a lot quicker. Worsening sleep and weaker immune system are the two main areas Multiple Sclerosis patients will suffer most when under stress. One of the biggest physical symptom patients with Multiple Sclerosis will experience is fatigue which results in an extreme lack of energy; so it is important to keep your energy level up by keeping a steady pace instead rushing yourself into doing things, and using your highest energy when you really need it to do things that are a little more difficult or requiring a higher level of energy than regular.
Another great way to maintain a high energy level is to exercise; though it is hard for people to understand why the energy levels are low when you have MS, it is still important to exercise. One of the most effective exercises is yoga, and they have even constructed yoga programs targeting people that have MS. Another way people can increase their energy levels is by choosing carefully what you eat and drink. Most people simply rely on caffeine to boost their energy such as coffee, and energy drinks; but eventually it will end up giving them a bad kind of energy level especially for those with Multiple Sclerosis. Instead of taking the chemical route; you should consider the natural route instead. It has been tested and proven that water with lemon will produce energy in someone by hydrating your body and giving you mental clarity. Energy conservation courses have also been proven to be helpful for those who have Multiple Sclerosis because it enhances daily energy and efficiency levels. These courses involve for a person to go through an examination on how much fatigue a person may be having throughout the day and the time of day as well.
It is important for people with Multiple Sclerosis to be able to recognize their energy limits and patterns. Some people may find it harder than others to keep track of how their energy levels can be because they can be at random times and are so consistent throughout the day. Using mind over your matter is a great way a person try to overcome their lack of energy because they have to think as positively as they can. Your mind can do many things just by thinking about a certain thing. Letting yourself know and thinking that you can overcome anything will give you more will power and give you a positive response which can give most people energy for that matter.
Eye sight is also a big symptom when you’re being diagnosed with MS. Blurry visions and complete loss of eyesight can result in losing all of your energy level because you’re not able to see correctly. Most people wouldn’t think about doing any kind of energy while this is happening to them so they don’t bother to do anything; but losing control of your body such as your legs are common in many people with Multiple Sclerosis. This is so common because MS plays with your brain which can cause your body to lose control of anything, so for this matter losing control of your legs along with other symptoms will make people extremely weak and able to do much exercise to boost energy levels.
“People with emotional issues can experience both restlessness and fatigue. For people living with MS, fatigue is already a common complaint; however, fatigue caused by an additional emotional problem should improve when the underlying psychological issue is treated.” (Brichford, 2011) The most important thing about being able to control your energy levels while on Multiple Sclerosis is to try not to stress out, as hard as that might be it’s shown that people with MS who can be less stressed out can initially have higher energy levels than others who are more stressed out. Immune-strengthening vitamins have also been another great way to keep energy levels high because they’re being controlled. Depending on how much you might need, it will be based on how much dosage your Doctor will let you have. Vitamins are overall a good substance to take whether you’re sick or not because it helps your bodies receive any type of vitamins that your body is looking for. Oxygen levels can also boost your energy levels there are many ways that you can improve your oxygen levels with easy steps, such as posture because it has a lot to do with how you stand and walk while receiving oxygen into your body. People with MS would be a lot better off with smoking because that will decrease your oxygen levels as well and then decrease your energy levels after. It’s a lot harder for those with MS to smoke and drink because of all the common symptoms you may have throughout the day.
Mood swings are another symptom that Multiple Sclerosis will give someone, and this is a lot harder to control because it’s the way you’re feeling at the time. Mood swings will make you feel upset or sad for any reasons which will most likely resolve in losing energy levels because of the emotions your body is taking. Anyone with Multiple Sclerosis can do as much as they can to improve their energy levels but only if they are willing to give it their best. It’s a very difficult thing to overcome because most people get depressed by knowing that they have this disorder and would rather take it in by not helping themselves, which is why some people never get better. This is something that Doctors and other people can help you with but if you’re not striven to get any better it won’t happen. Now that people provide help for disorders like MS it’s easier for you to feel helped and getting you into better shape physically and mentally. Even people with severe signs of MS have been able to overcome it with being positive and letting people help you. It all comes down to one person at the end of the day and that’s you. Bringing yourself down and getting depressed will only make your energy levels lower and might even cause yourself to get worse. By using all the support you can get and give yourself a better and more positive will help you achieve better things whether it’s someone who’s suffering from MS or any other kind of disease.
Multiple Sclerosis is a disease that is still being researched because of its unpredictable symptoms and varying effects on people; but with the information we covered in this paper, you will at least know more than you did on MS. To conclude, it is not always about fighting a disease but understanding

References:
- My Dr. (2002, September 20). Retrieved from My Dr from MIMS: http://www.mydr.com.au/mental-health/suicidal-thoughts-common-in-people-with-multiple-sclerosis
- A.D.A.M. Inc, M. E. (2011, September 26). PubMed Health. Retrieved from www.ncbi.nlm.nih.gov: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001747/
- Brichford, C. (2011, December 20). Everyday Health. Retrieved from Everyday Health: http://www.everydayhealth.com/medical-reviewers.aspx
- Gaskill A, F. F. (2011). PubMed. Retrieved from PubMed: http://www.ncbi.nlm.nih.gov/pubmed/21091136
- MS - Symptoms: Depression or Mood Swings. (n.d.). Retrieved from MS Life Lines: http://www.mslifelines.com/pages/what-is-ms/symptom_detail_depression_or_mood_swings
- MS Life Lines. (n.d.). Retrieved from MS Life Lines: http://www.mslifelines.com/pages/what-is-ms/symptom_detail_depression_or_mood_swings
- National Multiple Sclerosis Society. (n.d.). Retrieved from National Multiple Sclerosis Society: http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/symptoms/emotional-changes/index.aspx
- National Multiple Sclerosis Society - Depression. (n.d.). Retrieved from National Multiple Sclerosis Society: http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/symptoms/depression/index.aspx
- Silverman, S. M. (2004, January 8). People. Retrieved from People: http://www.people.com/people/article/0,,627518,00.html
- About, http://ms.about.com/od/livingwellwithms/tp/ms_longevity.htm
- Taming Multiple Sclerosis. (n.d.). Retrieved from Taming Multiple Sclerosis: http://tamingmultiplesclerosis.com/multiplesclerosisexercisearticle.html