Managing anxiety when you have MS

Anxiety disorders are common and can be even more so in people that have received a diagnosis of MS. Stress and anxious feelings can affect the body’s ability to fight disease, so it’s important to learn ways of managing anxiety levels as much as possible. The OMS Recovery Program dedicates a whole step to mindfulness and meditation as a clinically proven way of reducing stress. 

Can MS cause anxiety?

Anxiety is an emotion, and causes the body to go into a ‘fight-or-flight’ response which enables us to respond to what we think are danger and threats. This in turn means the body starts to produce adrenaline which can lead to physical side effects. These can include: 

  • Pounding heart

  • Feeling faint or dizzy

  • Breathing difficulties

  • Dry mouth

If you are experiencing anxiety you may feel worried, nervous or tense. Everyone has feelings of anxiety at some point in their life, but for some it may be hard to control their worries. Their feelings of anxiety are more constant and can often affect their daily lives. These people may receive a diagnosis of an anxiety disorder, these include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. These can range from mild to severe. 

Receiving a diagnosis of MS understandably will cause most people to experience anxious thoughts.  Due to the unpredictable nature of MS, it’s understandable that the feeling of the unknown can make you feel anxious. A common fear for people with MS is around their future and how it might be affected by increasing levels of disability. This is a completely understandable fear, which can leave you feeling persistently or excessively anxious. Feelings of anxiety at certain times are completely normal, see a GP if anxiety is affecting your daily life or causing you distress.

According to a study by the UK MS Register, over half people with MS reported symptoms of anxiety such as feeling tense or restless or sudden feelings of panic. 

Generalised anxiety disorder is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event. People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed.

Can anxiety worsen existing MS symptoms?

Anxiety can often be linked with stress and to depression, a common symptom of MS.

Similar psychological symptoms between anxiety and MS include:

  • Be unable to concentrate or make decisions

  • Being on edge, restless or irritable

As well as your mental wellbeing, anxiety can also manifest with physical symptoms, which may be similar to some MS symptoms, such as: 

What to do to manage anxiety 

There are many ways of managing anxiety and the anxiety attacks which you may experience. Here are some self-help strategies  which we hope can help you. 

  • Live ‘day-to-day’

Rather than worrying too much about tomorrow, try and live just one day at a time. This doesn’t mean putting off planning or burying your head in the sand, but living in the now and focusing on the present moment can help stop any unnecessary anxious thoughts. Being more mindful of the current moment is a key step of the Recovery Program. Be aware of common reactions to the uncertainty of an MS diagnosis such as avoidance, trying to pretend the issue isn’t there, or overcontrol,  trying to create the illusion of control over the uncontrollable. 

  • Practice focused, deep breathing

Mindfulness and mediation is a key part of the OMS program and can help with anxiety too. Try breathing in for four counts and breathing out for four counts for a total of five minutes. By evening out your breath, you’ll slow your heart rate which should help you feel more calm.

  • Stay active

Exercise is a great way of boosting your mood and keeping the mind and body active can reduce the time spent dwelling on negative thoughts. Click here to read more about the benefits of exercise.

  • Be kind to yourself

Often anxiety can undermine confidence and make you think negatively about yourself and your abilities. Try and remind yourself of your achievements and good qualities. A technique to assess this is questioning if the way you are speaking to yourself is how you would speak to a good friend? If the answer is no then it is important to try and improve how you talk to yourself. 

  • Write down your thoughts

Writing down what makes you anxious gets it out of your head and can make it less daunting. Take a listen to one of our podcast episodes ‘Journaling as a path to healing’.

  • Avoid caffeine, alcohol and refined sugars and instead eat wholefoods and healthy fats 

Reducing your refined sugar intake can help with the highs and lows of anxiety, as can eating regular meals. Caffeine and alcohol are stimulants which can also precipitate or mimic symptoms of anxiety.

Feed your brain by: 

  • eating foods rich in zinc, like whole grains, oysters, kale, broccoli, legumes, and nuts

  • eating foods rich in magnesium: fish, avocado, dark leafy greens

  • eating foods rich in vitamin B, such as asparagus, leafy greens, and avocado

  • eating foods rich in omega-3 fatty acids, for example, wild caught salmon

  • eating probiotic-rich foods and other fermented foods

If you need other support: 

  • Access online resources

Visit Every Mind Matters and you can make a personalised plan: https://www.nhs.uk/oneyou/every-mind-matters/anxiety/

For anxiety tips during the COVID-19 pandemic: 

https://www.nhs.uk/oneyou/every-mind-matters/coronavirus-covid-19-staying-at-home-tips/

  • Access services or psychological therapies 

  • Your GP or healthcare provider may be able to help you access psychological therapies like cognitive behavioural therapy (CBT). 

Research into new therapies tailored for people with MS such as acceptance and commitment therapy (ACT), specifically designed to help people with early MS become more comfortable with uncertainty, is ongoing. 

  • Anxiety medication

If psychological treatments or self haven't helped you might be offered medication by your doctor.Some medication is designed to be taken on a short-term basis, while other medicines are prescribed for longer periods.  It is worth thinking about the side effects of these.

They include: 

  • Selective serotonin reuptake inhibitors (SSRIs)

  • Serotonin and noradrenaline reuptake inhibitors (SNRIs)

  • Pregabalin

  • Benzodiazepines

View the OMS recovery program

As mentioned above, some of the ways to help cope with anxiety are steps in the OMS 7 Step Recovery Program. By following the program, you are already giving yourself the best chance at managing your anxiety. Click the links below to find out more about steps in the program which can directly help your anxiety.


References: 

  1. Jones KH, Ford DV, Jones PA, et al. A large-scale study of anxiety and depression in people with Multiple Sclerosis: a survey via the web portal of the UK MS Register. PLoS One. 2012;7(7):e41910. doi:10.1371/journal.pone.0041910

  2. https://en.wikipedia.org/wiki/Hospital_Anxiety_and_Depression_Scale#:~:text=Each%20item%20on%20the%20questionnaire,for%20either%20anxiety%20or%20depression.

  3. https://www.nhs.uk/conditions/generalised-anxiety-disorder/

  4. Molton, I. R., Koelmel, E., Curran, M., Geldern, G. V., Ordway, A., & Alschuler, K. N. (2019). Pilot intervention to promote tolerance for uncertainty in early multiple sclerosis. Rehabilitation Psychology, 64(3), 339-350. doi:10.1037/rep0000275

  5. Su K, Tseng P, Lin P, et al. Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety Symptoms: A Systematic Review and Meta-analysis. JAMA Netw Open. 2018;1(5):e182327. doi:10.1001/jamanetworkopen.2018.2327

  6. Molton, I. R., Koelmel, E., Curran, M., Geldern, G. V., Ordway, A., & Alschuler, K. N. (2019). Pilot intervention to promote tolerance for uncertainty in early multiple sclerosis. Rehabilitation Psychology, 64(3), 339-350. doi:10.1037/rep0000275

  7. https://www.health.harvard.edu/blog/eating-well-to-help-manage-anxiety-your-questions-answered-2018031413460