Mood swings can also be described as a ‘hidden symptom’ of MS as it isn’t as easily identifiable as physical symptoms.
Depression is a very common when living with MS, and is diagnosed in around 50% of PwMS at some point. Additionally, some people may also experience changes to their emotions or behaviour that is hard to control or understand. This can be known as ‘emotional lability’ or ‘emotionalism’.
MS & emotional changes
How might MS affect your emotions?
PwMS may experience mood swings which can happen very suddenly – intense periods of emotion that seem out of proportion or unrelated to whatever has triggered them. You may find that your emotions build up quickly and that you have a lack of control over them.
Why is this happening?
There are two main reasons for emotional change:
The rapid change in emotion experienced by some is often caused by MS related nerve damage in the areas of your brain that control your mood and emotions.
Psychological factors can also have an effect on mood and behaviour. This includes factors such as changes in health and employment or living arrangements.
Are there any treatments?
It is a good idea to talk with your family doctor or GP early if you are experiencing difficulties in your mental health.
They may advise you speak with a mental health specialist, who can help you manage your emotional mood swings by offering you tips and tools to keep in control.
Therapies such as Cognitive Behavioral Therapy (CBT), which focuses on challenging and changing unhelpful cognitive behaviours, can often be helpful. Some Local MS charities can also offer counselling over the phone or in person.
There is now a large body of evidence showing that Mindfulness based therapies (such as MBSR and MBCT) can be very effective in treating the symptoms of mood disturbance, depression and anxiety. OMS recommends 30 minutes of mindfulness daily.
Health professionals may also recommend medication to help with these mood swings. Antidepressants such as fluoxetine (Prozac) or citalopram are very commonly prescribed, and may help to balance your mood.
How can I help myself?
As well as medication and therapy there are several other ways that you can take back control of your emotions. Some ideas are:
Writing a mood diary. This can help rationalise how you are feeling and reflect on what might have caused certain emotions.
Practicing meditation and yoga. As one of the central elements to the OMS Recovery Program, meditation has many benefits, including reducing stress. Taking time out to breathe and focus the mind can help control mood swings.
Talking to family members and friends. It can help to talk about your mood swings to people close to you and explain that they are a symptom of MS. This can make you feel less embarrassed when you next experience a rapid change in mood.
MS & behavioural changes
How might MS affect behaviour?
A lot of associated behaviours with MS have had very little research and only affect a handful of pwMS.
Although disinhibition is one of rarer behavioural symptoms, it can affect a small percentage of people with MS. People experiencing disinhibition can often demonstrate inappropriate behaviour and a loss of the normal social rules.
Euphoria is also a fairly rare behavioral change, but it occurs when someone is overly cheerful and has a sense of optimism that may seem out of place. Euphoria is typically associated with a lack of insight.
Lack of insight
In some cases, nerve damage in the brain can cause pwMS to have a lack of insight about their situation which can mean that their judgment of safety may not be as good as it was.
Lack of initiative
Daily tasks such as getting dressed, engaging in social activities or housework are a struggle to start when someone is experiencing a lack of initiative. This behavioural change can again be due to nerve damage in the brain.
Mood swings are not something you have to deal with alone. Try talking with other PwMS, through your local Circle support group.
By following the OMS 7 step recovery program, the right combination of meditation, diet, emotional support and medication, can help you feel like yourself again.
MS and emotional lability
Emotional lability, also called emotionalism, refers to the uncontrollable displays of emotion that MS can bring on. You might feel that these intense periods of emotion seem to have no relation to your situation, or are out of proportion to whatever triggered them.
MS emotional lability can manifest itself as bursting into tears, laughing or suddenly becoming angry, and it can build up in what seems like no time at all. At times, your emotions might be the opposite to what you are feeling, such as crying when you are happy. It is known as pseudobulbar affect, and is thought to be due to damage to parts of the brain responsible for controlling our mood and emotional responses.
How diet could be impacting your mood swings
While mood swings are an identifiable symptom of MS, some of the things that cause mood swings in people without MS can make the symptom worse – and diet is one of the biggest of these. Unhealthy eating patterns have a direct impact on mood, with nutritional imbalances and fluctuations in blood sugar levels causing particularly unpredictable changes.
Skipping meals can lead to low blood sugar, and eating too many refined carbohydrates like white bread can cause levels to rise and fall quickly. Both of these lead to low energy and irritability. In addition, leaving certain food groups or micronutrients out of your diet can decrease energy and worsen your mood – especially if you are not getting enough zinc, iron, vitamin B, vitamin D and omega-3 fatty acids. The OMS 7-Step Recovery Program has plenty of great advice on how to maintain healthy eating habits with MS.