Many people believe that stress plays an important role either in precipitating the onset of multiple sclerosis (MS) or in triggering exacerbations. Anecdotes abound of people who had their first attack right after a major emotional trauma. Many studies have investigated this possible link, with mixed results. It is therefore unclear whether stress plays a major role in MS disease activity.
Immune dysregulation seems to be the major culprit in MS. There is plenty of evidence, mainly from disorders other than MS, that stress influences the immune system. However, it is not known how this complex relationship plays out in MS or what its sig nificance may be. Studies in disorders other than MS have indicated that stress, especially severe stress, can promote inflammation. This raises the possibility that stress may be linked to MS by triggering some aspect of the inflammatory process associated with exacerbations. However, much more research will be needed to clarify whether stress plays a significant role in MS and what exactly that role might be.
Unfortunately, belief in the negative effects of stress has caused many productive people with MS to cut short their careers unnecessarily to avoid occupational stress. In addition, many family members harbor unnecessary guilt concerning their role in causing the stress that made a loved one's MS worse. Hopefully, the true significance of stress in MS will be understood some day.
Can Stress Be Avoided? People with MS are often told to reduce or avoid stress in their lives. Avoiding stress is easier said than done, however, because avoiding stress often means avoiding life. Life is full of stress, and the fuller your life, the more likely you are to be exposed to stress. Instead of avoiding stress, you need to learn how to deal with it.
Dealing constructively and creatively with stress will be more satisfying than a futile attempt to escape from stress. For example, if you quit your job to avoid occupational stress, you may encounter the stresses of isolation, loss of self-esteem, and a lower standard of living. Remember, the human body is biologically programmed for fight or flight. Although flight may have worked well in the past, when people were confronted by saber-toothed tigers, it doesn't work well now, when sources of stress can relentlessly pursue you where tigers could never go.
What Is Coping?
In modern times, a third option has been added to the legacy of fight or flight: coping. The concept of coping is not really new; it is simply a refinement of the fight part of our heritage. Instead of flight from occupational stress, you might decide to stick it out and fight—that is, to try your best to cope with stress in all its myriad manifestations. The best way to understand the nature of coping is to compare it to stress. Stress involves anything that demands a response from you, particularly if the demand is for change. Coping can be thought of as the ability to respond comfortably to stress.
But what does comfortably mean in the context of coping? That's a question on which social scientists have disagreed for decades. To some, you are coping comfortably if you are not anxious and depressed. However, in some situations, feeling anxious and depressed may indicate that you are in healthy touch with reality and are processing feelings that you will inevitably have to confront. To others, you are coping well if you forge ahead through life, viewing each stress as a challenge to be mastered through clever problem-solving strategies. Still others believe that it is optimal if a person has a wide variety of coping strategies to draw upon, with the choice of method contingent upon the unique demands of the situation.
Each of these ideas of what constitutes good coping strategies can teach a valuable lesson. If you go through life perpetually depressed and anxious, it's time to take stock of your coping strategies to see if something is lacking. Coping with a chronic disabling disease like MS inevitably demands a lot of concrete problem solv ing—for example, how to surmount a curb. Life has a dizzying variety of stressors, and what works in one situation may not work in another.
Was this article helpful?