Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. It damages the myelin sheath that protects nerve fibers in the brain, spinal cord and optic nerves. This damage slows down or blocks messages between the brain and body, leading to MS symptoms like numbness, weakness, fatigue, vision problems, mobility issues, pain and more.
There is no known single cause of MS. Research suggests it may be triggered by a combination of genetic, environmental and lifestyle factors in people with susceptibility. There has been much interest in whether psychological stress could be one of these contributing factors.
What causes MS?
The exact causes of MS are not fully understood, but are believed to be a combination of:
- Genetics – having certain genes makes a person more susceptible
- Environmental factors – low vitamin D, smoking, certain viruses
- Abnormal immune response – immune system attacks the myelin sheath
Research into how these factors interplay is ongoing. Many speculate that severe emotional stress or trauma may also contribute by altering immune function. But there is conflicting evidence on stress as a definitive MS cause.
Can emotional stress lead to an MS diagnosis?
Several studies have looked for a link between stress and higher MS risk, with mixed results:
- A 2010 meta-analysis of 14 studies concluded stressful life events like bereavement, work stress, war trauma were not associated with increased MS risk.
- A 2005 study found significant life stresses in the year prior did not raise MS risk.
- But a 2004 study linked stressful life events like divorce or job loss in the 5 years before to higher MS risk.
Overall, research does not strongly indicate severe emotional stress or trauma directly causes or triggers onset of MS later in life. However, there are a few ways it may contribute indirectly:
Stress hormones impact immune function
High levels of stress hormones like cortisol can dysregulate the immune system over time and raise inflammation. Chronic stress and elevated cortisol can shift immune cells into attack mode. This may generally increase autoimmune activity.
Stress behaviors neglect healthy lifestyle
Living with chronic stress can impact behaviors like diet, exercise, sleep and smoking. Neglecting these healthy lifestyle factors may influence MS susceptibility.
Stress biases perceptions of early symptoms
People under severe stress and anxiety may focus more on physical symptoms like tingling or vision changes, and report them more urgently to a doctor. This could appear to diagnose MS earlier following a stressful period, even if there is no direct link.
Can stress worsen MS symptoms?
While the evidence for emotional stress as a root MS cause is weak, many studies show it can exacerbate symptoms in people already diagnosed:
- Stress worsens fatigue, a most common MS symptom
- Anxiety and depression are more common in people with MS
- Stress predicts more severe MS relapses and flair ups
Research on how stress impacts MS disease activity focuses on the stress hormone cortisol. Cortisol spikes during acute stress responses. But chronic stress leads to both high and low cortisol levels, which may:
Increase inflammation
High cortisol boosts inflammatory processes that can damage myelin and worsen MS severity.
Suppress the immune system
Too little cortisol weakens the immune response needed to repair myelin damage and nerve fibers.
Negate treatment effects
Cortisol changes in chronic stress can interfere with some MS drug treatments.
Managing stress is therefore considered an important part of MS symptom management.
Tips to reduce stress with MS
Living with MS is inherently stressful. Patients must cope with challenging symptoms, medical appointments, expensive treatments, uncertainty about the future, and more. This emotional burden makes stress management crucial.
Tips to minimize stress with MS include:
- Get regular exercise appropriate for your abilities – this relieves anxiety
- Practice relaxation techniques like deep breathing, meditation, yoga
- Maintain social connections and accept support from others
- Prioritize sleep and take time to recharge
- Consider counseling or joining a support group
- Communicate openly with your healthcare providers
- Keep stress levels low with lifestyle choices – eat well, avoid smoking, limit alcohol
Treatment plans should also address mental health concerns like depression that commonly accompany MS.
Key points
- Severe emotional stress is unlikely to directly cause MS onset later in life.
- But chronic stress may contribute by negatively impacting immune function, healthy behaviors, and perceptions of early symptoms.
- Stress exacerbates MS symptoms once diagnosed by increasing inflammation and disrupting treatments.
- Managing stress through lifestyle and self-care is an important part of coping with MS.
Conclusion
In summary, current research does not confirm severe emotional stress or trauma directly triggers MS development. But it does play an indirect role by influencing known genetic and environmental MS risk factors. Stress has a clearer impact on worsening symptoms and severity in MS patients. Controlling stress is therefore considered an essential part of MS management plans.