When you have multiple sclerosis, stress can make fatigue worse than usual, but these stress-busting tips can help you save energy and stay healthier.

Stress is a major factor for many people with multiple sclerosis (MS). From worry about the unpredictable nature of the disease to concerns about work, family, money, and more, having MS can be a significant stressor all on its own. Some people also feel their MS is worsened by stress, although the exact connection between stress and MS is still unclear, according to the National Multiple Sclerosis Society.

“There are currently no known studies that have established any causal relationship between stress and MS,” says Carrie Hersh, DO, a neurologist at the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas, Nevada. But there are several ways to explain the relationship. “Chronic stress causes alterations in naturally occurring glucocorticoids, our stress hormones, which in turn alter the body’s ability to regulate our inflammatory response,” Dr. Hersh says. In MS, the immune system attacks the nerve cells, which results in inflammation that damages these nerves, according to the National Library of Medicine.

Steps to Reduce Stress With MS

The relationship between stress and symptoms of MS varies widely from person to person and can depend on your ability to cope with stressful life events, Hersh says. Many people find that when stress subsides, MS symptoms lessen or sometimes totally disappear — all the more reason to get stress under control.

Managing stress can help reduce the development of new lesions in people with MS, according to a study published in 2012 in the journal Neurology.

Try these tips to keep stress to a minimum and possibly ease your MS:

Save your energy. “Much more energy is required to perform everyday activities in times of stress,” Hersh says. “Stress also triggers fatigue, which is an important issue for people with MS.” Conserve your energy as much as possible. Put off nonessential tasks for another day or ask a friend or loved one for help.

Be prepared for stress. When you’ll be having a family gathering or other special occasion at home or a big project at work, plan ahead and prepare for the impending stress of added responsibilities, the National Multiple Sclerosis Society suggests. Delegate tasks to others when possible, and on days when you have a lot to do, take some lesser responsibilities off your plate.

Consider complementary therapies. You can’t always avoid stress or plan for it, so find a go-to solution when your stress level rises, such as yoga, tai chi, massage therapy, meditation, mindfulness, or biofeedback. “Techniques that help reduce ‘catastrophic thinking’ through cognitive behavioral therapy can also be quite helpful,” Hersh says. Relaxation approaches help soothe the autonomic nervous system and affect your perception of stressful events, she says. People with MS who engaged in mindfulness experienced better quality of life, improved mental health, and reduced fatigue, according to research published in the January 2014 issue of the journal BMC Neurology. For a simple stress-reducing technique you can use throughout the day, try deep breathing.

Make the time to relax. Regardless of the de-stressing method you choose, consider practicing it on a daily basis. Allow yourself a few minutes each day to sit quietly and meditate or practice deep breathing as you visualize a soothing, peaceful scene.

Get more sleep. It’s a vicious cycle: Not only is your body more run-down and fatigued when you’re stressed, but stress can interfere with your sleep, Hersh says. Make an effort to get more good-quality sleep to recharge your energy.  Schedule seven to nine hours of sleep each night. Keep your bedroom cool, dark, and comfortable and avoid stimulation — such as caffeine, nicotine, and screen time — before bed. 

Use exercise as a de-stressing tool. “Exercise increases naturally occurringendorphins, our happy hormones, which can boost a person’s ability to cope with stress on a day-to-day basis,” Hersh says. Aim for 20- to 30-minute exercise sessions about three days a week, based to your abilities. Remember to take steps to keep your cool because heat can worsen MS symptoms. Hersh recommends using a cooling vest, exercising in the air conditioning, and drinking cool water during a workout.

Create a to-do list. Make a to-do list for yourself to help you stay organized, especially if you struggle with forgetfulness and concentration issues. But make sure to prioritize your responsibilities — do only the essentials when you’re stressed, Hersh says, so that you can have the time you need for rest and taking care of yourself.

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