Mood swings can be common in people with multiple sclerosis. The condition attacks the nerve cells, and a person may feel changes in their mental and physical health. Mood swings can take many forms that have different causes and treatment options.
Some causes of mood swing have links to the disorder itself. Multiple sclerosis or MS is unpredictable, and people may never know when its symptoms will hit. This uncertainty may result in a shifting mood. Other causes are also possible.
Addressing these mood changes is vital. The National Multiple Sclerosis Society note that people with MS tend to focus on their physical symptoms, and they may neglect their mental health. However, psychological health is vital to MS treatment.
Possible causes of mood swings for people with MS include:
When a person receives a diagnosis, they may notice their mood changes, or they may have mood swings.
This can be a sign that they are grieving over the change in their life that comes with a diagnosis.
People with a new diagnosis may find themselves overwhelmed with information about the condition.
They may learn about some negative effects, or question whether they will be able to continue doing their favorite activities. It is normal for people to experience mood swings or changes in these cases.
Low mood is not immediately a sign of depression. Unlike depression, grieving over changes will usually pass with time. Each person processes grief differently, so there is no set timeframe.
Talking to a counselor or support group may still help, even after grief passes.
People with MS may be susceptible to depression. The American Academy of Neurology state that one-third to one-half of people with MS will struggle with depression at some point.
Depression has no start or end, unlike grief. People may feel helpless and unable to engage with life or enjoy daily activities.
Symptoms also tend to last longer. Depression can last anywhere from weeks to months without stopping. Anyone who feels they are struggling with depression may want to consider contacting their doctor.
Other factors may cause mood changes that are shorter but more turbulent than depression or grief.
For example, it may feel as if a person goes from happy to sad quickly, or feels emotional over things that are relatively small. These causes may vary but can include:
These causes of sudden mood change may be the result of a person coping with their multiple sclerosis. They may feel fearful or anxious about their condition or symptom progression, for example, which may lead to changes in their mood.
The root cause of mood changes is sometimes the disease itself.
If the condition affects the nerves or parts of the brain that control emotions then people may experience feelings that include:
This can then cause further changes in mood, as people can find it difficult to cope with the loss of control.
Mood swings can make a person feel frustration or that their emotions are beyond their control, which can lead to more stress or anxiety and a repeating cycle. This may lead to what doctors call the pseudobulbar affect or PBA.
PBA causes uncontrollable episodes of laughing or crying that are not in proportion to what the person is feeling. The condition occurs in about 10 percent of people with MS, according to the National Multiple Sclerosis Society, and is treatable.
In addition to PBA, people with MS may seem to experience euphoria or inappropriate happiness. They can also appear to lack emotions or appear to have feelings that continuously change.
As with other treatments for MS, dealing with mood swings or emotional disorders often requires a variety of approaches.
Depending on the underlying cause, a doctor may recommend drugs for anxiety or depression. These drugs may affect each person differently, and side effects are possible.
The National Multiple Sclerosis Society note that a doctor may prescribe drugs for:
Emotional changes: dextromethorphan + quinidine (Nuedexta)
People should work closely with a doctor to monitor any side effects and change medications if needed.
Cognitive behavioral therapy
Cognitive behavioural therapy or CBT teaches people how to redirect harmful thought patterns into healthier ones, which may help change someone's thinking.
The American Academy of Neurology note that there is weak evidence to support using CBT in people with MS who have major depressive disorders. The evidence they cite relates to treatment sessions held by phone, however.
In many cases, doctors may still recommend CBT alongside other therapies.
Reaching out to friends and family may help someone who is experiencing mood changes. Helping loved ones understand what a person is experiencing may provide insight into ways they can help.
MS support groups can also offer help. Sharing experiences with others may reduce worry or make it easier for people to find peace of mind. People in groups may be able to share coping mechanisms they have experienced.
Mindfulness is a type of therapy that stems from ancient meditative practices.
Mindfulness meditation involves paying attention to the present moment. There are now many mindfulness-based interventions (MBIs) for various medical conditions.
A 2014 review in the journal BMC Neurology notes that MBIs may be of some benefit to people with MS, regarding their mental health, quality of life, and some physical health aspects.
Other natural remedies
Natural remedies may help people feel a sense of calm and general balance, which may translate to mood stability.
This may include the following:
- gentle exercises, for example, yoga or Tai Chi
- breathing exercises and taking deep breaths when feeling overwhelmed
- reflecting on feelings
People with MS may benefit from improving their diet and doing more exercise. A good diet is beneficial for overall health, and people may also respond to activities, such as cycling or swimming, if their body allows them.
Getting enough sleep may also help people with MS cope better with the challenges of the condition.
As with other symptoms of MS, changes in mood can vary greatly. Some people may have an easier time coping while others do not.
It is essential to have patience and allow emotions to play out, but it is also important to reach out for help if necessary.
Anyone having difficulty coping or who feels their mood changes are uncontrollable should talk to a doctor or neurologist who may be able to refer them to a specialist or recommend other ways to help someone find stability.