Stress management

Epub: van der Hiele et al. Daily hassles reported by Dutch multiple sclerosis patients. J Neurol Sci. 2012 Jul 14.

Background: There is growing evidence for the association between stress and relapse risk in MS. The current study focuses on daily hassles, which by their chronic and accumulating nature can cause considerable psychosocial stress. 

Aim: The main aim was to investigate the frequency, associated distress and type of daily hassles encountered by Dutch MSers from a large community-based sample. They further examined factors associated with high levels of psychosocial stress. 

Methods: Questionnaires concerning demographics, disease characteristics, physical functioning, daily hassles, fatigue, depression and anxiety were completed by 718 MSers. Three MSers younger than 18 were excluded, resulting in 715 MSers. 

Results: Compared with published norm data, more than 50% of the participants reported a high number of daily hassles (57.5%) and high levels of associated distress (55.7%). Frequently mentioned daily hassles concern personal functioning and social developments. A logistic regression model revealed that being female, being younger, having a higher educational level, using benzodiazepines*, exhibiting more symptoms of anxiety, and a higher physical impact of fatigue were all independently associated with high levels of psychosocial stress. 

*benzodiazepines are a group of drugs that can be prescribed as sedatives, anxiolytics, hypnotics, anti-convulsants or anti-spastic medications. The most well known in the class is diazepam. MSologists probably use clonazepam the most as an add-on drug to help with the control of spasticity. 

Conclusion: These findings may alert clinicians of the high prevalence and impact of daily hassles in MS and underline the need to incorporate stress and anxiety management strategies in (psycho)therapeutic interventions. 

“This study is self-explanatory. Do the results strike a cord with you?”

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6 thoughts on “Stress management”

  1. The first thought is to write 'no, sh!t sherlock', but am glad that a scientific study has been done to prove what most people living with MS already know. Next target is get the UK government to learn that stress can affect the lies of those with MS in a negative way

  2. For me, the issue of stress and its impact on my life is intimately tied to my 2 major MS symptoms: cognitive dysfunction and fatigue. There is definitely an interplay between these three things that, on a daily basis, dominates my activities. Each one tends to exacerbate the other. By the end of most days I feel cognitively "run-down", jittery, and often times irritable. Stress (most notably times when I am forced to multi-task) makes my cognitive struggle and fatigue worse … which in turn stresses me out more!!!Reading the abstract, I feel like it highlights almost perfectly my daily struggles.On the subject of benzos: I had been taking alprazolam (Xanax here in the US) for this end-of-the-day anxiety/irritability/jitteriness. However, as this is not a good long-term solution, my neurologist and I decided to give clonazepam a try. It doesn't give the warm fuzzy feeling of alprazolam (and thus probably why the risk of abuse/dependence is less), but I do feel that it does indeed calm me a bit at the end of the day. I would guess that the association with benzos in the study is a proxy for those like me who feel stressed and that this stress is affecting daily activities.Other coping mechanisms I use: reliance/faith in God; meditation (not as much as I should do!); relying more on family and friends to help out.Studies like these are not prestigious from a medical standpoint, but they are important for physicians treating those of us with MS. This one gives great insight into my daily struggles!

  3. I strongly believe that once the surveys are completed one should look a stress reaction from the "inside" – what chemical reactions does stress cause in the brain, can one trace it back into lesion formation (from a pathological point of view), can stress change one's DNA etc? I believe that stress is a cause of MS alongside other well-known factors not just a by-product. Stress, due to changed living and working patterns, is a constant fixture in the majority of the (MS-)population's lives and has been for as long as 250 years (Industrial Revolution) – that's so much longer that the 20+ years of sun-blockers and 80+ of tobacco industry.Stress is as big a puzzle as VitD and EBV, maybe even much bigger.

  4. Stress is known to increase clot-forming platelets. I belive clot-forming platelets has been studied in relation to MS

  5. My only major relapse was brought on by stress (caused by first neurologist I saw – his words and treatment of me). I have regular physio and they track any fluctuations I experience to stressful situations. All in their notes! Neuro told me I might improve after retirement – this has certainly happened and I now realise just how much stress I was carrying daily.

  6. Tim S saidGreat to see scientific backing for this. Everyone should work on stress management anyway. Its nice to find such a practical way of assisting with MS on Stress management

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