Stressful events, and stress, are linked to the occurrence of relapses. Are you surprised? #MSBlog #MSResearch
“I suspect readers of this blog have survey fatigue; it has taken 3 months to collect 122 responses. I set-up these surveys to engage readers around a topic and to see if the results are the same as those published using more robust methods.I don’t ignore the results; several surveys have changed the way I think about MS and how I manage it in the clinic.”
“The results of this survey are interesting. 68% of you identified a stress event as a precipitant of a relapse in the past and 22% said maybe; that is a whopping 90% of you. Only 5% of you said no, and 5% of you don’t have relapses presumably due to having PPMS. There was a similar response in relation to the question on background stress levels. If this survey is correct we should do something about it and consider implementing a trial of stress management alongside DMTs to prevent or reduce relapses? Any thoughts on now?”
“I suspect readers of this blog have survey fatigue; it has taken 3 months to collect 122 responses. I set-up these surveys to engage readers around a topic and to see if the results are the same as those published using more robust methods.I don’t ignore the results; several surveys have changed the way I think about MS and how I manage it in the clinic.”
“The results of this survey are interesting. 68% of you identified a stress event as a precipitant of a relapse in the past and 22% said maybe; that is a whopping 90% of you. Only 5% of you said no, and 5% of you don’t have relapses presumably due to having PPMS. There was a similar response in relation to the question on background stress levels. If this survey is correct we should do something about it and consider implementing a trial of stress management alongside DMTs to prevent or reduce relapses? Any thoughts on now?”
That would be a great initiative
Not only a great initiative but a NERVE-SAVING one at that – please do asap Prof G.
I'm certain stress impacts my MS in a number of ways. I've had major relapses that followed stressful life events (such as bereavement) but I feel that I don't manage the stresses of everyday life well either. I find supermarkets and public transport difficult and I think it's the combination of stimuli – too many sights, sounds, people. It feels like my brain and body slows down.In comparison, I find yoga and hiking both relaxing and invigorating. Focussing on a yoga posture or concentrating on my map and compass make me feel like myself again.
Dani, I like your blog very much (http://daniwithms.wordpress.com/); it is personal stories like yours that make MS understandable to others. If you get time you should post more often.Your observations that MS only starting catching-up with your after a few years is unfortunately very typical. It is those early years that count most in the course of the disease. It is not that your MS was not active during those years that allowed you to remain active; it was that you had the ability or brain reserve to deal and cope with the damage it was causing. It is only after this reserve was exhausted that you started to notice the problems. On my ‘Holistic Approach to MS’ tube, or train, map below this is the equivalent of moving from the minimal to the moderate impairment phase of the disease. I am desperately trying to get the message across with this blog is that we have a window of opportunity to treat MS early to prevent or delay MSers moving from the minimal, or no impairment phase, to the next phases of the disease that are characterised by increasing impairment. Some MSers understand what I am trying to achieve others simply shrug their shoulders and criticise me for trying to poison them with toxic drugs. The truth is we don’t have medications or treatments to reverse disability therefore the best opportunity we have of making a real difference to MSers is to treat early and effectively; my so called prevention strategy. To maximise the chances of remain free of disability we have to be active in the way we go about treating MS, which is why I am pushing the ZETO or zero tolerance approach of treat-2-target of no evidence of disease activity. It is also interesting that MS has brought you to a different place; this is not uncommon I see it happen a lot with MSers under my care. Living with MS can surprisingly be a rewarding experience, but to get there you need to have a very supportive family and friends. I call people like you MS Champions, but when I used this term the last time I was shouted down by the naysayers. I hope you are having a good weekend.
I think the whole issue of stress is almost incalculable because of its very nature. We live with stress – it is there all the time in all our lives, whether chronically ill or not. And most of the time, it is a positive and enabling force – it makes us do things. It is only in times of illness that we see it as 'bad'. So the person suffering an relapse, understandably, will naturally psychologically link the relapse with a 'stressful' life event/episode. Just as 'normal' people link short term illness with 'bad' stress. Unfortunately this instinctive linking (often retrospective) may or may not be valid – it is so hard to judge.
Prof G I think you should try a different strategy to scaring us to make the point about early treatment. There must be a better ways of doing it that referring to MS as the shredder. I am beginning to understand what you are trying to do. Thank you for caring, my neurologist doesn't.
The stressful events that I believe brought on relapses were greater than the 'everyday' stress that motivates us to do things: these events were almost unbearably stressful…
Yes I think stress is defiantely linked to triggering relapses. It causes inflammation the stress. MS is inflammation. It may be the stress is acute and extreme (i.e from a relationship breakup for example) or accumulated stress over a longer period.