Mood disorders and cognitive problems can occur with the progression of multiple sclerosis (MS), which researchers can now determine through eye movements. Mood swings can be quite common in those with MS, from crying at a commercial, to yelling at loved ones without much reason.
Multiple sclerosis is an autoimmune disease where the immune system attacks the myelin – the protective layer around nerves. All parts of the central nervous system – brain, spinal cord, and optic nerve – can become affected as the myelin becomes scarred. Mood swings can occur, but are often not recognized when compared to the physical symptoms of MS.
The causes of mood swings associated with MS can include stress, depression, pent-up frustration, anxiety, inability to cope with the disease and grief. Some patients report that emotional distress and mood swings worsen during an episode of MS.
Two parts of the brain are used to express emotions. One part of the brain forms the emotional response, while the other allows you to control your emotions. In those with MS, lesions can form in the part of the brain that allows you to control emotions, causing inappropriate emotional responses. Therefore, a person may cry during something funny or vice versa.
Dr. Joanne Fielding from the School of Psychological Sciences at Monash University said, “Over the past 10 years, our studies have shown that eye movement measures can reveal abnormal cognitive processes in MS patients, at all stages of the disease, even where a diagnosis is only suspected. Further, we have been able to show that the degree of abnormality increases with disease duration.”
The ability to monitor symptoms is important for those living with multiple sclerosis as it can aid in patient management. Additionally, it can reveal how successful a medication or treatment is or if it needs to be changed.
Dr. Fielding added, “We propose that it may be possible, therefore, to use eye movement measures to assist with early diagnosis, especially given that cognitive changes are thought to be among the earliest changes seen in MS, to monitor disease progression over time, and to monitor responses to treatment. These are the aims of our ongoing studies.”
The study was published in Nature Reviews Neurology.
Below are common emotional changes and mood disorders people with multiple sclerosis may encounter.
Grieving is a large part of MS as patients experience many losses – loss of bodily function, loss of independence – and with these losses comes grieving. This grieving process can be like a depression, except it can resolve on its own and may only be around for a limited time – unlike depression.
Grieving can be related to physical changes which occur with multiple sclerosis. Treatment of MS may help speed up the grieving time as the patient may become restored or learn to manage better.
MS patients may also experience depression, where feelings of sadness last for long periods of time; they disassociate themselves from others and begin to lose interest in hobbies they once loved. MS patients may also experience depression due to brain changes as it is a common symptom of the disease.
Due to the severity of depression, it can actually greatly impede on a patient by hindering their quality of life and potentially inhibiting them from seeking treatment or properly following it. Additionally, symptoms of MS will feel worse as depression lowers a person’s pain tolerance.
Generalized anxiety and distress
Generalized anxiety and distress, too, can be associated with emotional changes and mood disorders linked with MS. Because MS is progressive and debilitating, the unknown of what will happen next or how bad the person will be affected can lead to anxiety and distress. Each episode creates more uncertainty and unknown for future episodes – will it get worse? What ability will I lose next? It can all be very daunting for a patient suffering with MS.
Moodiness can be sudden and sporadic. MS patients may have bouts of anger and then go right back to being calm. This can greatly impact relationships; friends and family may not fully understand where the moodiness is stemming from, leading to frustration. Counseling may be useful to help friends and family become more understanding of the disease and the mood changes.
Pseudobulbar affect (PBA)
PBA is a condition where a person expels inappropriate emotional responses to a situation or environment. For example, a person may laugh at a funeral or cry at a joke. Essentially, because the individual cannot control their emotions, abnormal ones may be expressed and lead to uncomfortable situations.
There are medications available to reduce the symptoms of PBA in individuals with multiple sclerosis.
A diagnosis of MS can contribute to some much added stress. With major life changes occurring, loss of function, and being in the dark with what will happen next, it can be quite stressful living with MS. Stress on its own can have negative effects on the human body, so it can feel more intense for a person with MS. Although it would be nice to simply avoid stress, it’s advised to better manage it to still successfully live your life.
A much smaller group of those with MS portray inappropriate behavior such as sexual disinhibition. The behavior is believed to stem from damage in the normal inhibitory functions of the brain. Individuals may portray poor judgment and not seem to have much control over their behavior.
If you simply sit and dwell in your home, only to be left thinking about your condition, it’s quite easy to slip into a depression. For that reason, it’s important to still enjoy your life and get your mind off your disease.
You may want to reach out to your doctor and explain mood swings and other changes which you may have noticed – they may have to prescribe medications or therapies depending on severity.
Other means of coping with MS is by exercising, meditating, getting outdoors, reaching out to others and ultimately relaxing. MS may be scary, as there is still so much unknown about the disease, but it’s important to keep communicating with your doctor and loved ones in order to make transitions as smooth as possible.
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