Multiple sclerosis is a progressive disease that results from a person's immune system mistakenly attacking that person's own central nervous system. Most people with multiple sclerosis have a relapsing-remitting course of the disease, meaning symptoms will appear, disappear for a while and then reappear, explains the Multiple Sclerosis Foundation. Episodes when the symptoms reappear are often called relapses, exacerbations or acute attacks. Exactly what triggers these relapses is a subject of intense research, and few clear causes have been identified. The role of stress in triggering multiple sclerosis symptoms has been particularly controversial, and is still not fully understood.
Stress Triggers of Multiple Sclerosis
Despite numerous studies on the role of stress in triggering symptoms of multiple sclerosis, a clear relationship has not been found. However, most patients believe that stress does trigger relapses and symptoms of multiple sclerosis, reports a study published in the March 2004 issue of the "British Medical Journal." In an attempt to resolve the question, this study undertook a "meta-analysis" of 14 other studies that investigated the relationship between stress and multiple sclerosis. The results of the meta-analysis showed a statistically significant increase in the risk of relapse symptoms after stressful events. However, the authors were quick to point out that the study only showed that the two tended to occur at the same time, not that stress caused the symptoms to appear.
Reasons for Controversy
One of the reasons the topic of stress and multiple sclerosis is difficult to study is that the term "stress" has different meanings to different people, explains the National Multiple Sclerosis Society. Researchers do not have a way to objectively measure stress, and what feels stressful to one person may not seem stressful to another person. Another confounding factor is that multiple sclerosis itself causes stress in patients, which further complicates measuring stress levels. Additionally, some doctors suggest the changes in the body leading up to relapse symptoms might start occurring long before the symptoms appear, and that stress only increases the risk that these already occurring changes will turn into actual symptoms, the National Multiple Sclerosis Society reports.
Managing Stress
Even with the lack of clear evidence, most doctors agree that patients with multiple sclerosis should take steps to reduce stress in their lives, according to the Multiple Sclerosis Foundation. Whether or not the stress actually triggers the relapse symptoms, stress invariably lowers the quality of life of people with or without multiple sclerosis.
Beneficial Stress
The study in the "British Medical Journal" pointed out that a previous study, published in 1992 in the journal "Medicina Psicosomatica," demonstrated a beneficial effect of stress on the relapse of multiple sclerosis. This study found that patients with multiple sclerosis who experienced extreme, life-threatening stress, such as the threat of missile attacks in Tel Aviv, Israel, actually experienced a decrease in multiple sclerosis relapses. This protective effect may be caused by the release of cortisol, a stress hormone, which reduces inflammation and the risk of autoimmune attacks on the nervous system. However, the authors point out that the long-term occurrence of low levels of stress causes more complicated chemical changes in the body. This study further highlights the complicated role of stress in multiple sclerosis.
References
- Multiple Sclerosis Foundation: Multiple Sclerosis FAQ
- "British Medical Journal"; Association Between Stressful Life Events and Exacerbation in Multiple Sclerosis: a Meta-Analysis; David Mohr et al.; March 2004
- National Multiple Sclerosis Society: Stress
- "National Multiple Sclerosis Society"; MS and Stress; Marcella Durand; October-November 2005
- "Medicina Psicosomatica"; Stressful Events and Exacerbations in Multiple Sclerosis: A Pilot Study; G. Gaiatto, et al.; 1992.
