Anxiety is perhaps the most taxing and under-treated psychological effect of living with MS. It does not appear to result from the physical disease process of MS, but rather stems from the realities of living with MS. Individuals living with MS know that it’s the unpredictability, and therefore the difficulty, in planning and preparing for the effects of MS on your life, that drives one’s anxiety. Anxiety disorders are estimated to affect 43 percent of those with MS, and are also more common among women.

Traditionally, cognitive issues were not believed to be a symptom of MS. In more recent years, researchers and physicians have come to find that roughly half of the MS population will experience some type of change in their cognitive abilities during the course of their disease.

Researchers believe that the high rate of major depressive disorder, dysthymia (a chronic type of depression), and bipolar disorder with MS, is a result of the disease process or the etiology of the disease itself. In other words, the damage to the nerves within certain areas of the brain is believed to increase the chance of greater depressive reactions. Depressive reactions are not to be confused with sadness or fatigue.

Pseudobulbar affect (PBA) is a neurologic effect that occurs in 10 percent of people with MS, although some research suggests a much larger percentage. It is characterized by sudden, uncontrollable expressions of laughter or crying without an apparent trigger.

The cerebellum is located in the lower-back region of the brain, and helps to control movement, coordination, balance, and muscle tone. While demyelination in this area can cause tremor for some individuals, it can cause balance problems as well. Other components, such as vision, hearing, and movement of the arms and legs, are also involved in balance. Problems with the functioning of any of these areas can worsen balance, but conversely, some of these areas may be able to compensate for other deficits in balance.

Vertigo, or the sensation of “spinning,” may occur as the result of lesions in the brain areas that coordinate balance.

Fatigue has been described as an “overwhelming sense of tiredness.” Up to 80 percent of people with MS experience the disabling effects of fatigue. This overwhelming tiredness could occur any time in the course of MS, and it has not been shown to be related to measures of disability like the EDSS (Extended Disability Status Scale). Many people with MS find that fatigue increases as the day goes on, and worsens with a rise in body temperature, which might be caused by hot and humid weather.

A very common symptom of MS is numbness, often in the limbs or across the body in a band-like fashion.

More than 50 percent of individuals with MS identify pain as a significant symptom. For many years, the medical community did not support the idea that pain could be caused by the effects of MS, but physicians today recognize that pain is a common symptom.

There is nothing like a good night’s sleep to restore oneself physically, mentally, and emotionally. Unfortunately, more than half of people with MS experience difficulty sleeping. Inadequate sleep leads to fatigue, the most common and one of the most debilitating symptoms of MS. It also causes daytime drowsiness, lack of mental clarity, and a reduced ability to use one’s resources to solve problems.