This article is the third in a three-part series on the management of MS symptoms. The earlier articles in this series addressed the “hidden” symptoms of MS, such as pain and fatigue, as well as the physical symptoms of MS, which include mobility, spasticity, and several other well-recognized symptoms. These two articles appeared in the Winter/ Spring 2013 and the Summer/Fall 2013 issues of The Motivator, respectively.

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.

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.

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 needs of people with MS and their loved ones vary from individual to individual and change over time.What a person requires emotionally and psychologically at the time of diagnosis can be very different as the disease evolves.

Sexuality and intimacy have a significant impact on the quality of life for nearly everyone, including those with a chronic disease such as multiple sclerosis (MS). In MS, sexual dysfunction may be one of the more invisible symptoms of the disease. It is important to recognize and understand the factors that contribute to sexual dysfunction in order to adequately address it.

When we consider the impact that the diagnosis of multiple sclerosis has on an individual, one only needs to ask, “When were you diagnosed?” Most people remember the date, the time, the doctor, and what was happening in their life at that moment. The experience was life-changing not only for the individual, but also for his or her family, friends, and the future.

Individuals with MS are at higher risk for emotional disorders, which can significantly disrupt family, work, and social life. These mood disorders are highly treatable through a combination of psychiatric and psychological therapy and medication treatment.

Very likely, the FDA will soon decide on the status of the first alternative “biologic” drugs to challenge the branded disease-modifying therapies (DMTs) presently in use by individuals with multiple sclerosis (MS). Several of the current DMTs approved by the United States Food and Drug Administration (FDA) are “biologics,” which means that the active ingredient for each of these drugs is derived from living cells.

This past winter has been particularly unpredictable and challenging, with record-breaking snowfalls and cold temperatures. These past few months have also proven unpredictable and challenging for our MS population, as individuals experience record-breaking changes in the healthcare system with the introduction of the Affordable Care Act (ACA).