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Multiple Sclerosis and Moodiness

Moodiness is by far the most common emotional change seen in people with MS. Even though these mood shifts are much less intense than the mood swings seen in bipolar disorder (formerly called manic-depressive disorder), they can be very uncomfortable for people with MS and their family members.

People describe themselves (and their partners and children are happy to verify it) as unusually irritable, cranky, and quick-to-anger. (Note: Bipolar disorder is also more common in MS than in the general population.)

This brief story shows that even the most pleasant people can become moody and irritable: One MS patient was at the grocery store trying to decide between two brands of laundry detergent. Because of problems with attention and distractibility, his efforts were hampered by the hustle and bustle in the store and by two women who were talking loudly in the same aisle. Finally, overcome with frustration, he loudly shouted, “Shut up!”

This generally mild-mannered man was extremely surprised and embarrassed by his own behavior. He said of himself that he no longer had the same control over his emotions — he felt as though the nuts and bolts had been loosened a bit.

Others have described themselves as feeling raw, or super-sensitive to irritants around them. If you’re experiencing increased irritability or uncomfortable bouts of temper, be sure to let your doctor know. Irritability can occur by itself, but it can also be sign of depression.

Even though a person with MS can have a lot to feel cranky about, particularly if it’s been a bad day, the moodiness in MS often seems to bear little relationship to the severity of the disease or to day-to-day symptom activity. In other words, the irritability sometimes seems to happen out of the blue or for no apparent reason.

Here are some strategies that people with MS have found useful for dealing with irritability:

  • Talk it up: Even though your moodiness may be neurologic in origin, talking about it can still help to relieve it. In support groups, for example, people share their stories, discover how other people have dealt with their mood issues, and generally get more comfortable with the idea that moodiness or irritability are just one more aspect of MS that they need to come to terms with.

  • Identify your triggers: Paying attention to the things that seem to trigger your moods is also important. For example, if particular situations make you tense or irritable, try to create a buffer for yourself — remove yourself from the situation, practice some deep breathing or meditation, or speak up about what’s bothering you.

  • Get moving: Exercise can be very beneficial. A significant body of research in MS points to the benefits on mood of both cardiovascular exercise (which is of course geared to a person’s abilities and limitations) and yoga. And, in the end, almost everyone feels better when they’re getting sufficient exercise.

  • Discuss meds with your doc: If the irritability doesn’t respond to any of the other interventions, tell your doctor about it. A low dose of Depakote (depakene) can be very effective if the moodiness is unrelated to depression. This medication, which is primarily used to treat seizures, seems to help people feel more like themselves again. If the irritability is a sign of depression, an antidepressant medication may be called for.

If you want to read more about mood issues, check out these great resources for suggestions from practicing clinicians on how to manage the emotional ups and downs of MS:

  • It’s Not All in Your Head: Anxiety, Depression, Mood Swings, and Multiple Sclerosis by Patricia Farrell, PhD (Demos Health). This well-researched book offers a plan of action for dealing with emotional challenges and changes.

  • MS and Your Feelings by Allison Shadday, LCSW (Hunter House), The author shares her own experiences with MS as well as her clinical expertise in this roadmap for managing the emotional challenges of MS.

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