Anxiety & Multiple Sclerosis: The Connection You Need to Know

Multiple sclerosis (MS) and anxiety often occur together. If you live with MS and anxiety, there may be ways you can reduce the impact of this challenging combination.

MS is an autoimmune disease in which the immune system mistakenly targets a person’s nerve axons (fibers). It strips the axons of their myelin cover and damages them so they don’t work as well to transmit signals.

Anxiety and MS often occur together. Some people with MS have a few anxiety symptoms, while others have a co-occurring anxiety disorder.

If you live with MS and are experiencing anxiety, you may be wondering why and whether there is anything you can do about it.

MS and anxiety: The link

Anxiety commonly occurs with MS. In fact, emotional changes such as anxiety are a symptom of MS.

Research from 2019 provides the following statistics:

• The prevalence of comorbid anxiety disorders and MS is about 13–31.7%.
• An estimated 26–63.4% of people living with MS experience anxiety symptoms.
• Anxiety disorders occur at about triple the rate in people with MS compared with the general population.

The top three anxiety disorders that occur with MS are:

• generalized anxiety disorder (GAD): 18.6%
• panic disorder: 10%
• obsessive-compulsive disorder (OCD): 8.6%

There are several reasons for this co-occurrence.

MS symptoms are impactful and unpredictable, which can leave you feeling anxious and distressed.

MS treatment may also cause worry. For example, you might experience injection anxiety if your medication is injectable. Or you might be concerned about the potential adverse side effects of your treatment.

MS medications may even cause anxiety as a side effect

The MS demyelination of nerves in your brain can also lead to emotional changes like anxiety. MS anxiety can be associated with atrophy in the middle and superior gyri in the right frontal lobe of the brain.

Brain inflammation also connects MS and anxiety.

Neuroinflammation is part of the process that leads to the demyelination of nerve axons in MS. This demyelination leaves the axons vulnerable to injury, which impacts how well they can work.

Research has found evidence indicating that enhanced inflammation is also associated with anxiety disorders.

Symptoms of anxiety

Some of the symptoms of anxiety include:

Some anxiety symptoms are the same as or similar to MS symptoms:

Anxiety symptoms	MS symptoms
fatigue	fatigue
chest pain	dysesthesia (torso squeezing sensation)
tingling	numbness or tingling
gastrointestinal issues	bowel problems
reduced concentration or decision-making ability	cognitive changes
irritability	mood changes
unexplained muscle aches or pain	pain and itching
dizziness	vertigo and dizziness
shortness of breath	breathing problems

If you live with both MS and anxiety, there may be times when it’s hard to tell what’s causing your symptoms.

5 ways to cope with anxiety and MS

There are several ways you can reduce the impact of anxiety.

1. Medication

Medication is often helpful for treating anxiety. It works by changing the action of chemicals in the brain called neurotransmitters.

Sometimes, medications for MS symptoms can also treat anxiety. An example is venlafaxine (Effexor). It’s a type of medication called a serotonin and norepinephrine reuptake inhibitor (SNRI) and is a common anxiety medication. Doctors also prescribe it to treat neuropathic pain in MS.

Other anxiety medications doctors use to treat MS symptoms include diazepam (Valium) for spasticity, sertraline (Zoloft), and fluoxetine (Prozac) for depression.

Your doctor can also offer suggestions for other anxiety medications that are safe to take with your MS treatments.

2. Therapy

There are different forms of therapy for anxiety, many of which are often effective. If your family doctor refers you to a mental health professional, they can suggest a type of therapy for you to try first.

Not all therapies work for everyone. If the first type of therapy you try doesn’t help as much as you’d hoped, you can try another kind.

Cognitive behavioral therapy (CBT) is a therapy that’s widely used for treating anxiety. CBT can help you identify the way your thoughts lead to emotional, behavioral, and then physical responses.

Acceptance and commitment therapy (ACT) and mindfulness-based stress reduction (MBSR) were both found to reduce MS symptoms and enhance emotional competencies in a 2022 study.

ACT therapy helps people face difficult situations rather than ignoring them. MBSR uses a regular practice of mindfulness techniques like body scanning and awareness of breathing.

A 2020 study found that eye movement desensitization reprocessing (EMDR) therapy showed promise as a treatment for MS anxiety. EMDR desensitizes traumatic memories, reduces physiological arousal, and reformulates negative beliefs.

3. Social support

Social support can reduce the impact of anxiety when you live with MS. Research shows that the amount of social support a person has is a consistent predictor of their chance of developing anxiety or depression.

Social support can be informal time spent with family and friends. It can also develop from the connections you make through online or in-person support groups, clubs, or recreational activities.

4. Mindfulness

Mindfulness is a state of connection to the present moment. When you’re experiencing mindfulness, you’re not caught up in worrisome thoughts.

Instead, your mind is connected to the sensory input from your body and your environment, like your breathing and the sounds you hear.

A 2017 study found that an eight-week mindfulness intervention program for people with MS yielded positive results in:

The mindfulness program in the study included relaxing music, mindfulness meditation, and yoga movement.

5. Self-care

Sometimes, the most effective wellness strategies are ones that you can implement yourself.

Examples include:

If you feel like there are too many changes to make, you can try starting with one and add a second when you’re ready.

When to seek help

If the anxiety you experience feels overwhelming and unmanageable, you can seek help. While it may be possible to manage MS anxiety on your own, the support of a mental health professional can make it easier.

Even better is catching your anxiety early before it overwhelms you. Anxiety can increase a person’s chance of developing depression, so seeking support early can have a protective effect for your mental health.

Takeaway

There’s a well-established link between MS and anxiety. However, anxiety is treatable, and managing your mental health may improve your MS symptoms. This is because if you’re in a better frame of mind, it may be easier to stick to your MS treatment plan.

Treatments and strategies for managing anxiety include medication, therapy, social support, mindfulness, and self-care.

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