MS: The Relationship between Multiple Sclerosis and Fatigue
For millions of men and women around the world, the disease known as multiple sclerosis is nothing short of a mortal enemy. In addition to pain and depression, the fatigue that this condition brings with it can devastate any patient’s quality of life.
While almost everyone seems to have heard of multiple sclerosis – more commonly referred to as MS, few seem to really understand what it is or the devastating effects it can have on the lives of the patients it afflicts. Even worse, many who have loved ones with fatigue often mistake the fatigue those patients suffer as laziness or depression. That can lead to serious misunderstandings and a failure to provide the emotional support those patients need.
To properly understand how MS fatigue can impact a patient’s life, it is important to learn about the disease and the various types of fatigue that can be present. To go beyond understanding and actually assist a loved one with multiple sclerosis – or properly manage your own MS – you have to educate yourself about the techniques and treatments that can soften the effects of fatigue.
What is MS Anyway?
Multiple sclerosis is an auto-immune disease that has proven to be one of the most difficult medical conditions known to man. It is also one for which there is no known cure. The disease affects the brain and spinal cord, as well as the optic nerves. Despite all that we know about the condition, it remains one of the most difficult diseases to diagnose.
Patients with MS typically experience any number of the following symptoms:
- Vision problems such as blurriness, temporary or even permanent blindness
- Loss of equilibrium
- Muscle spasms or tremors
- Sexual dysfunction
- Numbness in the extremities
- Muscle and nerve pain
- Cognitive impairment, memory lapses
- Inability to focus
- Extreme levels of fatigue
One of the things that makes this disease so difficult to diagnosis and manage is the wide disparity in the symptoms experienced by different patients, as well as the way so many of the symptoms mirror those of many other autoimmune conditions. Fortunately, researchers have identified different markers that can help them to focus in on an MS diagnosis through various tests.
What Exactly Causes MS?
The cause of MS is unknown, though there are some factors that seem to increase the likelihood of it afflicting certain individuals. For example, there may be a genetic factor, since it has been identified among members of the same family. Researchers also suggest that smoking may make you more likely to contract MS, primarily due to that behavior’s impact on your immune system. Certain viral infections may be factors as well.
We also know that the majority of multiple sclerosis patients are women and that symptoms usually present themselves between early adulthood and age forty. We also now understand the way in which MS begins. The disease sets in as myelin –a fatty substance in the body designed to sheath nerve fibers and protect them from harm – somehow gets targeted by the body’s own immune system. As this myelin is destroyed, the nerves it once served to protect are damaged, leaving scar tissue. These damaged nerves cause a disruption in the communication between the brain and the rest of the body. It is that disruption that serves as the primary cause of most multiple sclerosis symptoms.
Types of MS Fatigue
Fatigue related to multiple sclerosis can occur for a variety of reasons. There is also a specific form of fatigue that is found only in people diagnosed with this disease.
Some MS fatigue is just a byproduct of the debilitating symptoms many patients experience. There are three main types of symptom-related fatigue that researchers have identified:
- Sleep deprivation fatigue. Since many of the symptoms of the diseases (bladder disruption, muscle pain and spasms, etc.) can prevent restful sleep, many patients experience lethargy throughout the day.
- Depression fatigue. Many people simply forget the emotional and mental impact that a disease like this can have on any patient. Depression can not only cause physical discomfort, but fatigue as well.
- Impairment-related fatigue. Because of the physical limitations that this disease imposes on its victims, even minor routine tasks can become major undertakings. Something as simple as changing clothes can literally wear an MS patient out.
Lassitude – the Real MS Fatigue
In addition to the fatigue caused by MS symptoms, there is also the issue of MS lassitude that must be addressed. This fatigue is seen only in MS patients, differs in many respects from other manifestations of fatigue, and is only now receiving the attention of researchers.
MS lassitude is something that occurs daily, and often strikes in the morning – even when the patient had what seemed to be a night of quality sleep. Unlike other fatigue manifestations which rise and fall throughout the day, lassitude tends to get more pronounced as the day wears on. It is also substantially greater than typical forms of exhaustion, more unpredictable in nature, and apparently worse during periods of high temperatures and humid conditions.
Because of those factors, this fatigue often prevents MS patients from engaging in normal everyday activities. It is also one of the primary reasons why so many patients with multiple sclerosis find themselves unable to remain in the workforce. Their fatigue, coupled with pain and other symptoms, prevents them from being the reliable and productive employees they might have been prior to MS. In fact, it is these impairments that caused the government of the United States to recognize multiple sclerosis as a valid disability for purposes of disability insurance payments.
How to Deal with MS Fatigue
MS fatigue is one of the most challenging conditions to manage. It can also be difficult to identify, since there are so many other things that can cause exhaustion, including anemia, inactivity, prescribed medications, thyroid difficulties, and more. The best strategy for dealing with this fatigue should always begin with a consultation with your doctor to determine exactly what you should be addressing and how.
After an evaluation, your physician can help you to develop the right plan to better manage your symptoms and increase your energy levels. While few patients ever eliminate fatigue entirely, most can obtain some measure of relief in this manner. Ultimately, any MS fatigue plan will be focused on several key areas of concern:
Physical therapy can be vital for coping with the fatigue of MS. While it sometimes entails learning to walk or move in ways that conserve energy, it can also provide an opportunity to get the body moving. That has the effect of increasing energy levels in a positive way. Physical therapists can also help to alleviate some of the pain MS patients suffer, improve blood flow, and increase mental focus.
Because MS is such a mentally and emotionally challenging disease, most patients who endure it should receive some form of counseling. In addition to the assistance therapists can provide in helping patients to come to terms with their illness, there are also other benefits received:
- Stress management skills. Because the stress response can exacerbate fatigue – and every other MS symptom – learning to deal with stress can be a critical part of any MS management program. Psychotherapy and other techniques can be helpful in that process.
- Relaxation techniques. There are many different psychological techniques that can help multiple sclerosis patients learn to relax. That can help them to avoid the anxiety that often makes it difficult to obtain proper rest.
- Emotional support. Group counseling and support centers can help patients to remember that they are not the only ones suffering from MS. This can help to prevent much of the loneliness and depression that would otherwise set in.
Lifestyle changes can help MS patients with not only fatigue, but many other symptoms as well. It is important to note that none of these changes can completely eliminate MS symptoms. In fact, for those whose MS is aggressive in nature, the only real strategies involve minimizing pain, fatigue, and other symptoms, while learning to cope and adapt your life to those things you cannot change.
- Focus on rest. Commit to eight hours of sleep each night, and turn off televisions, radios, and other things that might disrupt peaceful rest. In addition, give yourself permission to nap or just lie down when you need to. Often times, personal feelings of guilt over a perceived lack of productivity can make it difficult for patients to do that.
- Avoid heat. If possible, sleep and rest in a cool room. Try to avoid being outside when the temperature or humidity is high. That can help you avoid making things worse.
- Eat better foods. You’ve probably already been told that it is important not to binge on sugar or other fast-burning foods, since they elevate blood sugar and cause energy spikes and crashes. But beyond that, you also need to arrange your diet to provide for more energy stability. That begins with a focus on whole foods – lean proteins, lots of fruit and vegetables, and healthy oils to provide the fats your body needs. In addition, try to include food choices like blueberries and other items that are high in antioxidants.
- Exercise. Even if it’s just moderate, low-impact stretching, it is important to get your body moving. While it is all too tempting to just become sedentary when every movement causes pain or greater fatigue, the truth is that being idle is actually the worst thing you can do. Try a little yoga to get limber and relax the mind!
- Make life simple. Avoid those life complications that increase stress wherever possible. If that means quitting your job and working somewhere less stressful, so be it. And if you find that you simply cannot reliably make it to work any longer, don’t allow that stress to wear you down. Eliminate chaos and learn to cope with things as they are, not as you wish they might be.
While there is no magic pill that can eliminate MS fatigue, there are medications that can mitigate the worst effects of the disease, prolong the time between MS flares, and treat symptoms that can make fatigue worse. For example, depression should be treated by your physician so that it doesn’t exacerbate your condition. MS medications like Rebif and Gylenia can work to extend the period between MS flares, and enable patients to stave off some of the degenerative effects of the disease.
There is nothing easy about dealing with multiple sclerosis or the fatigue that accompanies that disease. And it is only natural that so many patients become discouraged by the limitations that they experience as a result of all that pain and exhaustion. While there is no cure for the disease or for MS fatigue, there are at least ways to deal with it that can help patients to enjoy a better quality of life.
You might also be interested in:
- Fatigue in Multiple Sclerosis: Mechanisms, Evaluation, and Treatment. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910465/
- Fatigue. http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Fatigue
- 7 Ways to Fight MS Fatigue. http://www.everydayhealth.com/multiple-sclerosis/7-ways-to-fight-ms-fatigue.aspx
- Fatigue. http://www.msif.org/about-ms/symptoms-of-ms/fatigue/
- Fatigue. http://www.mymsaa.org/about-ms/symptoms/fatigue/
- 7 Tips for Beating MS Fatigue. http://www.healthline.com/health/multiple-sclerosis/beating-fatigue#Overview1
- Multiple Sclerosis and Fatigue. http://www.webmd.com/multiple-sclerosis/guide/ms-related-fatigue