Multiple Sclerosis and PTSD

How They're Connected and Life With Both

There is some evidence to indicate that post-traumatic stress disorder (PTSD) may make you more likely to be diagnosed with multiple sclerosis (MS), and chronic diseases like MS are known to trigger psychological issues like PTSD. And, as you might suspect, living with both is often more challenging than living with one, as the combined effects of two major illnesses can take a significant toll.

Even more importantly, MS and PTSD can both produce symptoms such as anxiety, depression, pain, trouble sleeping, and personality changes, making it hard for you, your loved ones, and even your healthcare team to recognize which of your conditions is at the root of how you're feeling.

If you have both MS and PTSD, it is best to approach your treatment being mindful of how these two issues can affect you and to do what you can to prevent symptoms of each.

PTSD and the Risk of MS

PTSD—a trauma- and stressor-related disorder that develops after a traumatic event or recurrent traumatic experiences—is associated with an increased risk of autoimmune disorders, including MS, lupus, and rheumatoid arthritis.

While chronic anxiety, stress, and depression can disrupt the immune system, suppressing it and, thus, increasing your risk of infections, it can also make your immune system more reactive than it should be. This can trigger allergies (when your body fights a substance that isn't actually harmful) and autoimmune diseases (when your body fights itself).

In the case of MS, a demyelinating disease in which the protective coating around the nerves is diminished, your body's own immune system attacks your brain, spinal cord, and optic nerve.

In one study, for example, researchers found that war veterans with PTSD had an increased risk of developing autoimmune disorders, including MS. Importantly, however, the researchers suggested that, in addition to stress, there could also have been some shared environmental or lifestyle risk factors that may have predisposed this population to develop similar medical conditions years after they ended their military careers.

MS and the Risk of PTSD

While the incidence and prevalence of PTSD are about the same whether you have MS or not, chronic illnesses are among the known triggers of PTSD.

Being diagnosed with MS is considered a traumatic event and it is among the many types of trauma that can cause a person to develop PTSD.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines a traumatic event as a situation where you have experienced, witnessed, or have been confronted with an event where there was the threat of or actual death or serious injury. The event may also have involved a threat to your physical well-being or the physical well-being of another person.

Without a doubt, MS meets these criteria. It has a major impact on a person's body and life. Further, because the symptoms of MS, their severity, and their progression vary from person to person, you may experience a sense of helplessness and hopelessness at the time of diagnosis, as well as at any time throughout your disease course.

Shared Symptoms

About 25 percent of those with MS have at least one symptom of PTSD, which is likely due to the fact that there are so many overlapping symptoms between the two issues.

If you have both conditions, untangling whether your symptoms are caused by MS or PTSD is not easy, and there is always the possibility that both are, in fact, at play. The compounding effect of symptoms can be particularly challenging to cope with.

While PTSD and MS can each produce a number of symptoms, here's a look at common ones and which apply to both:

Symptom MS PTSD
Fatigue    ✓     ✓
Anxiety       ✓
Depression    ✓     ✓
Loss of Motivation    ✓     ✓
Cognitive Issues (e.g. problem solving, thinking)    ✓     ✓
Trouble Sleeping    ✓     ✓
Nightmares       ✓
Personality Changes    ✓     ✓
Muscle Weakness    ✓  
Pain, Tingling    ✓  
Vision Loss    ✓  

If you are experiencing any signs of MS relapse (which can be confused for PTSD symptoms), it is important to seek medical attention. Timely treatment for the right condition can prevent worsening disease effects.

Treatment for Combined MS and PTSD

Treatment for PTSD and MS is not typically coordinated, and there are no guidelines or formal recommendations regarding combined treatment.

There are treatments for PTSD, and the therapy requires consistency over time. In addition to addressing the disorder itself, management of symptoms such as insomnia may require additional prescription medication.

A 2016 study specifically focused on treatment of PTSD symptoms in a group of people who also had MS. The treatment involved using eye movement desensitization and reprocessing (EMDR) and relaxation techniques. EMDR is a type of guided therapy that focuses on a traumatic memory while using eye movements to reduce the intensity of the traumatic distress. The relaxation therapy focused on breathing, muscle relaxation, and visualization.

Most of the participants who took part in the study were able to overcome their PTSD with 10 treatments. EMDR was shown to be more effective than relaxation therapy, but both helped with anxiety, depression, and the severity of PTSD.

Disease-modifying therapies can help control the deterioration of MS, and treatment for symptoms such as muscle stiffness and pain may be necessary as well.

A Word From Verywell

Living with two chronic medical conditions can be challenging. MS is a lifelong illness, but it can be managed. PTSD can be a lifelong illness as well, although many people recover from this disorder.

If you have MS and PTSD, be sure to maintain regularly scheduled visits with your doctor, regardless of whether or not your symptoms are acting up. It is certainly better for you and your medical team to identify flare-ups of either of your conditions at an early stage (when a major relapse can still be prevented) than to wait until your symptoms become noticeable or even debilitating.

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