Like depression, anxiety is quite common in MS, affecting more than 35 percent of those with the disease—again, a number higher than the general population. People used to believe that depression and anxiety were two sides of the same coin, so to speak, but now these mood changes are increasingly seen as separate disorders. People with generalized anxiety feel tense and worried much of the time and often to a greater degree than external events would seem to demand. Other types of anxiety include panic attacks and obsessive-compulsive disorder, but generalized anxiety is much more common among people with MS. That’s not surprising, given the unpredictability of MS. People with the disease may feel great one day but have considerable pain, fatigue, or other symptoms the next. And there’s no road map that tells them how much or how fast their disease will progress.

“One of the things I hear very often in relation to anxiety is people saying, ‘Well, what do you expect? You’ve got a disease here that’s affecting young people. There’s no cure. There’s significant physical disability. Of course a person’s going to be anxious.’ But that’s a really simplistic approach to the problem,” says Dr. Feinstein. “I think anxiety, just like depression, is going to be [shown to be] generated by brain changes. It does have a profound effect on a person’s ability to function. We should not just view it as an understandable reaction to a nasty disease. I think for most people, it’s going to be a lot more complex than that.” Many antidepressant medications effectively treat both depression and anxiety. Specific anti-anxiety medications can work well for short periods of time but carry the risk of dependence. CBT and other forms of psychotherapy can be very effective for anxiety disorders. Also, yoga and meditation can help calm the nervous system and reduce activity in the parts of the brain that govern the stress response. A 2012 study published by David Mohr, PhD, in Neurology, found that people with MS who used stress management techniques were less likely to develop new MS brain lesions than people who didn’t use such tactics. More research in this area needs to be done before drawing definitive conclusions. Your doctor or mental health professional can help you find the right combination of treatments for you.

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