Stress is a part of life. Unchecked, stress can have significant effects on a person’s health, accelerate the aging process and even shorten life.
The role of stress in multiple sclerosis (MS) has been under scrutiny for decades. Early studies indicated that acute stress, such as a car crash or having surgery, did not increase the risk of MS relapse, although it may aggravate symptoms. However, several recent studies have suggested a connection between chronic stress (psychological distress over long periods of time) and more active MS, by experiencing a greater frequency of relapses or greater number of new brain lesions seen on MRI.
In a previous E-Zine, we discussed evidence that meditation may have beneficial effects. Now, we’ll discuss an important study recently published in Neurology in July, 2012. It found that taming stress through a structured stress management coaching process reduced MS activity on MRI.
The MS Center at EvergreenHealth was one of three centers collaborating in the study. Funding was by the National Institutes of Health. One hundred twenty one patients who were experiencing MS relapses or new lesion activity on brain MRI (magnetic resonance imaging) were randomized to receive stress management therapy or be in a control group. Those receiving the therapy received 16 sessions over a 24-week period through structured 1:1 sessions with a trained psychologist. They were taught how to recognize stressors in their lives, how to prevent stressful events from occurring and to improve their capacity to manage their responses to stressful events that do arise. Relaxation techniques included meditation and mental imagery. The control group waited to the end of the study and then attended a stress management workshop. All subjects underwent 7 MRIs over the course of one year. The key outcome measure of the study was the rate of development of new brain lesions measured with each MRI.
The results showed that the stress management therapy group had fewer new brain lesions using two measurements. The first type, gadolinium-enhancing brain lesions, indicate a breakdown of the blood-brain barrier, allowing the immune system access to attack and damage brain cells. The second type, a T2 brain lesion, is a more global marker of disease burden and is a more permanent lesion. Among patients who received stress management therapy, 55 percent had a new gadolinium-enhancing brain lesion during the treatment period, compared to 77 percent of those in the control group. The T2 brain lesion findings showed a similar difference favoring the stress management therapy. The stress reduction prevented new lesions whether or not the patients were taking M.S. disease-modifying medications (e.g., beta-interferon or glatiramer acetate).
However, after the stress-management therapy stopped, the rate of developing new brain lesions was no different between the two groups. The implication may be that to have lasting impact, stress management should be incorporated as a part of a healthy lifestyle, not just a short course. At the M.S. Center at EvergreenHealth, we place a lot of value in relieving stress for our patients. Our team of physicians, nurse, social worker, psychologists and rehabilitation staff can provide counseling and education to help people deal with stress.
There are a number of resources for stress management offered by the MS Center at EvergreenHealth and other agencies in the community. Therapeutic Yoga classes help with strengthening, balance, body awareness, and improved mood and energy. EvergreenHealth offers a Therapeutic Yoga for Multiple Sclerosis video which can be found on-line. This allows you to get the wonderful benefits of yoga from the comfort of your home. Other classes, including some designed specifically for people with physical limitations, can be found at various gyms and yoga studios in the community.
Meditation and exercise are also very helpful tools for stress management. There are many books, CD’s and on-line videos that can help you get started with meditation. Here are just a couple that I like…
Exercise is also very beneficial in helping to decrease stress. If you’re looking to incorporate exercise into your life, it’s helpful to try to establish a regular routine, and to start with realistic goals and work your way up to an optimum level of exercise. The National MS Society offers a Wellness Grant which can help to pay for gym membership or exercise classes. To inquire about this grant, call NMSS at 800.344.4867.
Good social support is another important tool for managing stress. It’s important to have at least one person you can talk to you about the challenges in your life. MS support groups are a great way to get this support. The following MS support groups are offered at EvergreenHealth:
Kirkland MS Self Help Group
3rd Thursday of each month, 7-9 p.m.
EvergreenHealth Medical Center - room Tan 121
12040 NE 128th Street, Kirkland, WA Get directions
Contact: Karen: firstname.lastname@example.org or Susan: 425.822.0462
Kirkland Care Partner Support Group
4th Thursday of each Month, 6-7:30 p.m.
EvergreenHealth Medical Center – room Green B204
12040 NE 128th Street, Kirkland, WA Get directions
Contact: Gregg Robinson at Gregg.email@example.com or 206.284.4254 x40243
EvergreenHealth Men’s Group
2nd Tuesday of each month, 3-4:30 p.m.
DeYoung Pavilion - 2nd floor, Rainier Room
12039 NE 128th Street, Kirkland, WA 98034 Get directions
For more information, call 425.899.3140
The National MS Society offers many other peer led support groups throughout the region. For information about these groups you can call 800.344.4867.
Finally, the National MS Society brochure, Taming Stress in Multiple Sclerosis has many useful recommendations for stress reduction. This brochure can be downloaded through the National MS Society website www.nationalmssociety.org or you can request a copy to be mailed to you by calling 800.344.4867.