Ask Ardra Anything: How Do You Deal with Anxiety and MS?

Welcome to Ask Ardra Anything, an advice column about life with multiple sclerosis from blogger Ardra Shephard. Ardra has lived with MS for 2 decades and is the creator of the award-winning blog Tripping on Air, as well as the hashtag #babeswithmobilityaids. Got a question for Ardra? Reach out on Instagram @ms_trippingonair.

Hi Ardra!

Fellow MS’er here. I wanted to ask if you’ve dealt with anxiety at all, and if you have, what have you done to help mitigate it and treat it? I find my anxiety can be debilitating, but I don’t know how anti-anxiety meds would mix with MS. Medication scares me.

— Kasia

MS and anxiety go together like Amy and Tina, gin and tonic, and corticosteroids and weight gain. If anxiety means worrying about uncertain outcomes, one thing we know for sure is that MS promises uncertain outcomes. Finding any chill in this unpredictable situation takes Jedi-level mind control.

When anxiety can be as debilitating as any MS symptom, our sense of well-being depends on our ability to effectively manage feelings of foreboding.

Like many of you, I can relate to Kasia’s concerns. In addition to my disease-modifying therapy (DMT), I take a number of supplements and pharmaceuticals to manage MS symptoms like spasticity, bowel dysfunction, and fatigue.

When you live with chronic illness, it’s natural to feel cautious about adding more drugs with potential side effects or contraindications onto the list of elixirs keeping you going.

That said, the management of mental health is too often stigmatized. Check in with yourself to see what’s holding you back from considering anxiety medication, even temporarily. Mental health is as important as physical health; while there’s no drug that cures anxiety, an effective treatment plan may sometimes include medication.

Be sure to talk with your doctor or a mental health professional about what’s going on. There are many anxiety-taming strategies you can try right now, though. These are some that work for me.

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Increase your social capital

People with MS who have strong relationships and community involvement report a significantly higher quality of life.

There are many ways you can improve your social capital. Invest in your friendships, volunteer, or engage with a religious organization. Join a book club, a sports team, or an adaptive yoga class.

MS can limit our ability to participate as fully as we might like, and you might need to find creative ways to stay connected. Meanwhile, if you’ve got social capital to spare, consider reaching out to someone else with MS who could use a friend.

Move

Exercise is beneficial to overall health, but its effects on anxiety can be immediate and include the release of endorphins — the body’s powerful feel-good hormones.

I trick myself into moving more by promising myself the minimum: that I will walk 10 minutes a day. By the time I get outside, I’m almost always motivated to do more.

Of course, MS is different for everyone, so find the bare minimum you can reasonably commit to. When fatigue or mobility issues get in the way, exercise can feel like the last thing you want to do, but there are always creative ways to keep moving.

Make a playlist

Music can affect how we feel, and according to research, the right tune may override anxiety’s panic signal that we’re in harm’s way.

You don’t have to listen to anything that might be included on a meditation soundtrack, either. Consider making a playlist of the songs you can’t resist moving to, for the next time you start to spiral. Include the jams that never fail to get you singing along. Singing, especially singing in a choir, can be a major anxiety-buster. (Singing in a choir also happens to be a great way to improve your social capital!)

Help someone else

It turns out that the adage “it’s better to give than to receive” is effective, stress-reducing advice that can actually help you live longer.

When we give something to others — our time, our energy, our attention, our care — we are telling ourselves we have enough.

At the end of every day, I use an app that prompts me to set intentions for the next day and even asks me who I can help the following day. When I log in the next morning, the reminder is in my calendar, prompting me to check in with my neighbor who’s been sick or to call the friend who’s been having a rough time.

Pet some dogs

Dogs are medicine. And if you’re a cat, or a bird, or even a turtle person, you already understand the healing power of pets.

We brought home a puppy in June 2020 and Tilly has since proven herself to be invaluable in keeping me (mostly) calm as we ride out the pandemic. Science backs me up. Research suggests that just petting a dog can significantly lower your levels of the stress hormone cortisol.

Cry it out

Many of us with MS are encouraged to be brave. We’re rewarded for staying positive. Sometimes we avoid expressing negative emotions because we don’t want to burden our loved ones. But keeping feelings bottled up doesn’t make them go away.

As a self-soothing behavior, crying can be good for us. Crying can invite a hug or the comforting words we need to hear, and letting it all out from time to time helps us work through emotional extremes so we can return to a more neutral vibe.

Giving in to tears can be normal and healthy, but if you think you’re crying too much, or at inappropriate times, or if you don’t feel a boost in mood after bawling your eyes out, talk with your doctor, as this can be a sign of depression.

Find a mindfulness practice that works for you

Meditation is a popular and effective way to manage anxiety, but for whatever reason, I just can’t get into it. The good news is there are other ways to practice mindfulness, and the one that works for me is journaling. Keeping a diary helps me process my anxiety by encouraging me to articulate exactly what’s bothering me.

Research has shown that journaling can reduce stress and increase resilience in people with medical conditions. Somehow, putting my problems on paper keeps me from turning them over in my head too much.

Whether it’s yoga, meditation, gardening, or something else, find a mindfulness activity that works for you and stick with it. It may take some time to see the benefits of mindfulness, so don’t be discouraged if it’s not instant relief.

Talk to your anxiety

Anxiety was designed to keep us alive. Anxiety is just doing its job, but it needs retraining.

When I’m feeling particularly angsty, I like to tell my anxiety something like, “Thanks for the heads up. There are currently no tigers chasing me. Please feel free to take the rest of the day off.”

The bottom line

I’ve often felt that the worst symptom of MS is fear. For many of us with MS, worrying about what might happen — to our bodies, our jobs, our benefits, our relationships — is a lifelong negotiation.

It’s normal to wig out from time to time, but we don’t need to be controlled by our concerns.

Easing anxiety is about getting comfortable with not knowing and then having faith that whatever happens, we will be OK. Reminding myself that I’ve already survived all of my worst-case scenarios is the single biggest reassurance that whatever comes next, I will adapt, I will handle it. And so will you.