Invisible Symptoms of MS: Mood Swings
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Profile photo of Devin Garlit

Like many with multiple sclerosis, I have my fair share of problems with walking, spasms, pain, and fatigue. Some of my worst symptoms though, are not physical in nature and fall under the category of emotional and cognitive deficits. I’m going to start off what will hopefully be a whole series covering these unseen and often misunderstood symptoms by talking about mood swings. For those with MS, the frequent and almost instant changing of moods is a symptom that no doubt has a profound effect on many relationships. It is a terrible symptom that many don’t even realize is related to their MS. While these constant emotional changes can be hurtful to those we care about the most, they can also be horrifying for us. There are, however, some ways we can battle this invisible symptom.

So what are these mood swings I’m talking about? I think of it as a rapid change in thought and emotion that seems to come on instantly. I can go from super happy to super depressed in the blink of an eye! The worst part of this is that it can seem like there is no reason for it all. Other times, the smallest of things, a commercial, a song, even seeing a certain color, can trigger it. It’s not only a matter of being happy and then depressed, pretty much any set of emotions can pop up. Anger, of course, is one of the scarier and more destructive ones. It’s also not always a positive emotion to a negative one, in can be in reverse too. I’m sure I seem awful when I suddenly get angry about something, anything, and everything, but I probably look just as crazy when I go from very angry to super happy and loving the world. The emotions really are all over the place.

Mood swings are a symptom that many people don’t realize can be attributed to MS. I’ve gotten the question many times from upset and frustrated people who finally start to wonder if their rapid and sometimes constant emotional changes are actually MS-related. It seems that this is another area where people don’t stop to think it could be their disease at work. You can have MS lesions in the area that controls your emotions the same way you can have them in areas that affect your arms or legs. There are two parts of the brain associated with emotions, one where they are formed and one where they are controlled. A lesion in either area can affect your mood swings or even cause pseudobulbar affect (PBA), where you laugh or cry suddenly with seemingly no trigger at all. You can also have your emotional responses scrambled, so you may cry when you really want to laugh and vice versa.

External factors can also lead to mood swings. Living with multiple sclerosis can cause a tremendous amount of pent up frustration, stress, anxiety, pain, and depression. It can be very hard to explain to others what it’s like going to bed each night not knowing if you will be able to walk in the morning. Not to mention the fact that many people lose their employment and even mobility due to the disease. Sometimes, no matter how happy a face you put on, there are still lingering concerns in the back of your mind, whether you realize it or not. If you don’t confront these thoughts, they can bubble to the surface at inappropriate times.

Whether they are caused by the disease itself or the effects of having the disease, sudden mood swings can be a living hell. It’s bad enough that many of us are in pain much of the time, but sudden mood swings have the awful effect of causing pain in the ones we love. I know I personally have had many relationships ruined by the sudden outburst of emotion caused by my mood swings. The worst part of that for me, is that when I have these outbursts, I know that it’s not me. That’s not the real me that’s angry or sad. It just happens and I end up feeling tremendous regret at the ways I’ve acted or about the things I’ve said. You begin to feel like a bad person. I know that it makes people think of me as being a different person then I really am. That would take a toll on anyone.

Like most multiple sclerosis symptoms, the level of severity can vary greatly from person to person, and even day to day for a particular person. I have days where I feel fine and notice no differences. I have others where I’m sure it seems I’m near bipolar. All of the normal MS triggers, like stress, temperature, humidity, and fatigue can play into the variance, frequency, and severity of my mood swings.

So what can we do? Well, first off, if you are experiencing mood swings, you should mention it to your neurologist. I also think it’s important to talk to your family and friends about it. You may not even realize that you are having mood swings. In my case, I talk with my wife about everything. That doesn’t always make it easier, but just being mindful that it’s an issue has seemed to help me (at least some of the time). It’s not using it as an excuse, it’s informing people. It’s ok to say “hey, I have this problem related to my MS.” It may sound like a convenient excuse to them, but that’s when you have the opportunity to share information with them and to show them that this is a real issue. It’s also important to consider talking to a mental health professional. They can help provide you with strategies on coping with your emotional issues. With everything on our plate, whether you have mood swings or not, just in general, it can be sound advice to talk to one about your MS.

The one goal I had with this article was to bring up just one of the many invisible symptoms those of us with multiple sclerosis may deal with. I feel that symptoms like mood swings are not spoken about enough. There are many aspects of the disease that are not well understood by some neurologists, let alone the general public. So if anything, I hope to trigger conversation and the sharing of information about these issues. If we work together, as a community, to talk about and share our issues and ways to combat them, we can beat this disease!

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