A woman with her entire neck and mouth covered in an orange scarf.

When My Voice Won't Work

Since I was young, I’ve been given a hard time about how soft-spoken I am. Not only that, but I’m soft-spoken and I tend to mumble. To me, I feel that I talk normally, but to others, I speak softly and it’s difficult to hear. I didn’t have any idea until a couple of years ago that this could be because of my MS.

My voice feels weak after speaking up

I am unsure of which speech problem I deal with the most, but I do know that I struggle with speech volume as well as a shaky voice on occasion. I will touch on the different types of speech issues in a second. My husband always tells me I have two volumes. He says I’m either barely talking or I’m yelling. As I mentioned earlier though, while to him it seems like I’m barely talking, to me it feels like I’m speaking normally. And then when I speak up so that he can hear better, I am actually yelling. I always feel like when I try to make extra effort to talk more loudly, that I feel like I strain my voice. Heaven forbid if I actually do yell, too, because then my voice really feels tired. After talking loudly or yelling, even if unintentionally, I can immediately tell how weak my voice feels. It feels so weak that it is almost painful. As I mentioned earlier, I am a mumbler. It is one of those things that I don’t even realize I am doing, but I am told I do it often. MS comes with many symptoms, but I had never really considered how my speech issues and MS were connected.

Different speech issues: dysarthria

In multiple sclerosis, there are several types of speech issues. MS lesions are in different parts of the brain for everyone, but depending on where they are located, they can cause several speech difficulties. These problems with speech are called dysarthria. I did not know this until I read it on the National MS Society's website, but dysarthria is commonly associated with other symptoms caused by lesions in the brainstem. These symptoms include tremor, head shaking and or incoordination, all of which I have experienced. Another speech issue is called scanning dysarthria. This means our normal speech patterns are disrupted causing abnormally long pauses between words or individual syllables of words. Slurring of the words and nasal speech are also possible.


MS patients may also deal with dysphonias. Dysphonia is difficulty speaking due to reduced control of the muscles of your lips, tongue, mouth, throat, and/or vocal cords. In MS, dysphonia causes trouble controlling the volume of speech, meaning speaking too softly to be heard or louder than what is usually appropriate. Some other examples include hoarseness, raspy voice, or a change in pitch when you try to talk. Actress Selma Blair, who recently came out with her diagnosis, revealed that her MS led to Spasmodic Dysphonia. This condition caused for her a speech pattern marked by a strained choppiness. She bravely shared this part of her disease in a televised interview. During the interview, viewers were clearly able to hear the choppiness, shakiness, and strain in her voice. While speech issues can be incredibly embarrassing and hard to deal with, she shared so openly and allowed others a view into some of the more unknown aspects of MS. I couldn’t help but tear up watching her interview because I know how terrifying and embarrassing speech issues can feel. Yet, she shared without hesitation on national television and raised such awareness about MS.

How does MS affect your speech?

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