Understanding and Managing Multiple Sclerosis Mood Swings

Many people with multiple sclerosis experience mood changes, and sometimes stress or grief can contribute. A healthcare professional can recommend ways to manage mood swings, such as therapy or medications.

You might be happy one minute and angry the next. A television commercial might bring you to tears. Or maybe you’re suddenly snapping at other people for no reason. These are all examples of mood swings, which are common in some people with multiple sclerosis (MS).

In MS, your immune system attacks your myelin, the protective covering that coats the nerves of your central nervous system (CNS), creating lesions or scars. Depending on what part of your CNS is involved, a wide range of symptoms can result.

Mood changes can be part of MS, and sometimes this may include moodiness or mood swings.

It’s easy to see many of the physical effects of MS, such as problems with balance, walking, or tremors. In comparison, the emotional impact of the disease is less visible from the outside.

With MS, you are likely to notice changes in mood, including feelings of sadness, anxiety, and irritability. And you may notice certain things that make these feelings worse, such as fatigue or pain.

Some advanced cases of MS can also raise the risk of emotional instability, which may lead to uncontrollable laughing, crying, or even euphoria. However, therapy, medication, and honest communication may help you manage your mood swings.

MS mood swings can strike without warning and leave you feeling frustrated and overcome by your seeming lack of emotional control.

It’s important to try to understand what you’re feeling and the reasons for your mood swings. Being as honest and observant as possible can help you determine the cause of your emotions.

Some common causes of MS-related mood swings include:

• stress
• anxiety
• depression
• pent-up frustration
• inability to cope
• grief
• fatigue
• feelings of uncertainty
• disability caused by MS
• isolation

Mood swings from grief typically resolve with time. They often last anywhere from a few weeks to a few months. It’s especially common to experience grief-related mood swings when you’ve been recently diagnosed with MS. It can be very difficult to learn that you have the condition.

Besides grief and other emotional responses to external factors, the disease itself may play a role in your mood swings.

There are two aspects of emotions, including emotional responses and emotional expression. MS can affect both aspects, sometimes resulting in decreased control over your emotional responses or emotional expressions.

This might lead to difficulties with self-control or unbalanced expressions of sadness or happiness. Your emotional responses can even be scrambled, causing you to laugh at sad news or cry at something funny.

Many people report a worsening of their emotional symptoms during an MS attack.

You can have mood swings, no matter how severe your MS is. It may seem like they come out of nowhere and end just as quickly as they began.

The first step in taming your MS-related mood swings is speaking with a doctor. A family doctor, neurologist, or mental health specialist can give you tools to help you escape the emotional roller coaster.

• counseling sessions with a trained mental health expert
• mood stabilizing drugs
• anti-anxiety medications
• antidepressants

In some cases, you may want to consider trying counseling or therapy alongside or instead of medications.

In addition to therapy and medications, you can take several proactive steps to help control your moods. Getting support from others is key. For example:

• Delegate: If you’re overwhelmed by your daily routine, reduce your stress levels by delegating some tasks to other people. Free yourself from burdens to give yourself more time to relax and focus.
• Turn to a friend: Confide in a trusted family member or friend about your frustrations, fears, and other feelings. Talking to others can help release your pent-up emotions and stop them from boiling over in the form of a mood swing.
• Find additional support: Join an MS support group to talk about your thoughts and feelings with other people who are going through a similar experience. Your fellow group members and group leader may also share tips and resources to help you cope.
• Tell others about your mood swings before they happen: Sometimes worrying about what others think about you can cause enough stress to bring on a mood swing. Letting others know that it’s part of your MS may help ease your mind.

You can also try to increase your sense of calm and peacefulness to reduce your mood swings. For example:

• Practice yoga or mindful meditation: The calming effects of these activities can help you unwind and focus.
• Practice deep breathing: Deep breathing can help calm you down and give you an extra moment to take back control when you find yourself in a stressful situation.
• Think your feelings through: If you pause and examine your feelings objectively, you may be able to reclaim control and realize what’s triggering your emotions.

Finally, staying mentally and physically active may help regulate your mood swings. Physical exercise has been shown to have a positive effect on mental well-being.

Besides being good for your body, the time you spend engaged in exercise is a great opportunity for personal reflection.

While mood swings are common in people with MS, you shouldn’t ignore them. Reach out to a primary care doctor or neurologist and let them know that you’re experiencing anxiety, depression, sadness, inappropriate bursts of laughter, or other emotional challenges.

They can refer you to a mental health specialist who can help you manage the emotional mood swings that often accompany MS.

Therapists and counselors are trained to help you understand what flips your emotional “switch.” They can also offer tips and tools to help you take emotional control.

If your relatives are affected by your mood swings, family counseling may also be beneficial.

If a doctor thinks medications may help, you can weigh the risks and benefits of different options together to find one that’s right for you.

With all of the help available to treat the emotional symptoms of MS, there’s no need to struggle with mood swings alone. The right combination of medication, counseling, social support, and healthy lifestyle habits can help you feel like yourself again.

Last medically reviewed on April 3, 2023

How we reviewed this article:

Austra Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Emotional-Changes
• Emotional changes. (n.d.).
• nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Exercise
• Exercise. (n.d.).
• nationalmssociety.org/Living-Well-With-MS/Emotional-Well-Being/Mood-Changes
• Mood changes. (n.d.).
• ninds.nih.gov/health-information/disorders/multiple-sclerosis
• Multiple sclerosis. (2023).
• stroke.org/en/about-stroke/effects-of-stroke/emotional-effects-of-stroke/pseudobulbar-affect
• Pseudobulbar affect (PBA). (2018).

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