Featuring Barry A. Hendin, MD
Question: Is anxiety a common symptom of MS, and if so, what are the signs and symptoms?
Answer: Anxiety is, indeed, a common symptom of MS. It is estimated to occur in almost half of the MS population, at some point. It often coexists with depression but can occur independently of depression. Unfortunately, anxiety is under-recognized and undertreated due to the clinical emphasis on depression alone.
Of course, anxiety is common at diagnosis when the future can seem so uncertain; but for many people, that anxiety continues for years. People define anxiety in various ways. For some, it seems like dread, uneasiness, or heightened tension. For others, there are increased phobias (including social phobias), obsessive-compulsive behavior, and panic attacks.
The causes of anxiety in multiple sclerosis are psychophysiological, which refers to both mental and bodily processes. The effects can be psychological as well as biological and include altered sleep, increased fatigue, poor memory and attention span, and social withdrawal.
As with depression, anxiety is treatable. The best approach to the treatment of anxiety is often a combination of psychological support – including cognitive behavioral therapy – and psychiatric treatment, including medications such as Cymbalta® (duloxetine hydrochloride), Effexor® (venlafaxine), and Lexapro® (escitalopram). Short-acting medications such as Valium® (diazepam) or Ativan® (lorazepam) can be employed on an “as needed” basis but can lose effectiveness over time when taken regularly. A wellness and self-directed approach should include exercise, healthy eating, and continued socialization. Meditation and yoga may also be useful for some individuals.
If you are experiencing significant anxiety that interferes with your quality of life, please be sure to tell your clinician. There’s much that can be done to help with this challenging symptom.
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Barry A. Hendin, MD, is a neurologist and director of the Arizona Integrated Neurology MS Center. He is also the director of the Multiple Sclerosis Clinic at Banner University Medical Center and a clinical professor of neurology at the University of Arizona Medical School.