Ask the Expert: Anxiety

Featuring Barry A. Hendin, MD

MSAA’s Chief Medical Officer

Headshot of doctor Barry Hendin, chief medical officer for MSAA

Barry Hendin, MD

Question: What are the symptoms of anxiety, and how does anxiety differ from depression?

Answer: It is common for people with and without MS to experience anxiety from time to time. Anxiety can be helpful in fact, alerting us to dangers around us or focusing our attention on stressors. Anxiety, however, can become more problematic when it’s severe, pervasive, and persistent. Then it becomes a disorder: generalized anxiety disorder. At that point, it distracts from our quality of life.

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Ask the Expert: Balance Problems

Featuring Barry A. Hendin, MD

MSAA’s Chief Medical Officer

Headshot of doctor Barry Hendin, chief medical officer for MSAA
Barry Hendin, MD

Question: In what ways are exercise, environment, and equipment involved with balance for individuals with MS?

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Ask the Expert: Heat Sensitivity

Featuring Barry A. Hendin, MD 

MSAA’s Chief Medical Officer 

Headshot of doctor Barry Hendin, chief medical officer for MSAA
Barry Hendin, MD

Question: What are the symptoms of heat sensitivity in MS, and how is it best treated?

Answer: Heat sensitivity, also known as Uhthoff’s Phenomenon, describes an increase in MS symptomatology caused by overheating. This could be due to external influences, when a person with multiple sclerosis is in an excessively hot environment. Alternatively, this can relate to an internal increase in body temperature due to exercise or infection with fever. Sometimes, of course, it’s a combination of the two when people are exercising in an overheated environment.

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Ask the Expert: Dizziness and Vertigo

Featuring Barry A. Hendin, MD 

MSAA’s Chief Medical Officer 

Headshot of doctor Barry Hendin, chief medical officer for MSAA
Barry Hendin, MD

Question: For people with multiple sclerosis, what can be the causes of dizziness and vertigo?

Answer: Dizziness and vertigo are common in the general population and even more common in people with MS. More than half of people with MS will experience dizziness or vertigo at some point.

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Ask the Expert: Tremor

Featuring Barry A. Hendin, MD 

MSAA’s Chief Medical Officer 

Headshot of doctor Barry Hendin, chief medical officer for MSAA
Barry Hendin, MD

Question: How do tremors with MS differ and what types of treatments help?

Answer: Tremor or shaking is relatively common in multiple sclerosis, affecting as many as one quarter to one half of people living with MS. Tremors may range from a mild nuisance, to moderate or severe, and affect activities of daily living.

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Ask the Expert: Weakness

Featuring Barry A. Hendin, MD 

MSAA’s Chief Medical Officer 

Headshot of doctor Barry Hendin, chief medical officer for MSAA
Barry Hendin, MD

Question: How is weakness in MS best treated?

Answer: Weakness in multiple sclerosis can be divided into “primary weakness,” due to injuries from lesions of the spinal cord and brain; or “secondary weakness,” which comes from issues such as inactivity, fatigue, pain, or medications used to treat multiple sclerosis and its symptoms.

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Ask the Expert: Sleep Issues

Featuring Barry A. Hendin, MD 

MSAA’s Chief Medical Officer 

Headshot of doctor Barry Hendin, chief medical officer for MSAA
Barry Hendin, MD

Question: What types of problems most often interfere with sleep for individuals with MS?

Answer: High quality sleep is generally recognized as an important health benefit for everyone, and this is especially true for people with MS. Poor quality sleep can increase MS symptoms such as fatigue, pain, daytime sleepiness, anxiety, and depression, as well as difficulties with memory and concentration. Unfortunately, more than half of those with MS have some kind of a sleep disorder or sleep dysfunction, which is a higher proportion than for those in the general population.

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Ask the Expert – Fatigue

Featuring Barry A. Hendin, MD 

MSAA’s Chief Medical Officer  

Headshot of doctor Barry Hendin, chief medical officer for MSAA
Barry Hendin, MD

Question: What symptom affects up to 80% of people with MS and can worsen as the day goes on?

Answer: Fatigue.

Question: What are your recommendations for people with MS who are experiencing fatigue?

Answer: Fatigue is the most common symptom of multiple sclerosis. Although fatigue occurs in the general population, it’s more common and often more problematic in people with multiple sclerosis. The first approach should be to investigate the cause of fatigue with your clinician or neurologist. When MS is the only cause for the fatigue, it is labeled primary fatigue.

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Ask the Expert – Spasticity

Featuring Barry A. Hendin, MD 

MSAA’s Chief Medical Officer  

Headshot of doctor Barry Hendin, chief medical officer for MSAA
Barry Hendin, MD

Question: Does spasticity in MS ever improve on its own and what are the best treatments for this symptom? 

Answer: First, it may help to define spasticity in simple terms. Spasticity is an increase in muscle tone due to an imbalance between excitatory and inhibitory influences on nerve flow along the motor pathways of the brain and spinal cord. Symptoms can vary from mild discomfort to severe pain and disability. Activities of daily living, quality of life, upper extremity function, and gait, can all be affected. 

As with all MS symptomatology, spasticity can vary in intensity. It can improve or worsen, depending upon MS relapses, progression, or outside influences – including events, such as urinary tract infections. Fortunately, many interventions can help to reduce spasticity and improve comfort and function. 

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Ask the Expert – Anxiety

Featuring Barry A. Hendin, MD 

Headshot of doctor Barry Hendin, chief medical officer for MSAA
Barry 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. 

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