The causes of mood, emotional and behavioural changes in people with MS are not well understood, and a variety of factors can contribute to them.
These factors fall into two broad categories - those that are directly related to, and not directly related to, MS.
It’s often difficult to pin down a specific cause for a specific symptom, as it’s more likely that a combination of factors is involved. This page takes a brief look at some of the causes, see our booklet for more in depth information.
Factors directly related to MS
MS-related nerve damage
The brain controls both conscious and unconscious actions by sending messages to all parts of the body. Different parts of the brain control different things, and the frontal lobe is responsible for the control of emotions and their outward expression.
Regardless of your personality, nerve damage in this region of the brain can affect the way you feel or react, and can cause you to behave in a way that seems out of character.
Psychological reaction to MS
Being diagnosed with MS, coping with, and adapting to the changes and uncertainty it brings, can be very unsettling. It may lead to a whole array of emotions such as grief, anxiety, guilt, fear, irritation and anger.
There is no right or wrong way to react, and reactions to the condition will vary greatly from person to person. Your own reaction will be influenced by how MS affects you, the symptoms you are experiencing and how you usually cope with what life throws at you.
I relapsed and was hospitalised - to say I took it badly is an understatement. I now know that although diagnosis doesn’t mean the end of my life, it does mean a different sort of life.Tasha, living with highly active relapsing MS
Factors not directly related to MS
Individual personality differences
Certain emotional and behavioural characteristics may have always been part of an individual’s personality and may have been obvious before their MS. Also, some people, regardless of an MS diagnosis, are more susceptible to depression and other emotional changes.
It is worth remembering that depression is something that affects people without MS as well.
Some people with MS who are depressed may be experiencing depression for the same reasons that people without MS experience depression.
Social, financial and domestic circumstances can also influence emotional health. If this is the case, you may need to make some practical adjustments and seek additional help or support.
Side effects of drugs
Most drugs have potential side effects, and some drugs commonly used to treat MS and its related symptoms can cause temporary changes in mood or behaviour in some people. For example: steroids, used to treat relapses, can cause hyperactivity or depression – and, a steroid ‘high’ often becomes a ‘low’ when treatment ends.
Modafinil, used to treat fatigue, can cause anxiety or depression. Certain other drugs, such as Baclofen, used for spasticity, can cause unpleasant hallucinogenic symptoms, agitation or altered moods if treatment is stopped suddenly.
For this reason, when stopping medication some drugs need to be phased out over a few weeks.
Not everyone will experience these side effects, and many people successfully use these drugs to manage MS symptoms.
If you think you are experiencing side effects, consult your doctor who can reassess your medication.