Cognition and emotional changes

Some of the most common but hidden symptoms of MS are the changes people may experience related to cognition and their emotions. These changes can affect the way people feel about themselves and alter their cognitive functions. For many, the emotional and cognitive effects of the disease represent its greatest challenges.

Emotional changes

There are a number of emotional responses that appear to be common as people learn to deal with having MS. Uncertainty, stress and anxiety are the most common, not just during diagnosis, but throughout the course of this unpredictable disease.

A person with MS may grieve for their life before MS and their self-image may take a while to renew to incorporate having MS. Other emotional changes that may occur in MS include clinical depression,bipolar disorder and mood swings. All of these are more common among people with MS than in the general population. Depression and bipolar disorder require professional attention and the use of effective treatments.

Emotional liability appears to be more common, and possibly more severe,in people with MS and includes frequent changes in mood from happy to sad to angry, for example. It is believed that the causes are both the extra stress brought on by MS as well as neurological changes at work.Uncontrollable laughing and crying is a disorder affecting a small proportion of people with MS, and is thought to be caused by MS-related changes in the brain.

Cognitive changes

Cognition refers to the“higher” brain functions such as memory and reasoning. About half of all people with MS will not experience any cognitive changes, but for others, the most commonly affected aspects of cognition are:

• Memory
• Attention and concentration
• Word-finding
• Speed of information processing
• Abstract reasoning and problem solving
• Visual spatial abilities
• Executive functions

Because MS can affect any part of the brain, almost any cognitive function can be impaired, and symptoms can range from having a mild impact on only one or two aspects through to more pervasive changes,which affect a person's daily life.

Cognitive changes can have a significant impact on a person's ability to work and fulfill family responsibilities. Family members may not realise that MS can cause cognitive problems and this misunderstanding can result in anger and confusion.

MS is a complex disease with many psychological ramifications. Adjusting successfully to MS requires understanding and addressing these changes along with the physical ones. There are many resources available for education, evaluation and treatment. By using these resources to the fullest, a person with MS and their family can continue to live their day to day life.

Find out more in MS in focus - cognition and emotions in MS