The Stress Paradox

by Dean Kramer 
September, 2001


One thing we with MS are often told by our doctors is that we should try to avoid stress. In other words, one should accept having an incurable neurological disease that may or may not more or less cripple one completely (and who knows when?) And, while doing that, one should avoid feeling stress, right? One is told to go home to one's parents, partner, children with this horrible news, go back to work perhaps unable to divulge this horrible news, and (by the way) try to keep clear of stressful situations. Are you with me so far? One is offered incredibly expensive treatments that many cannot afford, which may or may not work (but there's nothing better out there.) And, meanwhile, try to keep a lid on stress, okay? Ummm, is it just me, or is there something just a hair of a tad impossible about this suggestion?

There's some evidence, and many of us experience, that MS symptoms worsen with stress. This is true for both physical and cognitive symptoms. The paradox is that when under stress a person with MS is more likely to need what there is less of, be it physical prowess or the ability to think. Here are two little illustrations from my own adventures·

One day, this spring I rode my scooter near to our raspberry patch to pick some berries. We have paths mowed on which I can ride, narrow lanes surrounded by brush too high for the scooter to pass. I was feeling spry that day so I dismounted and walked down the path to the patch. As I moved forward, picking, I stepped on a ground-hornets' nest. One of them stung me and others were coming out of the hole. I couldn't run at all. Running for me is totally no longer an option. I couldn't walk back to my scooter because the nest was between me and it. I couldn't force my way through the brush, either, it being too high and too thick. All I could do was stagger along the path away from my scooter hoping to circle back to it on another lane. And I laughed as I staggered because the mental stress of being pursued by hornets was causing my legs to function less and less well. Laughing added to the physical stress I experienced. The more I laughed the less well I staggered. The less well I staggered the more I laughed. Toddling along as quickly as I could I remembered the theory that bee stings alleviate MS symptoms which made me laugh even harder. It's possible that the sound of maniacal laughter and a slow pace (as opposed to fleetness of foot and shrieks of fear) confused the hornets enough that they quit following me. At any rate I was able to circle back to my scooter on another path and get home safely and relatively unharmed. The point is that I was in trouble, needed my legs, and yet could rely on them less than is usual for me precisely because I needed them.

On another occasion I'd finished shopping and returned to my car. My car has an automatic shift. The options on the column are P R N D D 1 and 2. I was parked head-in and started the engine. But then I was stumped! There I sat, trying to remember whether I needed D or D to back the car out of the space. I was sure that one "D" meant drive forward and the other meant drive backward, but for the life of me I couldn't think which was which. My brain had become stuck on the idea that I was going to "drive" the car, and therefore I needed a drive gear. I became increasingly frustrated at my inability to remember and, the more frustrated I became the less clearly I was able to think through the problem. I was aware enough of the potential for danger that I did not try to move the car until I'd figured out which gear-setting to use. Well, with MS cognitive problems the good news is that it isn't Alzheimer's disease. The bad news? One may forget that it isn't Alzheimer's disease. But, because it isn't Alzheimer's disease, one eventually remembers again. And in this case I eventually remembered again that I needed R for reverse rather than D or D for drive.

There are a few things I'm learning to do which have helped me with the MS stress paradox. One important lesson I've been teaching myself is that I don't have to be perfect nor do I have to be exactly as I was before MS. When I can remind myself of this I'm able to let go of the shame and the panic that often accompany an increase in impairment during times of stress. Releasing those useless feelings gives me a little more space to think a problem through. And that enables me to solve some physical or mental predicaments more efficiently. I've begun to allow myself to be slow. Sometimes I want to take whatever time it takes to solve a problem for myself (as long as there's no danger) and, instead of asking for help or berating myself for being stupid or weak, I work my way through it at my own, cognitively impaired pace, and come up with a solution that takes MS into account. Conversely, I'm also giving myself permission to need help from others. Now, if someone is present to help, instead of telling myself I'm smart enough or strong enough to work my way out of any situation, I might ask for assistance.

I work outdoors a lot here on Cripple Creek. Last week I got my tractor stuck on a hillside while mowing tall brush in a very tight area. This was a stressful situation for both the tractor and myself. Prior to MS, I'd have quickly figured out how to free the tractor from its predicament. Now I had no clue. But I did not panic or feel ashamed of myself. Instead, I sat there calmly running the engine until I'd burned up the transmission belt. Then, I got off the tractor and began to work out a solution to the problem which took my MS into account. I had time. There was no danger. The tractor wasn't going anywhere soon. I decided that if I could lift the mower deck and free the half-mowed thorn bushes lodged beneath it I might get the tractor back to the barn. I could have done this with one hand before MS. With MS, I reasoned, it was going to take both my arm and back muscles. Thus, I wrenched both my arm and back muscles lifting the mower deck. With the my other hand I pulled at the thorny branches. I had no work gloves because, in my cognitive impairment, I'd forgotten to wear them and, given my physical impairment, I wasn't going to waste energy walking back to the house to get them. Thus, bloody handed and sore of arm and back, I finally managed to get the tractor back to the barn where, using another of my new-found skills, asking for help, I called the repair service to come and fix it.

Yes, readers, the MS stress paradox can be handled using simple skills which anyone can learn. Only, apparently, one hasn't yet. Maybe by next time.