When actor Christina Applegate recently told her followers on Instagram that her legs were “busted” because stress makes her multiple sclerosis (MS) worse, many people with the condition immediately recognised the feeling.

Her comment summed up something researchers have been studying for decades and people with MS have been describing for even longer: stress, even from everyday situations, can trigger symptoms or make existing ones flare.

An estimated 2.8 million people live with MS around the world. The condition affects more women than men and is usually diagnosed between the ages of 20 and 40.

MS affects the brain and spinal cord, disrupting how signals travel through the nervous system. This can lead to extreme tiredness, mobility problems and difficulties with memory or concentration. People with MS often experience relapses, which are periods when symptoms suddenly worsen. These relapses can increase disability over time and make everyday activities more challenging.

A relapse occurs when new symptoms appear or existing symptoms become worse for more than 24 hours, after at least 30 days of stability, and without being caused by fever or infection.

Relapses can present in many different ways. Some people develop vision problems such as blurred or double vision, or pain when moving the eyes, which is known as optic neuritis. Others experience muscle weakness or stiffness in their arms or legs, which can make walking and balance more difficult. Many people notice numbness or tingling in the face, limbs or trunk. Severe fatigue that feels very different from normal tiredness is also common.

Coordination problems may also appear, leading to unsteadiness, tremors or dizziness. Speech may become slurred, swallowing may become more difficult and bladder or bowel habits can change. Some people also experience cognitive changes such as trouble concentrating, slower thinking or lapses in memory. These symptoms can occur alone or in combination and can have a significant impact on day-to-day life.

Research has shown that stress can make MS worse. In 2003, Dutch researchers found that stressful events can double the risk of a relapse within four weeks. Infections can triple the risk. When both stress and infection occur together, the risk may increase up to six times. In practical terms, this means that a major stressful event can significantly raise the chance of a relapse in the following month.

A year later, American researchers reviewed 14 studies and found a strong connection between stress and MS flare-ups. These flare-ups are important because they often lead to long-term increases in disability, meaning that avoiding relapses is crucial for maintaining independence and quality of life.

More recent research continues to show a clear link between stress and relapses. However, it remains unclear whether stress increases the likelihood of developing MS in the first place. A 2022 study found that stress in childhood or adulthood does not appear to change the risk of developing MS.

Fear and worry can lower quality of life

Many people with MS worry about when the next relapse will happen. This fear is known as Fear of Relapse. It goes beyond ordinary concern. It can disrupt daily routines, relationships and a person’s overall sense of well-being. Persistent fear often leads to health anxiety, which increases stress levels.

Stress has physical consequences too. People who believe their memory or thinking skills are declining often feel more anxious and stressed. Over time, this can contribute to depression, and poor sleep can make depression worse.

Depression and stress can reinforce each other. They lower quality of life and may even increase the risk of a relapse. Emotional health and physical health are deeply connected in MS. Managing stress, improving sleep and addressing anxiety are not simply about feeling better. These steps can help protect against flare-ups and support long-term independence.

Practical approaches that can help

Gratitude involves taking time to notice and appreciate the good things in life. Research shows that people who practice gratitude feel happier, less stressed and more satisfied with their lives. A simple habit such as writing down a few things you are thankful for each day can lift mood and build resilience.

Mindfulness involves paying attention to the present moment without judgement. Mindfulness practices have been shown to reduce stress and depression. They can also improve fatigue levels, which is particularly important for people with MS. For many, mindfulness helps ease daily pressures and may reduce the cycle of anxiety that contributes to relapses.

Read more: How mindfulness therapy could help those left behind by depression treatment

Although practices such as mindfulness and gratitude are not cures, they can make daily life easier, enhance emotional wellbeing and help people with MS feel more in control of their health.

Applegate’s comment about her legs being “busted” after a stressful moment reflects this reality in a powerful, relatable way. Stress is not a minor inconvenience for people with MS. It can alter how their body functions from one day to the next. Recognising this truth and giving people the tools and support they need to manage stress is an important step in helping everyone with MS protect their health and maintain independence.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Alexandra Palombi, Royal Holloway, University of London

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Alexandra Palombi does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.