Recovering alcoholics are unstable

Multiple sclerosis and psyche

If you fare like most people, you will experience the onset of multiple sclerosis as a major turning point in your life. You may even feel completely thrown off the beaten track and simply do not know what to do next.

MS is usually diagnosed at a young age - at a time when independent life has only just begun. The special features of the disease are the diverse symptoms, the unpredictability and the uncertainty of the course.

So what to do How will it go on? Can I continue to live as before? Can my life still be planned?

The current stage of development of a family - the “when in life” - plays a crucial role in coping with the diagnosis and in dealing with the disease. Everyone goes through a certain cycle in the family framework (childhood, youth, partner search, starting a family, etc.). The disease often begins in young adulthood. At this point in time, the “moving closer together” due to the diagnosis can lead to difficulties in separating from the parental home. Or there is already a young couple relationship. It shows itself to be particularly endangered during this time. In order for such a young relationship to continue, it is important whether it is possible to develop joint future prospects.

If the disease only occurs at a later point in life and many goals in life have already been achieved (e.g. education, career, starting a family, raising children), this makes it easier to reorientate yourself and to cope with the rest of your life the disease.

Adaptation and coping

Disease coping phases

Adaptation: A recurring process

Life is change

Resilience - the immune system of the psyche

Coping

life quality

Factors influencing quality of life

Rituals

Psychological challenges

Stress and excessive demands

Grief and depression

Fears and worries

Irritability, anger, and aggressiveness

Obsession

Family and partnership

Accompaniment instead of paternalism

Develop family resilience

Strategies for relatives

Adjustment and reorientation as a couple

Children and young people as relatives

psychotherapy

Practical tips for those affected and their families

The medical interview

Uncertain, unpredictable - but surmountable

The fact that the disease shows up and progresses differently in each person also harbors hope. Because this also allows you to find many ways to live with the disease.

We present coping strategies that enable you to recognize and use resources, both as sufferers and as relatives - for a high quality of life, for a good future.

Adaptation and coping

“I don't even know how I feel about the diagnosis.
I feel like I don't know my way around at all.
What does it mean to have this disease? There's so much in my head
I don't know how to structure my thoughts.
I also don't know if I have a head for something ”.

People with multiple sclerosis go through different stages of coping with the disease. The coping process is influenced, on the one hand, by the disease itself - for example in which way the MS makes itself noticeable, whether suddenly or insidiously, at what speed the disease progresses, whether a disability occurs or not - but also by how those affected react to it - and that is very different from person to person. In most cases, people who are close to each other first move closer together in a crisis situation.

Just as diverse and changing as the disease shows, just as diverse and changing are the feelings that make themselves felt: fear and hope, resignation and confidence, despair and optimism. Dealing with these feelings will sooner or later become inevitable, both for the sick people themselves and for those close to them.

Sick body, sick soul?

Due to the uncertainty and unpredictability of multiple sclerosis, the positive coping and acceptance of the disease can repeatedly be broken by disappointment, despair or anger. But there are also phases that can evoke hope, confidence and optimism.

Dealing with the disease means much more than coming to terms with physical changes, losses and disabilities. It also means dealing with one's self-image and one's social identity.

In the best case, a phase of acceptance of the disease occurs so that everyday life can come back to the fore. Life is lived with multiple sclerosis, but not with multiple sclerosis.

Disease coping phases

The initial diagnosis often comes with a shock that can trigger a strong emotional shock. To protect one's own psychological stability, the diagnosis is often followed by a phase of repression and denial of the disease. There can be phases of anger about the illness as well as fears and grief processes.1

Some people with MS feel they are to blame for the unhappiness in their partnership or family. You may be confronted with many experiences of loss, for example the loss of self-control and identity or important matters in life.2 The disease can also be accompanied by a loss of contact with people who were previously important and who were because of the disease
withdraw.

In some cases, the fear of the future can become so great that depressive episodes accompany life. It is particularly important to get help here.

After these emotional consequences of fear, anger and sadness, phases of coping and adjustment to the new life situation and a reorientation set in. These phases can be a shorter or longer process. The duration of the respective phase depends on the life experiences of those affected and which coping strategies have been developed. Which resources are available, how the multiple
Sclerosis progresses individually and how well people with MS feel medically cared for also has an impact on the duration of the processing process.

Profound changes can take place within the family, which relate primarily to usual activities and the position of the individual within the family. The social status of those affected and of the family can also change.

Adaptation - a recurring process

“I don't even know how I feel about the diagnosis.
I feel like I don't know my way around at all.
What does it mean to have this disease? So much in my head
I don't know how to structure my thoughts.
I also don't know if I have a head for something ”.

If, after the diagnosis, it is possible to adjust to the disease, to deal with the feelings associated with it and to live well with it, the next flare-up can lead to uncertainty again and require a new discussion. This recurring confrontation with the illness in the physical, psychological and social areas is a very special challenge and characteristic of multiple sclerosis.

It is therefore worthwhile to find out what can be used to improve the quality of life.

Life is change

Self-evident changes in the life cycle such as the birth of a child, weddings or critical events such as separations or the diagnosis of a chronic illness require the ability to adapt to the respective new life situation - with a critical event requiring significantly more adjustment effort.

It can be difficult to find the right coping strategies and apply them in everyday life. If this does not succeed, this event can trigger a psychological crisis.

Early warning signs of mental crises

Everyone reacts differently to a critical life event, so there are also different coping strategies. In the past, individually proven strategies very often no longer work when a chronic disease occurs. Then these proven strategies have to be adapted or new ways of reacting have to be developed.

Resilience - the immune system of the psyche

"Resilience is the ability to survive and grow in the face of stressful life challenges, i.e. to discover and use new sources of strength".3

In psychology, that dynamic process is called “resilience”, which enables a person to adapt positively in the context of significant adversity. People who have practiced resilience learn coping strategies and can thus improve their quality of life.

Resilient people are not so easily discouraged by the challenges that can come with multiple sclerosis, they react more calmly and learn to define boundaries more easily. In addition, resilience enables people with multiple sclerosis to find their inner balance in challenging situations and to develop psychological resilience.

In an investigation4 it could be shown that existing resilience had a positive effect on the self-efficacy, optimism and social support of people with MS.

Promote resilience

The good news is: Resilience consists of several factors and can be practiced and promoted at any time.

This is how you strengthen your resilience5

  • Accept the crisis and the feelings that go with it!
  • Actively look for solutions and support!
  • Strive for an optimistic and proactive attitude!
  • Avoid self-accusations!
  • Try to maintain warm and stable relationships!
  • Look for social support outside of the family too!
  • Take on dosed social responsibilities!
  • Stay flexible and trust yourself to do something!
  • Make your own decisions!
  • Accept your illness!

Acceptance is by no means about liking the disease - it can certainly be perceived as frightening. Rather, it is about accepting that a disease or disability is present.

Live with the fact that you are sick - and don't fight it!
And don't forget one thing: MS is only part of your life.
Don't let the disease rule your life!

Self-efficacy as a key factor in resilience

Self-efficacy in the course of the disease is understood as the ability to make your own decisions and to initiate changes in familiar lifestyle habits. A person is also self-effective when he consciously maintains familiar habits such as rituals or celebrations.

The ability to set limits also falls under self-efficacy. Sometimes it seems as if the course of the disease is in control of the individual or family. Anyone who is then able to seek help without losing their own autonomy acts just as self-effectively.6

Self-efficacy is promoted when people experience that they can exert influence: influence on the choice of therapy, influence on maintaining or changing familiar lifestyle habits, influence on the level of support that is accepted.

Coping

"How does it even work - positive coping with illness?
My neurologist thinks psychotherapy could help.
But how do I manage to cope with MS?
Do I have to deal a lot with this disease?
Maybe it is better not to do too much research about MS. "

Coping - coping with a difficult life situation in a positive way

The term “coping” has established itself in psychology. This is understood to mean individually developed strategies in a critical, overwhelming and stressful situation in which people cannot fall back on individual adjustment options. Above all, this involves trying to cope with the demands that a stressful situation brings with it. When it comes to a chronic illness, the aim is to find a constructive way of dealing with the illness.

Chronic illnesses confront those affected with specific psychological demands. People react very differently to these requirements in order to “solve the problem, so to speak” - for example through frequent visits to doctors. Others rely more on self-reassurance by dampening stress-related, emotional reactions, for example through denial or optimistic comparisons. Some people rely on attempts at self-regulation, in which their own feelings and emotions are controlled in order to be able to process and influence them.7

Positive versus negative coping with illness

Mourning processes about the various losses that go along with multiple sclerosis are of great importance for positive coping with illness. So that the new situation can be well accepted, those affected should be fully informed about the disease and have realistic expectations for the future. Here it is particularly important to express the associated feelings and share them with other people.

Physical limitations can change roles within the family, the effects of the illness on the partnership and the parent-child relationship become noticeable. In this role-finding process, the needs of each family member should be considered. A positive way of coping with illness also includes accepting a possibly changed role in professional life.

Basically, the challenges of MS should be adequately dealt with and adjusted and there should be openness to continuous professional support.

Coping with the illness usually develops negatively when there is no grieving process about experiences of loss caused by the illness and associated feelings cannot be expressed and processed. If the illness is not talked about and if it is denied over a longer period of time, or if it becomes the focus of all negative events and feelings, an emotional downward spiral develops that prevents a positive processing of the illness.