Extended stress may temporarily exacerbate existing symptoms.
“Living with multiple sclerosis is about playing the long game,” says Dubai-based Marie Meillaud. While the diagnosis initially struck like a “tsunami,” she, like many others with the condition, embraces a “moving forward” approach rather than an adversarial mindset.
Despite the challenges posed by multiple sclerosis, Meillaud, a member of the National Multiple Sclerosis Society, UAE, focuses on maintaining a sense of normalcy in her life. “I want to live as normally as possible. I have a demanding operations role where I lead a team, maintain an active social life, and raise 10-year-old twins like any typical family. I constantly set new personal goals for myself,” she explains.
MS affects each individual differently, making it essential for patients and caregivers to understand the condition, its causes, symptoms, and various forms.
Understanding multiple sclerosis
Dr. Rajit Pillai, Specialist Neurology at Aster Clinic, explains MS as a chronic neurological condition in which the immune system attacks the protective covering of nerve fibres in the central nervous system. This disrupts communication between the brain and the body, producing a wide range of symptoms.
Essentially, myelin—the protective sheath insulating nerve fibres—functions like electrical insulation, ensuring efficient transmission of nerve signals. The immune system’s attack on myelin is believed to result from a process called molecular mimicry. Researchers suggest that prior exposure to a foreign agent, such as a virus, may prime the immune system against a protein structure resembling human myelin. Consequently, T cells may mistakenly target myelin, causing the immune system to attack healthy nerve tissue.
When myelin is damaged, nerve signals can be slowed or misdirected, leading to symptoms that vary widely between individuals. These may include fatigue, vision changes, numbness, balance difficulties, and muscle weakness. Symptoms can be intermittent or progressively worsen over time, making daily life unpredictable.
Multiple sclerosis can present in several forms:
- Relapsing-remitting MS (RRMS): Flare-ups followed by periods of recovery, which can eventually evolve into secondary progressive MS (SPMS)
- Primary progressive MS (PPMS): Symptoms steadily worsen from onset
- Clinically isolated syndrome (CIS): A first episode that may or may not develop into MS
Current therapies aim to manage symptoms, reduce relapses, and slow disease progression, helping patients maintain daily routines with confidence.
Stress does not cause MS and is not a direct driver of disease progression. However, it can influence symptom fluctuation, with prolonged stress sometimes temporarily worsening existing symptoms such as fatigue.
Ruqqia Mir, Consultant Neurologist at Yas Clinic, provides insights into managing MS amid stress, highlighting the importance of symptom monitoring and supportive care.
Stress and MS: Why it matters
For people living with multiple sclerosis, stress can significantly disrupt daily life. Dr. Ruqqia Mir, Consultant Neurologist at Yas Clinic and member of the National MS Society’s Medical Advisory Committee, explains that stress activates the body’s fight-or-flight response, releasing cortisol. This response increases heart rate, raises blood pressure, causes muscle tension, and heightens alertness.
Dr. Mir emphasises: “Stress does not cause MS and is not a direct driver of disease progression. However, it plays a significant role in symptom fluctuation.” Prolonged stress can temporarily worsen existing symptoms such as fatigue, brain fog, or mobility issues. While these effects may feel severe, they are generally not linked to new neurological damage—stress acts as an amplifier rather than a trigger of new disease activity.
People with MS are particularly sensitive to stress because their central nervous system is already affected by inflammation and damage. “It can intensify existing symptoms, which in turn increases anxiety and creates a cycle of worsening symptoms and emotional distress,” Dr. Mir adds.
Breaking this cycle is crucial for maintaining stability and managing daily life effectively.
Signs of stress-induced symptom worsening
Dr. Ruqqia Mir explains how to differentiate temporary flare-ups from true disease progression. “Pseudo-flare-ups are short-lived episodes where existing MS symptoms worsen due to external triggers such as stress, heat, infection, or lack of sleep. These usually last less than 24 hours and improve with rest, hydration, or cooling. They are not caused by new disease activity but by external stressors affecting the body,” she says.
A true relapse, by contrast, reflects new neurological inflammation. It involves new symptoms—such as vision loss or new weakness—and typically lasts longer than 24–48 hours, often gradually worsening over time.
Common triggers include:
- Emotional stress: anxiety, uncertainty, family pressures
- Physical stress: lack of sleep, overexertion, dehydration, illness
- Environmental stress: heat, prolonged exposure to negative news
- Additional triggers: infections (fever, urinary infections) or poorly controlled conditions such as diabetes
Practical strategies for managing stress
Dr. Mir offers actionable, day-to-day strategies to help people living with MS reduce stress and minimise symptom flare-ups.
- Manage information intake: Limit exposure to distressing news to reduce anxiety and emotional overload.
- Practice breathing techniques: Methods like the 4-7-8 technique help regulate the nervous system and calm stress responses.
- Prioritise and pace tasks: Break activities into smaller steps, take regular breaks, and avoid overexertion to manage energy effectively.
- Engage in gentle physical activity: Stretching or short walks support circulation, mobility, and mental well-being.
- Maintain good sleep habits: Keep a consistent bedtime routine, reduce screen time before sleep, and create a comfortable environment to aid recovery and immune regulation.
- Follow a healthy diet: Adopt a balanced approach, such as the Mediterranean diet, and discuss supplements like vitamins C and D with a healthcare professional.
Living with MS can be unpredictable, but understanding the condition and the role stress plays in symptom fluctuations empowers patients to take control of their health. With medical guidance, community support, and practical coping strategies, people with MS in the UAE can navigate stressful periods while continuing to lead active, fulfilling lives.
