Intriguing new findings from an EvergreenHealth study

Stress is a part of life. Unchecked, stress can have significant effects on a person’s health, accelerate the aging process and even shorten life.

The role of stress in multiple sclerosis (MS) has been under scrutiny for decades.

Early studies indicated that acute stress, such as a car crash or having surgery, did not increase the risk of MS relapse, although it may aggravate symptoms.

However, several recent studies have suggested a connection between chronic stress (psychological distress over long periods of time) and more active MS, by experiencing a greater frequency of relapses or greater number of new brain lesions seen on MRI.

The MS Center at EvergreenHealth was part of a study that found taming stress through a structured stress management coaching process reduced MS activity on MRI.


About the study

The MS Center at EvergreenHealth was one of three centers collaborating in the study, which was funded by the National Institutes of Health.

One hundred twenty one patients who were experiencing MS relapses or new lesion activity on brain MRI  were randomized to receive stress management therapy or be in a control group.

Those receiving the therapy received 16 sessions over a 24-week period through structured 1:1 sessions with a trained psychologist.

They were taught how to recognize stressors in their lives, how to prevent stressful events from occurring and to improve their capacity to manage their responses to stressful events that do arise. Relaxation techniques included meditation and mental imagery.

The control group waited to the end of the study and then attended a stress management workshop.

All subjects underwent seven MRIs over the course of one year.

The key outcome measure of the study was the rate of development of new brain lesions measured with each MRI.


The results of the study

The results showed that the stress management therapy group had fewer new brain lesions using two measurements.

The first type, gadolinium-enhancing brain lesions, indicate a breakdown of the blood-brain barrier, allowing the immune system access to attack and damage brain cells.

The second type, a T2 brain lesion, is a more global marker of disease burden and is a more permanent lesion.

Among patients who received stress management therapy, 55 percent had a new gadolinium-enhancing brain lesion during the treatment period, compared to 77 percent of those in the control group.

The T2 brain lesion findings showed a similar difference favoring the stress management therapy. The stress reduction prevented new lesions whether or not the patients were taking MS disease-modifying medications (e.g., beta-interferon or glatiramer acetate).

However, after the stress-management therapy stopped, the rate of developing new brain lesions was no different between the two groups.

The implication may be that to have lasting impact, stress management should be incorporated as a part of a healthy lifestyle, not just a short course.

At the MS Center at EvergreenHealth, we place a lot of value in relieving stress for our patients. Our team of physicians, nurse, social worker, psychologists and rehabilitation staff can provide counseling and education to help people deal with stress.


A note from our social worker…

There are a number of resources for stress management offered by the MS Center at EvergreenHealth and other agencies in the community.  

Therapeutic Yoga classes help with strengthening, balance, body awareness, and improved mood and energy.

EvergreenHealth offers Therapeutic Yoga for Multiple Sclerosis videos, which provide the wonderful benefits of yoga from the comfort of your home.  

Other classes, including some designed specifically for people with physical limitations, can be found at various gyms and yoga studios in the community.   

Meditation and exercise are also very helpful tools for stress management. There are many books, CD’s and on-line videos that can help you get started with meditation. Here are just a couple that I like:

  • Jon Kabat-Zinn: Full Catastrophe Living (book on meditation) and meditation CD’s
  • iTunes: Mindfulness Meditation application

Exercise is also very beneficial in helping to decrease stress. If you’re looking to incorporate exercise into your life, it’s helpful to try to establish a regular routine, and to start with realistic goals and work your way up to an optimum level of exercise.

The National MS Society offers a Wellness Grant which can help to pay for gym membership or exercise classes. To inquire about this grant, call NMSS at 800.344.4867.

Good social support is another important tool for managing stress.

It’s important to have at least one person you can talk to you about the challenges in your life, and MS classes and support groups are a great way to get this support.

Check out the classes, workshops and support groups offered at EvergreenHealth

The National MS Society offers many other peer led support groups throughout the region. For information about these groups you can call 800.344.4867.