Everyone experiences mood swings or “moodiness” from time to time. But some people experience rapid, uncontrollable changes of mood and behavior as one of the emotional symptoms of multiple sclerosis (MS). You may hear something negative and start laughing, begin crying when you actually feel happy, or notice that your emotional state can change on a dime. “I often feel like I don’t have a filter,” said one member of MyMSTeam. “I can’t predict from one day to the next how my moods will be.” Another member described their mood as “up and down like a yo-yo.”

Mood swings can also affect your behavior. Some people diagnosed with MS experience pseudobulbar affect, a condition in which a person bursts into tears or laughter without any situational or emotional trigger. Changes in mood can continue as symptoms change and as relapses or remissions occur.

These emotional reactions might seem to come out of nowhere and be out of proportion to the situation that triggered them. Emotional reactions may also feel out of control — like you can’t stop them or that your emotions are taking over your life. Understanding and addressing these common symptoms may help you feel better and improve your quality of life dramatically.

Effects of Mood Changes With MS

MS-related mood swings can be challenging, making relationships with family members and friends difficult. Sometimes, these new challenges can be overwhelming and discouraging, and you might feel as though your mood swings are out of your control.

Most people with multiple sclerosis don’t enjoy their mood swings, but they do learn how to live with them. Some accept that mood swings may come as part of their MS diagnosis and are reassured to know that they’re not being unreasonable.

Causes of Mood Changes With MS

“How are you supposed to control your mood swings when you can’t even figure out why they keep changing?” asked a MyMSTeam member. Multiple factors can cause or contribute to mood swings with multiple sclerosis. Learning more about these factors may help you and your loved ones find ways to better cope.

Changes in the Brain

In people with MS, the body’s defenders (white blood cells) attack the central nervous system, stripping nerves of their protective coating (myelin) and causing inflammation. This process, known as demyelination, can occur in locations in the brain that produce and manage emotions. When nerves in those regions are stripped of myelin and inflammation develops, you may experience changes in your mental health, including mood swings.

Grief

Receiving a diagnosis of multiple sclerosis can trigger many intense emotions, including sadness and feelings of loss as your everyday life begins to change. Together, these feelings can result in grief. As MS progresses, you may experience changes that cause further grieving. Grief can both cause emotional changes and intensify mood swings.

As one MyMSTeam member shared, “Even with having an upbeat and positive attitude, it’s hard grieving the loss of the old me.”

Stress

Being diagnosed with multiple sclerosis can add stress to your life and the lives of your loved ones and caregivers. As you modify your lifestyle to accommodate the physical symptoms of MS, such as leg weakness and muscle spasms, you also learn to manage medications, deal with the ways the condition changes over time, and handle difficult conversations with loved ones. All of this can be very stressful.

Some doctors believe that stress can aggravate the mood swings that come with MS. Managing that stress well may reduce mood swings and other MS symptoms. Learning stress management techniques may be helpful for some people. Many strategies can help reduce stress, but they don’t all work for everyone. You may need to try several approaches before you find the one that works for you.

Medications

Certain medications that are used to treat MS or manage its symptoms can cause mood swings and other behavioral changes. One member said, “I had horrible mood swings at first, but once I quit taking the gabapentin, they quickly disappeared!” Not all people experience the same side effects from the same medications, such as gabapentin (Neurontin). Additionally, some mood changes may be caused by a combination of drugs.

It’s important to work with your doctor to find out how your treatment may affect your mood. If you experience any emotional changes or notice more mood swings after starting a certain medication or combination, talk to your doctor right away to determine the cause.

Behavior Changes and Mood Swings

A rapidly changing mood sometimes leads to behavior changes such as:

• Crying or getting angry at times that seem inappropriate
• Withdrawing socially or becoming irritable with loved ones while trying to cope with mood swings
• Losing control over impulses (disinhibition)
• Cognitive changes, such as inability to concentrate or make decisions, due to difficulty handling overwhelming and rapidly changing emotions

It’s important to note that your behavioral changes related to mood swings may differ from those of other people with MS.

Ways To Manage Mood Swings Associated With MS

You can choose from a variety of strategies to help manage mood swings associated with multiple sclerosis.

Talk to a Therapist

If you believe that your mood swings are caused mostly by stress or grief, ask your doctor about finding a therapist. They may be able to recommend a practitioner who specializes in helping people diagnosed with chronic diseases such as MS. These practitioners may employ specific methods, such as cognitive behavioral therapy or talk therapy, to help you work through grief and find healthy ways to deal with stress. Meeting with a mental health care professional may also help improve your overall sense of well-being.

You may also choose to join a support group led by a psychotherapy expert. These groups allow you to meet people in similar situations and find support. If it’s helpful to you, therapy can become a useful component of your health care.

“Therapy can really help,” encouraged a MyMSTeam member. “You have to find a good therapist, someone that you really click with.”

Try Occupational Therapy

Occupational therapists can relieve some of the stress brought on by MS-related changes in your daily life. Occupational therapists can help make certain tasks more manageable so that you can still do them on your own. They may help you find ways to get more sleep, manage your energy throughout the day, increase your confidence, and improve your wellness.

Ask Your Doctor About Medications

Many medications can help regulate mood swings brought on by MS. One option, dextromethorphan/quinidine sulfate (Nuedexta), can help with episodes of uncontrollable laughing or crying.

Antidepressants may also be beneficial, even if you aren’t diagnosed with depression, because they can help your brain balance the chemicals needed for optimal regulation. Talk with your doctor about effective antidepressant options that have fewer side effects and won’t interact with your other medications. Your neurologist will be able to offer medical advice and help you try different treatments until you find what works for you.

If you’re experiencing mood swings associated with MS, talk to your doctor today. Your neurologist or another medical specialist can help you find the solution you need to stabilize your mood and feel better soon. Different people diagnosed with MS will find that different solutions work best for them, so don’t be afraid to try various options until you find the best choice for you.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 207,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you noticed mood and behavior changes since you’ve been living with MS? Share your experience in the comments below, or start a conversation by posting on your Activities page.