Some patients are not able to perform the activities of daily living (ADL) by themselves and are dependant on the care and support of their family members. Feelings of despondency and depression are common and it is important to be sensitive to the patient's mindset during this period. The acute psychological distress further dampens the motivation of the individual to actively participate at the social level and hence the patients manifest withdrawal symptoms. Some patients may have difficulty in adapting to the changes and may even refrain from using mobility gadgets (walking stick, wheelchair) which worsens the problem. [Chan A]
We see that mobility difficulty when combined with depression and cognitive impairment can seriously undermine the overall functioning of the individual. As Kay Toombs, a multiple sclerosis researcher and a patient says, "To live with multiple sclerosis is to experience a global sense of disorder -- a disorder which incorporates a changed relation with one's body, a transformation in the surrounding world, a threat to the self, and a change in one's relation to others" [Toombs, 1995, p. 12]. Learning to adapt and adjust to the new situation is a big problem for most of the patients and hence caregivers must provide psychological counseling sessions to help the patients adapt to change.
While drugs may help in alleviating symptoms their long-term effects are doubtful and not without serious side effects. In particular the use of corticosteroids in multiple sclerosis to contain the inflammatory response of the immune system has the effect of compromising the immune system leaving the person open for opportunistic infections. In a latest research release from the Mayo clinic Dr. Sean Pittock, M.D. says, "Our study demonstrates that the longer the duration of MS and the lower the disability, the more likely a patient is to remain stable and not progress to a greater level of disability," "This isn't a small issue; it's a big issue." [Mayo Clinic]. So physicians can consider delaying or even avoiding imunomodulatory drug treatment for patients with benign form of multiple sclerosis.
There has been a tremendous change in the treatment methods that are available for multiple sclerosis over the last few years. Favorable outcome for patients depends a lot on early diagnosis followed by appropriate medical intervention. Behavioral and psychological coping strategies are also important for delaying the onset of disability and containing the ill effects of the disease. Effective management of the disease would involve a combination of pharmacological, psychological, as well as experimental therapy based on clinical trials. Management of a chronic illness like multiple sclerosis can be a very challenging task however proper understanding, acceptance and a positive attitude would definitely go a long way in effective handling of the disease condition.
1) Family Caregiver Alliance, "Multiple Sclerosis," Accessed on 10th October 2004, http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=576
2) Stark, Sharon, "Cognitive Symptoms and Correlates of Physical Disability in Individuals with Multiple Sclerosis," Journal of Neuroscience Nursing, 12/1/2003
3) Chan A, Heck CS, "Mobility in Multiple Sclerosis: More than Just a Physical Problem," Int J. MSCare [serial online]. Mar 2000; 3:35 -- 40. Available at:
4) Toombs, S.K. (1995). Sufficient unto the day: A life with multiple sclerosis. In S.K. Toombs, D. Barnard & R. Carson (Eds.). Chronic illness: from experience to policy. Bloomington and Indianapolis: Indiana University Press.
5) Mayo Clinic, "Patients With Multiple Sclerosis May Want to Take Wait-and-See
Approach to Medications," Accessed on Oct 10th 2004,