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The Benefits of Psychotherapy for People with MS

By Erica Patino
Reviewed by Susan Ko, Ph.D. , Jeff Wilken, Ph.D.
April 12, 2024

Everyday life can be full of stress, whether from work, home, world affairs, or any number of other factors. For people with multiple sclerosis (MS), add to that difficult symptoms and complications that can affect emotional health, plus the unpredictability of the disease and its relapses. While it may feel like a never-ending perfect storm of stress, you may be surprised at how much relief you can find when you know where to look. Psychotherapy is a tool that may help you feel better equipped to handle whatever MS—and the rest of life—throws your way.

Psychotherapy is commonly called talk therapy or counseling, but it involves much more than just talking. It’s a form of treatment aimed at helping people manage and reduce negative emotional symptoms so they can function better with MS and other parts of daily life, according to the American Psychiatric Association. You may find it through a social worker, psychologist, psychiatrist, marriage and family therapist, psychiatric nurse, or other professional with specialized training in psychotherapy—so long as they’re qualified and licensed in the field.

There are plenty of good reasons to try psychotherapy, even if you feel perfectly capable of handling things on your own. “People feel like they should be able to work things out by themselves, but everyone deserves, at certain points in their life, to speak to a trained specialist—especially if they have a chronic illness like MS,” says Diane Solomon, Ph.D., a board-certified psychiatric nurse practitioner in Portland, Oregon.

If you’re unsure whether therapy may be right for you, or if you’re curious to learn more, here’s what to know about this valuable resource for living your best life with MS.

How Could Psychotherapy Help with MS?

Psychotherapy may be particularly beneficial for people with MS, especially because having MS may put you at risk for mood changes and/or mood disorders.

“Certain mental health issues are more common in people with MS than in the general population, and they can impair a person's quality of life,” says Barbara Giesser, M.D., a board-certified neurologist and MS specialist at Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica. These issues can include depression, anxiety, even bipolar disorder.

What’s more, about 10% of people with MS also have the neurological condition pseudobulbar affect (PBA), characterized by sudden, uncontrollable outbursts of laughter or crying without an apparent trigger. Psychotherapy may help those people cope.

MS symptoms like fatigue and mobility issues can also impact you emotionally, as can the unpredictable nature of MS flares and disease progression.

“The most important thing to know about these emotional issues is that they can be addressed,” Giesser says. Some research points to psychotherapy as a helpful option in managing not only mental health issues like depression but also other MS symptoms like fatigue and insomnia.

Yet it’s often best to use a combination of treatments and techniques to manage mental health issues, especially bipolar disorder and pseudobulbar affect. Such techniques may include psychotherapy in conjunction with medication and/or lifestyle habits like regular exercise and support systems (such as social support groups).

What Are Signs It May Be Time to Seek Therapy?

You don’t need to be in crisis to go to therapy. Simply put, people should try therapy any time they think they could use a little extra support. And if you notice your MS, stress, anxiety, or moods negatively impacting your everyday life, that’s even more reason to consider therapy. “If you're having any emotional or physical symptoms that are interfering with your ability to function, it’s worth seeking help,” says Solomon.

Physical symptoms of stress may include sleep issues (like insomnia), an inability to concentrate, and increased fatigue. Other symptoms include “trouble doing the things that you used to do, and not enjoying the things that you used to enjoy,” Solomon adds. Thoughts of death or suicide may also occur.

If you’re having thoughts of death or suicide, immediate help is available 24/7 at the 988 Suicide & Crisis Lifeline. You can get connected by calling 988 or by chatting with counselors online.

How Do I Find the Right Therapist?

To ensure a high level of care, professionals doing therapy are required to have certain competencies and to hold a license in the field. When you’re looking for a therapist, it’s important to find someone who is qualified, so look to see that they’re licensed.

Finding the right therapist for you can take some searching, but you can start by asking your friends and family for recommendations. You can also ask people in an MS support group, if you're connected to one. Your neurologist or primary care provider may also be able to suggest a mental health professional.

Psychology Today also has a database of therapists that you can filter by zip code, accepted insurance, and the issues they specialize in, including chronic illness. Additionally, the National Multiple Sclerosis Society offers a search tool for finding providers, including mental health professionals, in your area.

"I always tell people to pick two or three therapists to call, even if you just speak to them on the phone. Some people even go to two or three therapists before deciding on one," Solomon says. On the phone, you can ask any questions you may have for them, including how much experience the therapist has working with people who have MS or other chronic illnesses.

It may take a few sessions to build a rapport with a new therapist, but pay attention to how you feel off the bat. "Basically, you should see if you feel like it's a fit, and trust your instincts about that," Solomon says.

Above all, you should feel comfortable with a therapist, not like you have to talk yourself into seeing them. “The hardest part is reaching out and making that connection, because the first therapist you meet may not be the right one,” says Solomon. “It's worth searching a bit to feel like you are really seen and heard and listened to, and to feel good with the person and want to tell them your story. If you don't feel that, it's probably worth looking elsewhere.”

What Should I Expect from My Sessions?

You shouldn’t need to do anything to prepare for a session ahead of time, unless the therapist has online forms for you to fill out. Especially if it’s your first session with a new therapist, expect to answer a lot of questions about why you decided to come in, what’s been going on recently, and your history with MS and/or emotional issues.

During your sessions, you may also discover that some myths about therapy simply aren’t true. For instance, some people may not want to try therapy because they don't want to see a therapist who takes only a passive listening role or someone who focuses only on childhood (or other times from the past). A good therapist will reflect back and engage with you, Solomon says. Other people may worry that if they start therapy, they will have to do it for years—but this isn’t always the case, either. "There are very effective short-term psychotherapies," Solomon says.

As part of certain therapies, such as cognitive behavioral therapy, you can expect to learn different skills and strategies that have been shown to help reduce the impact of distressing thoughts and emotions on your life.

If you aren’t feeling ready for psychotherapy but feel like you need some emotional support, you have options. The National Multiple Sclerosis Society has a peer support program that can connect you with another person who has MS and may be able to support you as you cope with some of your ups and downs, Giesser says. Social support from others who understand life with MS is also available here in our MS community.

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