Mood swings are infuriating to us, upsetting to our nearest and dearest but one of very many possible symptoms associated with multiple sclerosis.

I was just starting to do some research, preparing to write a blog on the subject when the following turned up on the website of the UK’s MS Society. It was written by clinical neuropsychologist Dr Annie Hickox and it deserves a bigger audience.

Mood swings are very common in MS. They may arise as part of an emotional reaction to the illness, or may arise from depression and anxiety. Occasionally, the illness can affect the emotional control centres of the brain. Mood swings can seem to come ‘out of the blue’ and it can be difficult to identify specific triggers that set them off. Fatigue is a very common cause of daytime moodiness and may play a role in your mood.

Dr Annie Hickox.

Keeping a mood diary can be a valuable way of identifying triggers. Note the time of day, and what thoughts went through your mind (such as, “I don’t have the energy to do everything the way I did before, I am letting everyone down”). Then note how that thought made you feel. You may find that the same negative thoughts go through your mind day in and day out. Once you have kept a diary for a few days, try to find a more helpful way of thinking about the situation, e.g. “I’ll have a 20 minute nap after lunch every day, then I will have more energy for cooking”. If you are saying the word should to yourself, drop it, and say something like, “I would like…or I can…”. Self-criticism is a major factor in low mood.

Ups and downs are a normal part of life, but the strategies above can help you catching them early and turn them around.  Communicate to others how you feel, and make sure that you have a balance of pleasurable and fulfilling activities. Seeking support from your MS nurse or a clinical psychologist can help you tackle the stresses that may be maintaining your poor sleep and anxiety.

Dr Hickox has been working as a clinical neuropsychologist for more than 25 years, in both the NHS and private practice. She has a PhD in Clinical Neurosciences from the University of Edinburgh.