Coping with a crisis when you have multiple sclerosis

Julie Stachowiak, PhD 

Writer, ms.about.com

I used to think that I was pretty good in a crisis. I could calmly and quickly assess a situation and come up with a mental flowchart of what had to be done, complete with alternate plans in case one of my steps didn't work out. More than once, someone would say to me that they wish they could be as logical and composed as I was when things needed to get done quickly and decisively. Of course, that was the old me, the person without multiple sclerosis.

These days, I am no longer the paragon of composure during times of stress. Quite the opposite –if more than one thing requiring my attention is happening at one time, I freeze, my circuits overloaded. I would never want to see a video of myself during these times – it would undoubtedly show someone who is so confused that she becomes dysfunctional, a person prone to lock herself out of the house or unable to find her car keys when they are most needed.

Recently, I had to run the dog to the vet on an emergency basis, make a call before I left, wrangle my young twins into clothes and then into the car, and get all of this done within an hour, as someone was coming by the house to fix something. These "normal" tasks had me standing in the middle of my kitchen, holding keys to the wrong car, rotating in slow circles and rubbing my forehead. Eventually, I was able to mobilize myself, but I had wasted valuable minutes trying to figure out what to do first. If this had been a true crisis, it would have undoubtedly taken much longer, with more mistakes along the way.

Undoubtedly, this inability to multitask in an urgent situation is related in part to cognitive dysfunction, which makes it difficult to hold onto more than one thought at a time or process things quickly.  There are a couple of tips that I have come up with to help "unstick" myself and get moving under stress:

Take a minute and assess the situation. In the vast majority of situations, taking 30 to 60 seconds to think things through will actually save time. Take a deep breath and mentally go through all of the steps that you will need to take and jot them down. Picture yourself doing the things in your plan, including making necessary calls, locating destinations on the map, bringing particular items along.  Think through what you are going to say to people whom you need to call. A quick mental run-through will make you more efficient when time is of the essence.

Make it quiet. Turn off all music, turn off the television. Tell people to stop talking to you. Go in another room, if necessary. This will greatly help you figure out what you need to do.

Ask for help when possible. There have been many times when I told a friend or my husband about a seemingly impossible situation and they said, "Why didn't you call me? I could have helped." It helps just to talk through something with someone as you are forming your strategy for addressing your problem. Often, others who are not wrapped up in the situation at hand can offer very simple suggestions that will reduce stress and effort.

Stay as calm as you can. I know that my MS symptoms become much more noticeable when I get worked up. Increased tingling, tremor, spasticity or headache is not what anyone needs when they are trying to act under pressure. While it is easier said than done, staying calm in a crisis will improve your chances for success in taking care of the problem.

Bottom line: These tips do not just apply to people with MS, as I think many people tend to "short-circuit" when things become urgent. However, for people with MS, the extra challenges of cognitive dysfunction and impact of stress on symptoms can make crisis situations even more difficult. By approaching a situation calmly and strategically, you can build confidence that you can handle things that life throws at you, despite your MS.

What about you? How do you handle stressful situations? Is there a particular instant (that you handled well or poorly) that sticks out in your mind? Share your stories and tips with us.