New Paper: How to Keep your Mood Up if You Have MS and Chronic Pain

 What was this research about?

Chronic pain is common for people who have multiple sclerosis (MS). Chronic pain can be frequent, and may not go away. When pain is bad enough to limit our daily activities, it can sometimes make us feel down or depressed, also called “low mood.” In this study, we wanted to figure out how chronic pain contributes to lower mood. We looked to see if pain changes mood directly.  We also wanted to know if pain changes mood indirectly by increasing:

  1. Anxiety (feeling stressed or worried)
  2. Fatigue (feeling exhausted or worn down)
  3. Sleeping Problems

What did the researchers do?

We sent surveys to a large number of people with MS, and more than 1,200 people filled out our surveys. We asked questions about how much pain they experienced and how much the pain got in the way of doing things like working, socializing or running errands. We also asked about experiences with anxiety, fatigue, trouble sleeping, and feeling depressed.

What did the researchers find?

People with more pain also reported lower mood. In addition, people who had more pain also reported more anxiety, fatigue, and trouble sleeping. All three of these symptoms, in turn, were related to feeling more depressed. Instead of lowering mood directly, chronic pain can lower our mood by causing anxiety, fatigue, and trouble sleeping. Of the three symptoms (anxiety, fatigue and sleep) pain’s impact on fatigue was most strongly related to lower mood. This is useful for researchers to know because it suggests that treating fatigue may be a good way to improve mood.

How can you use this research?

If you have chronic pain, you may be able to improve your mood by reducing stress, managing your energy, and improving your sleep. Here are some tips:

  • Pace yourself. Slowing down and taking rest breaks can help reduce stress and keep you from getting too tired. (See our fact sheet on Managing Your Energy)
  • Mindfulness meditation can reduce anxiety by helping you focus on the present moment. Learn more about mindfulness meditation here.
  • Being physically active is a great way to stay energized, stave off stress, and sleep better at night. For more information, check out our fact sheet on How to Stay Physically Active.
  • Many people find that taking short naps during the day help save energy. However, napping for too long can make it harder to sleep well at night.
  • Practice good sleep habits by waking up and going to bed around the same times each day. Try to follow a regular bedtime routine, and avoid alcohol and caffeine before bedtime.
  • If you have chronic pain along with anxiety, fatigue or sleep problems, counseling approaches such as cognitive-behavioral therapy can help you learn how to manage these issues at the same time.

What you need to know:

  • People with chronic conditions have a higher risk of becoming depressed. If you think that you or a loved one might be feeling depressed, check out our fact sheet on How to Cope with Depression.
  • Reducing fatigue can improve your mood and quality of life. Check out our fact sheet on How to Manage Your Energy.
  • Sleeping well can also improve your mood and quality of life. Check out our fact sheet on How to Sleep Better.

Original Research Article

Amtmann D, Askew RL, Kim J, Chung H, Ehde DM, Bombardier CH, Kraft GH, Jones SM, Johnson KL. Pain affects depression through anxiety, fatigue, and sleep in multiple sclerosis. Rehabil. Psychol. 2015; 60:81-90.

About the Author:

Dagmar Amtmann, PhD is a research associate professor at the University of Washington and co-investigator on the Healthy Aging RRTC.  Dr. Amtmann’s research interests include measurement of patient-reported outcomes and participation using modern measurement theories.