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Fatigue & stress


Fatigue is the most commonly reported symptom in MS. Several studies cite fatigue as being experienced by as many as 90% of people with MS at some point throughout the course of the condition. Fatigue can impact all areas of daily life, including employment, exercise, relationships and general activity levels throughout the day. It varies between people and can present as an overwhelming feeling of weariness, tiredness or lack of energy with no obvious cause.

Factors such as sleep disturbance, infections – eg urinary tract infection, cold/flu – and stress, can also increase the severity of fatigue experienced. Extra rest, attention to reducing contributing factors, and having assistance at home may be required during these times.

Management Strategies

  • Taking regular rest is highly recommended.  If you are able to have a ten minute rest period this may be enough, but for some people, longer periods may be needed.
  • Resolving possible underlying contributing factors such as treating infections, reducing sleep issues or managing pain and stress.
  • Working smarter, not harder. Prioritise, delegate tasks, find alternative energy saving ways of completing activities.
  • Ask for help from your support network when needed.
  • Our MSWA Occupational Therapy Department offers information resources and advice as well as running regular Fatigue Management Programs. Telephone 9365 4888 to join one of these courses and become adept at self-managing this symptom.
  • ‘Fatigue and MS’ booklets are also available through MSWA on 9365 4888 or
    contact us by email


Stress is a part of everyday life and is difficult to avoid. It is often described as a feeling of being overloaded, wound-up, tense and worried. Having an unpredictable, chronic condition such as MS, can contribute to elevated stress levels and cause anxiety on a daily basis.

Short term, minor stress may contribute to a temporary increase in fatigue and anxiety in people with MS, which can be rectified by rest and removal of the stressor. 

Stress has some physiological effects within the body system as it sets up the ‘fight-or-flight’ response which involves the release of hormones and chemicals from the adrenal glands and the pituitary gland and the hypothalamus in the brain.

When stress constitutes a major event or is prolonged, the inflammatory responses typical of MS are activated and the immune cells implicated in MS are raised. This may be demonstrated as an exacerbation of existing symptoms and, in some cases, prompt a relapse.

Many research studies from around the world have examined the impact of stress on the general population, as well as multiple studies in relation to MS. The outcomes confirm the physiological changes that occur and the importance of self-management strategies.

Managing Stress

  • Identify the warning signs – muscle tension, breathing changes, fatigue and mood changes. Become aware when you are overworking or becoming fatigued or anxious.
  • Identify the triggers – anticipate and intercept. Triggers may include tiredness, hunger, deadlines, over-committing yourself. Look at ways to reduce or eliminate triggers.
  • Include those close to you in assisting to reduce triggers. Share your feelings and expectations.
  • Establish routines – include regular times for exercise and relaxation, ensuring adequate sleep and rest.
  • Look after your general health – adequate fluids and nutrition; avoid use of alcohol, tobacco or other drugs.
  • Notice self-talk – eg  ”I can’t cope” and change to more helpful strategies – eg calming yourself, breathing and focusing.
  • Exercise – traditional exercise such as walking, gardening and swimming are also useful tools for relieving stress.
  • Find what works for you.
  • Mindfulness activities can be incorporated on a daily basis to significantly reduce stress. These include:
    - Relaxation
    - Meditation
    - Deep breathing
    - Progressive muscle relaxation
    - Yoga, Tai Chi
    - Courses and books are available for you to learn

MSWA Nursing staff, Counsellors and Occupational Therapists can be contacted on 9365 4888 if further advice or assistance is required regarding stress and its management. Mindfulness classes and courses are held regularly at MSWA.

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