Mood Swings and Emotional Challenges

Most people have experienced mood swings at some point in their life and they can usually pinpoint the cause; hormonal changes, stress, and fatigue are examples. Mood swings and uncontrolled emotion in MS, however, tend to be more common than in the general population. Those who deal with these challenges describe symptoms that range from angry outbursts to uncontrollable laughing and crying and inappropriate giddiness. These problems are not the same as the reaction you may have to a new MS diagnosis, for instance, where an emotional response (such as, sadness) is a normal part of the acceptance process.

Involuntary Emotional Expressive Disorder (IEED)

What this mouthful means in a nutshell is this: IEED is a disorder that causes sudden and unpredictable episodes of laughing, crying, or other emotional displays. No one is really sure what causes this neurologic disorder, but it is thought that lesions in the frontal lobe (which keeps emotion in check) compromise its ability to function properly. This damage can disrupt brain signaling, causing a short circuit that triggers the episodes. About 10 percent of the MS population is affected by IEED, but it is most often seen in those who have progressive disease and significant cognitive changes.


It is important to clarify the cause of emotional problems because a diagnosis will determine the course of treatment. IEED should be separated from other problems, such as depression. Patients who experience these episodes can often be embarrassed by them and avoid social contact, so early recognition and management is important to maintaining a healthy life.


Treatment is still evolving, but the same drugs used to treat depression are often effective in IEED, such as Elavil (amitriptyline) or Prozac (fluoxetine). Dextromethorphan, a component of some cough syrups, is being studied to treat patients who have IEED.

Handling Mood Swings

Medications and counseling are effective treatment strategies for mood swings, but there are other ways to help you cope.

Studies show that regular exercise can help improve mood and even help you sleep better. Exercising twenty minutes a day, three times a week can help you to focus your energy and leave your emotions behind for a while.

Using your support network to talk things out can also be beneficial, especially with others who are experiencing some of the same things that you are. And talk to your doctor if your mood swings aren't improving despite your interventions.

There's nothing like a whole lot of stress (or even a little) to exacerbate your symptoms, including mood swings. Find ways to relax, such as reading or taking a walk. You might want to look into some other approaches, such as yoga and meditation.

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