Families have their own styles; some are open and communicative, while others tend to hold things inside. Your family's unique coping and communication styles will have a big impact on how it deals with the reality of MS. Mental health professionals stress the importance of cultivating new communication skills and strategies to keep the family functioning in a healthy way.

Living with MS involves more than the physical challenges created by the illness. It may also contribute to financial, relationship, and emotional challenges as well. Family life may be vastly altered if the primary wage earner is unable to work or if treatment requires long-term changes in the family routine and activities. Learning how to follow medical instructions, managing medication, working out financial challenges, and adapting to limitations and changes created by the illness all require learning new skills and ways of coping.

Emotional Responses

Your diagnosis likely spurred a myriad of different responses in your family members. Here are some of the more common responses:

• Depression. It's common for family members to alternate between worrying about the person who was diagnosed and worrying about themselves. They may lose interest in activities or relationships or feel overwhelmed by new roles and responsibilities.

• Anger. Feeling angry at unexpected life events is normal. Family members may feel angry at a change in routine or family roles. Anger is often part of the acceptance process.

• Guilt. Family members can feel guilt over the misperception that they somehow caused the person to have MS. They may also feel guilty about the anger they are experiencing, or the feeling that they aren't doing enough to help.

• Uncertainty. Feeling concerned and unsure about the future is a common emotional response, particularly in young children. Life's new unpredictability can cause anxiety or depression.

Reaching out for support and help is important for families that are learning to cope with a life-altering event. Since we all cope in our own way, it's important to decipher what family members are experiencing, especially young children, who tend to lack effective communication skills. Seeking out support from mental health professionals may help ease anxiety and assist you in reworking your roles in the family system.

Talking to Your Kids

Honesty and openness are key when talking to children about your diagnosis. It's well known that kids are a lot more perceptive than we give them credit for. When they perceive changes in the house and in the family dynamics, they can become fearful if no explanation has been given. But it's also important to keep the discussion age-and child-appropriate.

When it comes to telling your children about your diagnosis, experts say the sooner the better. Be prepared to explain to them what MS is. Use illustrations or pamphlets to aid you.

During your conversation, children will usually respond with a few questions of their own. It's not uncommon to be asked whether or not you're going to die, to which, thankfully, you can respond that people with MS generally have a normal life expectancy. You may also want to reassure them that you are going to work hard to manage the disease by establishing a pattern of self-care. You might even consider involving your children in one or two of your routines, such as exercising with you or running to get the cotton balls before you give yourself an interferon injection.

Knowing what reactions are normal and abnormal in your child can help you figure out how they're coping with the news. Young children may develop their own physical maladies, such as stomachaches. They may want to cling a little tighter or sleep in your bed more than usual. Teenagers may choose to spend more time with their friends and less time at home. You'll want to be on the lookout for signs of depression or anxiety down the road — trouble at school, problems with friends, anything unusual that concerns you — but the important thing is to convey that there is nothing wrong with how they feel. Let them know it is okay to be angry or upset and give them a safe place to express it.

Before having a family meeting, you'll also want to get a handle on your own feelings. Experts say that once you have come to terms with your feelings, it's easier to help the children come to terms with theirs.

Community Resources

Your physician is a great resource in providing referrals for mental health counselors or community-based support. Here are some potential resources to consider when looking for support for family issues:

• Pediatric offices usually have connections to mental health professionals and can make appropriate referrals when counseling or psychotherapy is needed.

• There are some great books on coping with chronic illnesses. The NMSS also has some great brochures to help you cope with MS, including brochures for your children to read. Take a look online at www.nationalmssociety.org/brochures or call 1-800-FIGHT-MS.

• Children's museums and other museums often have exhibits or displays dealing with the human body and health. Educating your child about MS can be used as an opportunity to spend time together.

• Churches and synagogues often offer counseling or host support groups for children or families that are dealing with a chronic illness at home.

Children need support and understanding during this process. Since MS is a complex disease, it's not always easy to explain. Being educated about MS and being able to describe it well is important — and challenging. Experts say that given the right tools to help them cope, children can weather the changes in the family and emerge as healthy and well-adjusted kids. What happens to the parent impacts all family members, but when children are allowed to participate in the discussions and feel a part of the situation, it benefits everyone.