Like everyone else, you probably have a lot of responsibilities and worries — a career, a family, long commutes, a mortgage. And of course, managing MS brings on a whole other slew of concerns and stressors. But here's the reason why you have to get stress under control: The more the stress response is activated, the harder it is to shut off. Even when the crisis is past, your heart rate, stress hormones, and blood pressure remain elevated. This can all take a big toll on your body. Long-term exposure to stress can cause obesity, heart disease, anxiety, and memory problems. Your goal then, is to reduce its impact on your daily life.

What you consider to be stressful is unique to you. Your personality, your social support system, and your temperament are a few of the factors that determine your potential stressors.

Learning how to cope with stress is the key to your well-being. Your best bet is to sit down and make a list of what stresses you out. Note activities that put a strain on your energy and time or trigger anger or anxiety. You may also want to note positive experiences, especially those that give you a sense of well-being or produce a sense of accomplishment. Take a few days or weeks if you need to make this list; it might take some time to identify your triggers. Following are some of the common stressors for people living with MS.

Daily Demands

Battling traffic, doing injections, and medical appointments are some of the typical daily demands of people living with MS. By themselves, they are small upsets, but piled up together they can make for a stressful day. It's imperative to get a handle on your daily stress levels.

• Learn to pare down your lists. There's a difference between “should” and “must.” Know the difference between them and prioritize your tasks.

• Say “no.” Identify your limits and stick to them. Adding responsibilities to an already hectic day may guarantee that you're taking on more than you can handle.

• Delegate. It's time to get the kids to wash the dishes and help mow the lawn. There are hundreds of ways you can minimize household chores, including delegating responsibility, hiring others to clean or do yard work, or letting go of perfectionist tendencies.

• Manage your time. Time management remains one of the most effective ways to deal with stress. Make a daily schedule and stick with it. Reward yourself at the end of the day for staying calm and focused.

• Be assertive. If you're too tired to drive your daughter to the movies, then say so. It isn't easy to teach others to respect your boundaries, but if you're consistent, they'll learn.

A good rule of thumb is to learn to alter stressful situations that you can't avoid. Take the train to work, start a carpool for soccer practice, and buy the birthday cake instead of making one.

Work can also be a source of daily stress. Things such as job satisfaction, a big workload, or feeling as if you're not making the grade can all contribute to a stressful work life. Many people with MS have had to take a good look at their present employment situation and decide whether or not to find a less stressful job. Those who decide to stay with their job cope best by learning stress-management skills.

MS Stress

When it comes to stressors that you cannot change, acceptance is your only alternative. You cannot prevent the death of a loved one, change the content of the evening news, or, unfortunately, change the fact that you have MS. Many things in life are beyond your control, but you have a choice as to how you handle and react to them. Focus on those things you can control.

So, what can you control when it comes to your life and having MS? It's a good thing to think about, because the answers you come up with will largely determine how well you manage your condition.

Staying healthy by eating well and exercising regularly is a good way to control the overall state of your health. You can also agree to focus on the positive things in your life. Education and commitment are also stress relievers. Stay on top of new treatments and therapies and commit to your medication regimen. It's also important to see your specialists on a regular basis.

MS stress can also be caused by fear of the unknown, so identifying your fears and facing each and every one of them is a good idea. Reframe your fears by trying to take a positive approach. For example, if one of your fears is that someday you might need a cane, take that fear out and analyze it. What if you do need a cane one day? You might imagine in your mind all of the people in the world who have had to use a cane. Consider that most of those people adjusted to using a cane and lived good lives despite it. Sometimes when people dissect their fears, they find they aren't as scary as they had once imagined them to be. In fact, facing your fears head-on is a good way to take the air out of them. It may be helpful to visualize the worst possible outcome while keeping in mind that most people with MS do not need a wheelchair.

Adapting to the unavoidable things that cause you stress can help you regain a sense of control. See the challenges before you as an opportunity for personal growth — as well as the growth of those around you.

Stress on the Home Front

Familial stress seems to have its own label; it's composed of many different factors, including relationship, environmental, and financial factors. Problems with a spouse, a noisy neighbor, and a broken washing machine can each contribute to the menu of stressors that make up your daily life at home. Careful planning and time management can help. Delegating tasks and learning to be assertive about your needs can also go a long way in helping you to cope. Family relationships can be complicated, so be sure to seek out help if you're having problems getting everyone to agree on a course of action. You may want to get a referral to an individual, couples, or family therapist. Home should be your salvation — the place where you can unwind and enjoy a reprieve from the daily grind of life.

Emotional Stressors

It probably doesn't come as a big surprise to learn that people can be their own worst enemies. Not all stress is caused by outside factors; we often do a pretty good job of it ourselves. Worrying, low self-esteem, seeking perfection — these are all self-generated types of internal stress. A good way to resolve internal stress is to set up realistic goals and expectations for your life. Since it's often hard to change behaviors, it may be wise to seek out professional help.