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Resilience: Addressing the Challenges of Multiple Sclerosis

Coleen Friedman, MSW -- National MS Society

People with MS may find that the physical, emotional, cognitive, psychological, and spiritual challenges of living with the disease can be overwhelming. Some may feel that the challenges of living with a chronic disease are very hard to face day after day. But many people living with chronic diseases, including MS, have learned that practicing behaviors which promote resilience is the secret to not just coping with the disease, but thriving with it.

What is resilience?

Resilience is commonly described as the ability to bounce back from difficult circumstances - to find happiness and life satisfaction despite challenges. These challenges can be with relationships, finances, health, or any of the myriad stressors that we face in life. It’s finding hope and meaning in life, even while confronting obstacles. It’s finding the motivation to take on new challenges and opportunities. It’s thriving in the face of whatever life throws at you. Resilience is the ability to maintain or regain well-being and progress toward valued goals in the face of adversity.

Resilience is not about acting happy all the time or ignoring the very real difficulties in life. Resilience is not even about trying to eliminate negative thoughts or feelings. In fact, it’s quite the opposite: A significant part of being resilient involves what researchers call “positive adaptation” or “realistic optimism” - remaining hopeful about the future while making plans that enable us to cope with our actual reality. It requires moving forward despite facing difficult events and emotions. It requires courage and hope.

Results of several studies suggest that people who are resilient report significantly greater satisfaction with their lives. A study in the Journal of Health Psychology evaluated 1,862 people with MS, muscular dystrophy, post-polio syndrome, or spinal cord injuries. The researchers used various tests to assess the participants’ resilience, including levels of depression, pain, and fatigue, and overall quality of life. The study team found that people with higher resilience scores also had lower rates of depression and a higher quality of life, even if they had high levels of pain and fatigue.

Other studies suggest that when people engage in activities that boost resilience, for example, stress management, social activities, or exercise, they report greater life satisfaction. Some people may be more naturally resilient than others. Researchers have found that people have a natural “set point” for resilience that is determined partly by genetics and partly by their early environmental circumstances. Together, those factors make up about half of a person's capacity to adapt positively to significant challenges. The other half of resilience comes from learning and using cognitive, behavioral, and interpersonal skills. Even if it doesn’t come entirely naturally, you can learn to be more resilient.

Dawn Ehde, PhD, a psychologist at the University of Washington, collaborated with the National MS Society and MS Society of Canada to create a video and workbook about resilience. The workbook describes three steps to building resilience:

  1. Understanding - Learn as much as you can about MS and how it can change over time. Talk to others living with this chronic disease.
  2. Managing - Use your knowledge to learn new ways to cope and live your life with MS, with physical, social, and financial adjustments. You may feel more confident and in charge.
  3. Growth - Begin to shift your priorities and determine what is most important in life.

There are also lifestyle practices which can help people develop resilience:

  • Maintain strong social connections - family, friends, and others who have MS
  • Maximize physical wellness - healthy eating habits, exercise, sleep, and MS therapies
  • Set realistic goals and move towards them - attainable goals result in feelings of competence
  • Practice gratitude - be mindful of positive things in life
  • Nurture positive emotions and savor them when they occur - hope, optimism, and humor
  • Allow negative feelings - recognize, express, and move on
  • Use mindfulness and relaxation approaches -develop techniques to reduce worry
  • Practice forgiveness towards people and situations - release resentment and bitterness
  • Plan for the future - make realistic assessments and practical adjustments
  • Find a sense of meaning and purpose in life -relationships, activities, or other avenues
  • Help others - volunteer
  • Turn to faith or spirituality - seek a larger sense of belonging and meaning in life
  • Learn to tell a different version of your story -reframe it to see both sides
  • Nurture your sense of humor

Rather than making a chore of your resilience-building activities, focus on the ones you really enjoy. Watching a movie with your friends or children builds resilience. So does having a hobby and taking time to enjoy it. Taking time to meditate or engage in mindful breathing can also boost your resilience. “It’s within the vast majority of humans to become more resilient - to develop the hope that leads to feeling more happy or content,” says Dr. Ehde.

“People with MS, perhaps more than most, can benefit from building their resilience because of the ongoing, unpredictable changes they face in their health, abilities, and self-image,” notes Dr. Ehde. “People who are resilient have the ability to grow from adversity. They can learn things about themselves, about what they value. They learn that they can get through tough things.”

To find out more about resilience, visit the National MS Society website at In the search engine window, type “resilience” and a wealth of information will be at your fingertips.

(Content in this article was drawn from “Resilience - Addressing the Challenges of MS” created by the National MS Society and MS Society of Canada.)