MS Mood And Cognition

Does your emotional state seem to change week-to-week or day-to-day?

Have you noticed changes in your thinking, memory, or problem solving?


You are not alone!  Approximately 50% of people with MS experience changes in mood, including:

  • Depression (persistent feelings of sadness or loss of interest in activities)
  • Anxiety (persistent worry, nervousness, or irritability)

 At the same time, about two-thirds of people experience changes in cognition, such as:

  • “Cog fog” (feeling like your mind is foggy, feelings of forgetfulness, or difficulty accessing information in your brain)
  • Executive functions (difficulty planning, prioritizing, decision-making, or poor judgment)

What does this mean for your wellbeing?

First, it is important to recognize that mood and cognitive symptoms are strongly related to one another. Addressing both is an important part of comprehensive MS care.

If you find yourself having any of the following symptoms for longer than a couple weeks, it is important for you to mention them to your health care provider (especially if your provider does not ask):

  • Feeling down, depressed, or hopeless
  • Losing interest in activities you used to enjoy
  • Being preoccupied with worries or general nervousness
  • Feeling overwhelmed by life’s stressors and not knowing how to respond
  • Feeling more irritable or agitated with others or yourself
  • Feeling cognitively “slowed down” or “foggy”

Think about your mental health the same way you think about your physical health with MS: when something is wrong, you seek treatment.

Remember: It’s OK to ask for help!

While it can be intimidating to open up, you may find that working with a professional provides you a safe environment and clear steps to a better quality of life.

What types of treatments are there for mood and cognition changes? 

You and your health care providers will explore what type of psychological or behavioral treatments are right for you.

Here are a few of the common therapies and practices that are helpful for improving both mood and cognitive symptoms without medication:

  • Cognitive behavioral therapy (CBT) - addresses unhelpful thoughts and teaches us new and different ways of responding to stressors so those experiences don’t have such a negative impact on daily functioning and quality of life. Studies have shown that CBT improves depression, fatigue, pain, and perceived cognitive dysfunction in people with MS.
  • Acceptance and commitment therapy (ACT) - focuses on confronting and accepting unpleasant thoughts/experiences while pursuing activities that are in line with one’s values. Emerging studies have shown that ACT is helpful for people with MS and their support partners to reduce emotional distress and improve coping and cognitive function.
  • Mindfulness - focuses on your awareness, feelings, thoughts, and sensations in the present moment. Recent research suggests that mindfulness practice is just as effective as computerized cognitive training for improving cognition, and it can help with your mood.
  • Cognitive rehabilitation - encourages restoration and improvements in cognitive function, as well as teach specific strategies to compensate for cognitive impairment. There are training programs available in-person and  or online (e.g., BrainHQ). You can learn more about cognitive rehabilitation here. (https://www.cando-ms.org/online-resources/can-do-library/cognitive-rehabilitation-in-ms-research-update
How can you get started? 

Again, if you’re noticing mood or cognition changes, bring them up to your neurologist, general health care provider, or contact a comprehensive MS Center. They can recommend or refer you to a specialist.

You can also research providers of the mental health treatments listed above on your own.

Unable to seek in-person treatment? You can still meet with a professional!

Research suggests that remotely-delivered treatments over video or phone call are acceptable, convenient, and effective for people with MS and their support partners.

Telemedicine is a great option for you if:

  • You do not have reliable access to transportation
  • You live far from providers with expertise in MS
  • You want to have more options for providers and find the best fit
One more thing: Don’t forget support partners! 

Given that MS can affect the whole family, support partners are also likely to experience changes in mood and cognition. Remind your support partner to monitor their mental health and encourage them to seek treatment if needed.

Mental health is a critical part of your overall health.

You’re already dedicated to maintaining healthy nutrition, getting physical activity, sleeping well, taking MS medications as prescribed, and avoiding excessive tobacco and alcohol use. Remember that your mental health plays just as important of a role in your overall health! Caring for your mood and cognition is key to wellness throughout your life!