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Taming Stress in Multiple Sclerosis
by Frederick Foley, PhD with Jane Sarnoff


You may want to continue on to deeper meditation once you have learned to clear your mind. Many people find that meditation greatly decreases the stress in their lives. It takes about 15 minutes once or twice a day. Try to meditate at the same times each day.

1. Sit as you would for mind clearing in a quiet place, free from distractions. Unplug the phone and close the door. Tell everyone you are going to be busy for 15 minutes.

2. Do two or three cycles of deep breathing.

3. Pick a word or phrase that makes you feel calm. Although any word will do, many people find that words that end in an m or n sound are most helpful—words like “calm,” “home,” “noon,” or “one.”

4. Close your eyes and repeat the word or phrase over and over either in your mind or out loud. Concentrate on the way the word sounds inside your head. Try not to think about what you are doing or how you are feeling.

5. If you have trouble relaxing or concentrating on the word, stop, do a cycle of deep breathing, and try again.

6. End the exercise by gently stretching and exhaling.

7. Although 15 minutes may be the ultimate goal of the meditation period, the actual time isn’t really important. Be realistic. Don’t worry if you only are able to concentrate for a few minutes at first. Just sit quietly for the rest of the time period. (Just sitting quietly will do you good.) With practice, the time and the depth of relaxation will increase.



Visualization is a combination of meditation, clearing your mind, imagination, and deep breathing. With visualization you do more than just see an appealing scene. You move yourself—in your mind—into the picture. You watch yourself reaching your hand out to pick a flower or to trail your fingers through a sunlit stream. You go to the beach and let the sand sift through your hand onto your leg.

Start the exercise by doing three or four cycles of deep breathing, and end the exercise by stretching and exhaling. If you can’t enter the picture at first, do a cycle or two of deep breathing and try again. As with the “Clear Your Mind” exercise, try to experience the scene with as many of your senses as possible. Hear the sound the rushing stream makes, and how the sound changes as you change the position of your hand. Smell the cool fresh scent of the stream, and feel the water on your fingers. The entire exercise can take as little as five and as long as 15 minutes.


Progressive muscle relaxation

Progressive muscle relaxation is often used as an aid to stress management. And, done in bed before you go to sleep, it can be an aid to a sound night’s sleep.

Going through your body’s entire group of muscles—tensing, relaxing, and focusing on the changes—will take about 12 to 15 minutes. If it takes less than that, you are moving at a non-relaxing speed. These exercises will provide the most benefit if you do them twice a day. If there are some muscle groups that you cannot work with comfortably, skip them.

If you have significant spasticity in some muscles, strongly tensing those muscle groups could trigger a spasm. You may want to speak with a physical therapist or other MS health professional about ways to work in a more comfortable way.

Many people, especially those with cognitive problems, find that the exercises are easier to do along with a prerecorded tape. You can prepare the tape yourself or ask someone with a relaxing voice to do it for you.

You will work with each of 17 muscle groups in a specific order. Tense, but don’t strain each muscle group. Hold the tense position for the slow count of five, paying attention to the way those muscles feel. Relax the muscles—letting them go totally limp. Focus for a count of five on how the muscles feel when relaxed.

To prepare for the exercise, wear comfortable, loose-fitting clothing, remove glasses or contact lenses, and sit up in a chair without crossing your legs or arms. You may also do this lying down in bed.

1. Clench both hands. Focus on how your hands feel and how the tension moves into the forearms. Relax. Notice what the muscles in your hands and forearms feel like now.

2. Touch your fingers to your shoulders. Raise your arms level with your shoulders. Focus on the tension in your biceps and upper arms. Relax and focus on the change in feeling.

3. Shrug your shoulders, raising them as high as possible. Focus on the tension in your shoulders. Relax and focus on the change.

4. Wrinkle your forehead. Notice where tension occurs—around your eyes and forehead. Relax and focus on the change.

5. Close your eyes tightly. Focus on the tension. Relax and focus on the change.

6. Clench your teeth. Focus on the tension in your jaw and, mouth, and chin. Relax and focus on the change.

7. Press as much of your tongue as possible onto the roof of your mouth. Focus on the tension in your mouth and throat. Relax and focus on the change.

8. Move your head slowly backwards as far as you comfortably can, keeping your shoulders level. Focus on the tension in your neck and upper back. Relax and focus on the change.

9. Pull your head forward, down onto your chest. Focus on the tension in your neck, shoulders, and upper back. Relax and focus on the change.

(Note: If you experience Lhermitte’s sign—an electrical-like shock—in your spine when you tip your neck forward, skip this step.)

10. Move away from the back of your chair, arch your back and push your arms upward. Focus on the tension in your back and shoulders. Relax and focus on the change.

11. Fill your lungs with air and hold the breath. Focus on the tension in your chest and back. Exhale all the way, relax and focus on the change.

12. Pull your stomach as far back toward your spine as you can. Focus on the tension in your stomach muscles and changes in your breathing. Relax and focus on the change.

13. Without pulling your stomach in, tense your stomach muscles. Focus on the tension. Relax and focus on the change.

14. Tense the muscles in your buttocks. Focus on the tension. Relax and focus on the change.

15. Flex your thigh muscles by straightening your legs or tensing the muscles. Focus on the tension. Relax and focus on the change.

16. Lift your feet off of the ground. Point your toes up, your heels down. Focus on the tension in your feet, ankles, and calves. Lower your feet, relax, and focus on the change.

17. Lift your feet slightly and curl your toes all the way down. Focus on the tension on the top of your feet and in your arches. Lower your feet, relax, and focus on the change.

After you have learned to be aware of tension in all 17 muscle groups, you may want to focus only on those groups that give you the most trouble. Tense and relax those groups—often the jaw, neck, and stomach—several times during the day. Check your “high tension” muscle groups from time to time to judge how relaxed you are.



Yoga involves breathing exercises and a range of stretches that revolve around the spine. Yoga increases the body’s flexibility and releases tension. Many community centers have courses in yoga. Some of the movements may be easy for you. Other movements may need practice or adaptation. And still others may need to be omitted. Discuss your plans with your physician or physical therapist before you begin.


Tai chi

Tai chi involves deep breathing, slow gentle movements, and relaxation. As a conditioning regime, it is considered more gentle than yoga. Many of the positions can be done while sitting. Discuss your plans with your physician or physical therapist and ask your Society chapter about “adapted” tai chi classes in your area.


Traditional exercise programs

Any physical activity done on a regular basis has been found to reduce stress and improve physical and mental health. Walking, swimming, or gardening can all relieve stress. Speak with your physician or physical therapist about developing a program to suit your needs and abilities.


There is no “right way”
It is important to remember that there is no “right way” to cope with stress. Even within the same family, some members may handle the MS situation by wanting to talk about it, read about it, and participate in support groups. Others may ignore it much of the time. If an approach is working for you, you may be tempted to conclude it is the right way for your loved ones.

Dr. Nicholas LaRocca, an expert on coping and MS, advises people to recognize that no one method is inherently better or worse than any other. Family members and professionals should refrain from passing judgment on what is “healthy” or “right” for others. Respect is a stress reducer by itself.

Further reading
Multiple Sclerosis: A Self-Care Guide to Wellness, 2nd Edition by Nancy J. Holland, MSCN, EdD, and June Halper, MSCN. New York, Demos Press, 2005, 288 pp. $19.95

Living with Multiple Sclerosis: A Wellness Approach, 2nd Edition by George H. Kraft, MD, and Marci Catanzaro, RN, PhD. New York: Demos Press, 2000, 144 pp. $19.95

Living Beyond Multiple Sclerosis by Judith Lynn Nichols. New York: Demos Press, 2000, 288 pp. $14.95

300 Tips for Making Life with Multiple Sclerosis Easier, 2nd Edition by Shelley Peterman Schwarz. New York: Demos Press, 2006, 128 pp. $16.95



For additional information
Mind and Emotions
Fatigue: What You Should Know
Depression and Multiple Sclerosis
  Copyright National Multiple Sclerosis Society, 2007