Gait and balance issues and MS go together like peanut butter and chocolate.
At least they do to me.
In one way or another they’ve been in the foreground of my life since I was diagnosed in 2013.
But more and more, I’ve come to think of balance in terms of the lowercase “b” balance and the uppercase version, too.
I’m pretty sure they’re not just related, they’re inseparable.
The small “b”
In early February I read the National Multiple Sclerosis Society’s summary of findings from the 7th International Symposium on Gait and Balance in MS held in early September 2017 in Portland, Oregon. Among the symposium’s presentations and discussions were the positive results shown by a vestibular rehabilitation program called BEEMS (balance and eye movement exercises for persons with MS). Created specifically for people with MS, the BEEMS program, “Improved balance, dizziness, fatigue, and quality of life in people with multiple sclerosis (MS), researchers reported.”
Gait problems, according to the National Multiple Sclerosis Society, can lead to “Concerns about falling and appearing impaired in public cause problems too, sometimes leading to social isolation”. In other words, gait problems can lead to anxiety, and anxiety, especially among those with MS, is a fairly certain predictor of depression..
And why not?
MS and all of its uncertainties are happy to traffic in anxiety all day long. The increasing lack of our ability to control the steady distribution of our weight while standing or walking, i.e., achieving and maintaining physical balance, only serves to highlight that.
The big “B”
Then I stumbled across “Tips to Ease Anxiety, an Often Overlooked Effect of MS.” Written by Ms. Debi Wilson, the column shares the effects that stress and anxiety were having on her during a very difficult time in her life along with some tips for coping with it.
Wilson notes an estimated 43% of people with MS experience some form of anxiety due to the disease. Citing “Anxiety in MS: Frequently Overlooked and Undetected,” an article from the Multiple Sclerosis Association of America, she writes, “The anxiety relief methods suggested are exercise, thought pattern changes, and the dissection of fearful concerns you have to make them manageable. Also, solving problems that cause fear and dealing with losses by expressing your feelings are important. A therapist can help with that and possibly prescribe anti-anxiety medicines.”
Based in part on cognitive behavioral therapy (CBT), “Anxiety in MS: Frequently Overlooked and Undetected” states, “Learning to control [emphasis mine] your reactions and quiet yourself can allow you to feel anxiety when needed to problem-solve, but not to become so overwhelmed by it. Increasing the areas of where you can have control and prioritizing activities can also help.”
The tenets of CBT and coping with anxiety seem to me to be philosophically similar to the “Serenity Prayer,” which begins with the phrase “God grant me the serenity to accept the things I cannot change [emphasis mine]; courage to change the things I can; and wisdom to know the difference.”
It’s a philosophy at the foundation of a number of coping strategies.
A few months ago I spoke with a therapist who has MS who suggested to me that, “having MS puts us 10 feet closer to everything in life.” Her point was that many of the effects of MS make us prone to experiencing some of the mental/cognitive, emotional and physical decline that every person inevitably experiences, only faster.
Many of the effects of MS — most in fact — are out of our control. MS is a troubling combination of unpredictability and certainty, the unpredictability of never quite knowing when and how badly it will trip us up or make us feel out of control coupled with the certainty of knowing that it almost always certainly will. And while often gradual, each little loss may make us feel ever more out of control, breeding even more anxiety in our lives as a result.
But her other point was that — with or without MS — so many things in our lives are always out of our control. Learning to accept that and then focus on what we can control and change is balance with the uppercase “b” in MS.
Increasingly I’m pretty certain it may be the more important one, too.
This column originally appeared at Multiple Sclerosis News Today.