Some of the most common but hidden symptoms of MS are the changes people may experience related to cognition and their emotions. These changes can affect the way people feel about themselves and alter their cognitive functions. For many, the emotional and cognitive effects of the disease represent its greatest challenges.

Emotional changes

There are a number of emotional responses that appear to be common as people learn to deal with having MS. Uncertainty, stress and anxiety are the most common, not just during diagnosis, but throughout the course of the disease.

A person with MS may grieve for their life before MS and their self-image may take a while to adjust to having MS. Other emotional changes that may occur in MS include clinical depression, bipolar disorder, and mood swings. All of these are more common among people with MS than in the general population. Depression and bipolar disorder require professional attention and the use of effective treatments.

Emotional lability appears to be more common, and possibly more severe, in people with MS. This may include frequent mood changes, for example from happy to sad to angry.

It is believed that the causes are the extra stress brought on by MS as well as neurological changes.

Uncontrollable laughing and crying is a disorder affecting a small proportion of people with MS, and is thought to be caused by MS-related changes in the brain.

Low self-esteem

Having MS can affect self-esteem. There may be times when it’s difficult to do everything a person is used to doing, or they may have to do things differently. Focusing too much on the negative aspects can feel overwhelming. This one minute infographic gives some confidence boosters and tips for managing low self-esteem and MS. Thanks to the UK MS Society for providing the text for this infographic.

MS organisations around the world have translated the infographic into a range of languages.

If you’re interested in translating it into an additional language, contact

Cognitive changes

Cognition refers to the “higher” brain functions such as memory and reasoning. About half of all people with MS will not experience any cognitive changes, but for others, the most commonly affected aspects of cognition are:

  • Memory
  • Attention and concentration
  • Word-finding
  • Speed of information processing
  • Abstract reasoning and problem solving
  • Visual spatial abilities
  • Executive functions

Because MS can affect any part of the brain, almost any cognitive function can be impaired, and symptoms can range from having a mild impact on only one or two aspects through to more pervasive changes, which affect a person’s daily life.

Cognitive changes can have a significant impact on a person’s ability to work and fulfil family responsibilities. Family members may not realise that MS can cause cognitive problems and this misunderstanding can result in anger and confusion.

MS is a complex disease with many psychological aspects. Adjusting successfully to MS requires understanding and addressing these changes along with the physical ones. There are many resources available for education, evaluation and treatment. By using these resources to the fullest, a person with MS and their family can continue to live their day to day life.

Woman feeds her husband, who has MS, in his bed

Minsk, Belarus, 10/2011. Alena Kleshchanka (51) has spent most of the past seven years organising her days around Nicolai’s needs. Blind and virtually paralysed from the neck down, Nicolai is mentally sharp. While the physical burden of care is heavy for Alena, the couple continue to share a loving relationship. Credit: Walter Astrada. Published on this website by kind permission of the European Multiple Sclerosis Platform.

A man with MS in Iceland, sitting, with a car park behind him

10/2011, Akureyri, Iceland. In 2008, a severe attack all but paralysed Haukur Dur’s legs, leaving him no choice but to use a wheelchair. It was a difficult period for an active man with a wife and three young kids. For now, a switch to Tysabri seems to have reversed the course of his MS. Haukur recalls being told the drug carried risks, but doesn’t remember exactly what the risk is – only that given his condition at the time, he felt any risk was worth taking. Credit: Fernando Moleres. Published on this website by kind permission of the European Multiple Sclerosis Platform.