Inability to Express or Process Emotions Also Prevalent in MS Patients, Study Reports

Inability to Express or Process Emotions Also Prevalent in MS Patients, Study Reports

A significant number of multiple sclerosis patients show signs not only of depression and anxiety, but also of alexithymia — an inability to describe or process emotional responses, a research group in Brazil reported.

The study, “High levels of alexithymia in patients with multiple sclerosis,” published in the journal Dementia & Neuropsychologia, also found that MS patients with depression or anxiety were more likely to show signs of alexithymia.

Psychological difficulties are known to accompany multiple sclerosis, a disease of the nervous system with symptoms that affect both motor and cognitive skills. Depression and anxiety are well-studied psychological ills of MS and known to affect health-related quality of life. Alexithymia — a psychological condition characterized by a marked difficulty in identifying, describing, and expressing emotions — is lesser, although estimated to be prevalent in 10% to 53% of the MS population.

Researchers investigated the prevalence of alexithymia among MS patients compared with healthy peers. They also studied how depression, anxiety, and disability status might affect the prevalence of alexithymia in MS patients.

A total of 180 people with relapsing-remitting MS (RRMS; 126 women and 54 men) and 180 healthy volunteers — all with a median age of 37 — participated in the study.

Disability was assessed using the expanded disability status scale (EDSS), which ranges from 0 (low) to 10 (severe disability); the hospital anxiety and depression (HAD) scale was used to determine patients’ anxiety and depression status; and the Toronto alexithymia scale (TAS) was used to assess alexithymia. Median disease duration among patients was eight years, and their median EDSS score was 2.0.

Based on the TAS score, participants had either no alexithymia (score of 51 or lower), were borderline (scores between 52–60), or had alexithymia (a score of 61 or higher).

Researchers also evaluated the influence of age, education level, and employment status on the development of alexithymia.

Results showed that the number of individuals with alexithymia was higher in the MS group (93 patients) than in the healthy control group (27 individuals). Similarly, higher levels of depression and anxiety were observed in MS patients compared with controls.

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The researchers noted a correlation between depression, anxiety, and alexithymia. They reported that 14.1% of MS patients with depression and 30.8% with anxiety — as seen in HAD scores ≥12 — exhibited higher levels of alexithymia.

Older MS patients, and those without steady employment and with a lower educational level also had higher rates of alexithymia.

Alexithymia was also seen to be significantly influenced by the disability status of MS patients  — the greater the disability, the higher was the level of alexithymia reported. Alexithymia was also associated with worse neurological disability.

Among people serving as controls, alexithymia was higher in those with depression (23% of group) and anxiety (40%).

These findings suggest that better known mood disorders like depression and anxiety may influence the development of lesser-known ones like alexithymia in MS patients, the researchers said, suggesting that this condition also be addressed when evaluating an MS patient’s psychological well-being, so as to improve their personal and professional lives.

“Alexithymia was a relevant finding in patients with MS and should be addressed when psychological testing and care are considered for these individuals,” the team concluded.


  1. Deb Whitmore says:

    This artical on Alexithymia is exactly how I feel, it has gotten worse each year. I can’t get Doctors, Husband, anybody to understand what I say. Very frustrated, can’t feel any happiness, don’t understand things husband talks about. My memory is messed up. I sleep an hate waking up to the same existing WhatEver.

    • Evelyn says:

      Hang in there! Share this article and other relevant articles with the doctors and your husband. Doctors and my husband like to be able to “fix” things and this is something that they can not necessarily fix but it can help them to understand better what is going on if we share the information out there. Find a support group and take your husband so he can see there are others with the same issues. It has helped my husband and me. If the doctors so not respond than find others who will.

  2. I have this. I didn’t realize it had to do with my ms. I always have a hard time trying to explain myself or something 😢 and my adult daughter treats me like crap and I’ve tried to tell her things and now I see this

  3. Cynthia King says:

    Huh. I’ve had ms for 25 years, and over this time I have to learned to travel ‘light’. Big purse- gone. High heels- gone. I have deliberately tried to cut out some useless emotions. Like jealousy, because everyone I know seems to be moving forward and I am not. Like guilt, for having ms that has robbed everyone of who I used to be. I never thought that this emotional pruning has downside. I have no sympathy for others who create drama, and people who are so stupid they can’t get out their own way. My family thinks I am a ‘cold’ person. I guess this may be why. But I was thinking it I was in survival mode.

  4. Helen says:

    My hubby has had MS for 28 years. At this point his ambulation is very unsteady and requires a cane outside of house. He still works, but has gotten fired twice in last two years after working at a job for 18. I have observed that his cognition has progressively deteriorated in the last few years. Doesn’t think thinks through, forgets, unable to anticipate, plan, very apathetic, no sense of urgency about anything. He is very detached and flat. It has become a very difficult situation in which I desperately try to make sense of-this helped. Sometimes it feels like such an impossible relationship that is constantly draining. I love him, I just spend a lot of time not liking him and trying to understand what is happening….

  5. Sara says:

    I live with this, and it seems to get worse every year. I’m glad to know that I’m not alone, but I wish doctors were more comfortable addressing these changes. As this gets worse, it becomes increasingly difficult to maintain good relationships. I find that it is most disabling when I am in groups of people who might have conflicting emotions. If I think a situation is unsettled or someone close to me might have hard feelings, it is like cognitive/emotional chaos in my mind/body, and I end up sobbing, disoriented, and scared of the people around me. Afterwards, I am physically weak, extremely fatigued, and ashamed. The “spell” can last for minutes but can take a couple days to recover from. I am 47, but I tell people that I process emotions like a 2 year old. Sometimes that seems to help people understand, but mostly it is beyond frustrating for my family. Thank you for sharing this article. It will be a useful aid in helping people to understand.

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