How PTSD might manifest for people with a chronic illness like MS

Many people tend to associate post-traumatic stress disorder (PTSD) with military service. While the military may provide ample opportunities for exposure to a traumatic event, it by no means has a monopoly on the disorder. Trauma can be caused by many other situations, including terrifying or stressful medical experiences. Examples include a painful injury, a botched procedure, a particularly bad or humiliating visit with a provider, or the struggles of living with a chronic condition.

I feel very fortunate that even after 22 years, I don’t have any PTSD symptoms from my military service. I do sometimes wonder if I have any from my seemingly never-ending battle with multiple sclerosis (MS), even though my experience doesn’t really fit the classical definition of the disorder.

PTSD is typically thought of as being caused by a single, external traumatic event. With chronic conditions like MS, the traumatic event may take place within our own bodies. And it’s not a one-time event or even a series of events, either. Instead, it’s ongoing, which means that any stress or anxiety is ongoing as well. Recognizing this, researchers introduced the enduring somatic threat (EST) model of PTSD to better understand and explain this disorder.

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PTSD in chronic illness

The key difference between the EST model and standard PTSD is the word “enduring.” The symptoms are largely the same, but while people with classical PTSD reexperience a discrete past traumatic event, people with chronic illness may reexperience ongoing issues or repeated situations, such as doctor appointments, procedures, or pain.

Another common symptom is hyperarousal. Someone experiencing a stressor may become very aware of their surroundings, bodily sensations, and emotions. For those of us with chronic conditions like MS, we have no choice but to be attuned to what’s going on in our bodies. I worry I seem like a hypochondriac because I notice every minor change and new pain. This might be part of the reason I tend to downplay my symptoms when speaking to a provider or someone without MS.

The last PTSD symptom I want to discuss is avoidance. Those with the disorder often try to avoid any place or situation that reminds them of the triggering event. With my primary progressive MS, there is no avoiding the trigger, because my own body is the source of danger. Avoidance can be both a symptom of PTSD and a coping mechanism, as it may provide a temporary feeling of control or safety. Since MS is internal rather than external, we are often denied those feelings of safety and control.

Treatment for both types of PTSD is similar, possibly including medication (such as antidepressant or anti-anxiety drugs), talk therapy, coping skills, and support groups. The specific tools or techniques may vary depending on your individual experience and the source of your trauma.

Self-advocacy is also recommended as a way to establish control and create a safe place. I try to practice it and advise anyone with MS to do the same. Now, it seems I have even more reason to do so.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.