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Beyond the Physical: Understanding the Cognitive and Emotional Impact of Multiple Sclerosis in Work and Academic Settings

Ada Zhou

Written by Ada Zhou

Edited by Shivani Shah



Introduction

Affecting nearly 3 million people’s lives worldwide, with a third of cases occurring in the United States (National Multiple Sclerosis Society, 2019), multiple sclerosis (MS) comes with a spectrum of symptoms ranging from mild to severe. Most people recognize multiple sclerosis (MS) through its physical manifestations, particularly motor impairment: muscle weakness, stiffness, tremors, or spasms. However, the effects of MS go deeper than walking “weirdly” or sitting “strangely.” The cognitive and emotional symptoms are overlooked and misunderstood. This article will delve into the neurocognitive and emotional impacts of MS that bring about more challenges for these individuals, especially in work and academic settings, and how by creating a more supportive environment, we can help reduce the social barriers in their daily lives, allowing them to thrive.

How Symptoms of MS Go Misunderstood

Multiple sclerosis is an unpredictable, often debilitating autoimmune condition that causes the immune system to attack the myelin sheaths around nerve cells in the central nervous system, disrupting communication in the brain and body. The cognitive symptoms of demyelination of nerve cells in areas of the prefrontal cortex, which plays a crucial role in decision-making, makes it difficult to quickly process and plan out procedures, which can be mistaken for disinterest or laziness. A student or employee with MS may struggle to follow lecture material, remember important deadlines, or simply complete assigned tasks. It’s vital to remember, especially from a supervisor or colleague’s point of view, that these issues are not reflective of a lack of individual intelligence, but rather a direct consequence of impaired cognition. Without proper understanding and awareness, those with MS are very likely to experience feelings of inadequacy and isolation, which could lead to clinical depression.

Emotional symptoms can also pose major interferences. The demyelination of the limbic system, which is a major component of the brain’s emotional regulatory system, causes individuals to be more vulnerable to mood swings or pseudobulbar effects (PBA) of unpredictable laughter or crying that don’t align with the individual’s current emotional state (Cleveland Clinic, 2022). For instance, a person with MS may be in an important meeting or interview, but suddenly be overtaken by a wave of laughter even if there wasn’t anything funny. This can be extremely embarrassing and distressing for them, since others will misinterpret them as unprofessional and inappropriate. As a result, they’re likely to avoid seeking support or accommodations, further alienating themselves in work and academic settings.

Going Forward

In work and academic settings, supervisors, colleagues, and peers can help by taking the time to understand the challenges that individuals with MS face, instead of assuming that cognitive difficulties or emotional outbursts are results of personal-life stress, poor time management, or lack of effort. To truly support individuals with MS, it’s essential to acknowledge the cognitive and emotional symptoms as neurological causes rather than personal shortcomings.

Practical solutions can make a significant difference. In the workplace, employers can offer flexible deadlines, remote work options, and cognitive support programs to help employees with MS manage their workload without feeling overwhelmed. In academic settings, universities can provide note-taking services, extended exam times, and access to mental health counselors familiar with MS-related challenges. Additionally, organizing awareness workshops can help peers and colleagues better understand the hidden symptoms of MS, reducing stigma and encouraging a more empathetic environment.

Above all, it’s important to see individuals with MS for their strengths and perseverance rather than their condition. By providing both structural support and emotional understanding, we can empower them to thrive despite their challenges. A more compassionate and informed environment will not only help individuals with MS feel more accepted and comfortable but also ensure they have the resources they need to reach their full potential. Small, thoughtful changes—like allowing extra time for complex tasks, encouraging open communication about emotional health, and responding with empathy rather than judgment—can create a lasting, positive impact.


References

Pseudobulbar affect (PBA): Causes, symptoms & treatment. Cleveland Clinic. (2024, December

MS Trust. (2021, May 16). How common is multiple sclerosis?

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