Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. It is characterized by a triad of inflammation, demyelination, and gliosis; the course can be relapsing and remitting or can be progressive. Some nerves found in our body are encased by myelin. These nerves have faster conduction speeds then would be found in unmyelinated nerves. Segmental demyelination of the nerve as caused by multiple sclerosis has been shown to be due to an autoimmune reaction, with auto-reactive T lymphocytes, B-cell activation, and the release of cytokines (Harrison’s, 2008, pg.-2612). The axonal damage leads to a progressive and irreversible neurological disability. Because of the progressive nature of the disease, approximately fifteen years after onset, only about 20% of patients have no limitations in function (Harrison’s, 2008, pg.2616). There is no definitive cure for the disease, and thus patients are at risk to develop depression and self-loathing because of this.
Chronic illnesses, such as multiple sclerosis, are no doubt a financial and physical burden to the patient and their families; however, many times the social stigmas that come along with having a chronic illness are over looked. People that are diagnosed with chronic illnesses face problems in the workplace such as, being fired, social rejection by their colleagues, and poor healthcare. The problem lies in that besides the physically affects on the body that multiple sclerosis has; added stress from being socially isolated causes excess stress that not only exacerbates the condition but also leads to a decreased quality of life.
Social interaction is very important for ones well-being; social support from family, friends, and even healthcare professionals can improve the quality of life of a patient with chronic illness. Social support involves not only information that can result in better care but also more comfort and assistance in dealing with illness (Earnshaw, Quinn, & Park, 2012. pg. 2). The affects of a lack of social support among people living with chronic illness include poor mental and poor physical well-being (Earnshaw, Quinn, & Park, 2012, pg.2). Healthcare professions have a vital role in educating and counseling people with MS on how to engage in social relationships (Grytten & Måseide, 2006, pg.197). The healthcare professional should also be able to adequately educate the patients surrounding social circle, whether it be family or friends, on how to adequately socially engage; this means understanding not to overemphasize or underemphasize the patients illness (Grytten & Måseide, 2006, pg.205).
A patient with a chronic illness may unconsciously anticipate stigma, meaning that there is a belief that “prejudice, discrimination, and stereotyping will be directed at the self from others in the future” (Earnshaw, Quinn, & Park, 2012, pg.1). Anticipated stigma leads to an extreme amount of stress added to an already stressful situation. The added stress experienced by the patient with MS as well as other chronic illnesses may be a result of expectations of prejudice, discrimination, and stereotyping. The people living in this situation “may perceive social rejection from friends and family, discrimination from work colleagues and poor caregiving from healthcare workers as demands that they do not have the resources to handle” (Earnshaw, Quinn, & Park, 2012, pg.2).
When a patient with a chronic illness experiences anticipated stigma they may be doing more harm for themselves not just socially but also from a medical stand point. If a patient feels isolated they may not be so forthcoming with information regarding their symptoms and their illness. This lack of information leads the healthcare provider having less information to diagnose and treat the problems, leading to a patient feeling less satisfied with their care, this in turn leads to a decreased level of well being experienced by the patient.
Suffering from a chronic illness, multiple sclerosis included, is not easy. The lack of a medical cure leads to progressive suffering by the patient as well as that of their family. As mentioned previously, anticipated stigma from the patients family, friends, work colleagues, and healthcare professionals leads to a poorer quality of life, more so then the disease causes in its own right. Higher stress levels, lower social support, and a lower patient satisfaction with the quality of care, best explain this lower quality of life associated with anticipated stigma. The study done by Earnshaw, Quinn, & Park (2012) found that the patient does not need to actually experience these stigmas but in fact just the idea of them occurring in the future is enough to decrease their quality of life.
Works Cited
Braunwald E., Fauci, S., Hauser S., Jameson J. Kasper D., Longo D., Loscalso J. (Eds.). (2008). Harrison’s Principles of Internal Medicine (17th edition) New York. McGraw Hill Medical.
Earnshaw, V., Quinn, D., & Park, C. (2012) Anticipated Stigma and Quality of Life Among People Living with Chronic Illness. Chronic Illn. 2012 June ; 8(2): 79–88. doi:10.1177/1742395311429393.
Grytten, N. & Måseide, P. (2006). ‘When I am together with them I feel more ill.’ The stigma
of multiple sclerosis experienced in social relationships. Chonic Illness. 2. 195-208
