Ask the Doc: Q & A with Edward Kasarskis, MD, PhD

Edward Kasarskis, MD, PhD is Director of the University of Kentucky ALS Multidisciplinary Clinic at Cardinal Hill Rehabilitation Hospital in Lexington, Kentucky, professor in the Department of Neurology at the University of Kentucky, and Chief of Neurology at the VA Medical Center in Lexington KY. 

Dr. Kasarskis

Q:  What should we know about stress and ALS? Do you think stress increases your chances of getting the disease?

Dr. Kasarskis:  I’m not aware of any study that suggests that a stressful life or prolonged periods of stress are associated with getting ALS. But we do know that once you have ALS, it is very common to experience a wide variety of stressors, as will your spouse, partner or caregiver.

The sources of stress are so obvious and prevalent among people with ALS that physicians typically don’t wonder why people are experiencing anxiety and don’t typically recommend psychiatric therapy to help people cope. There are, however, some very practical things that can be done to enhance your ability to deal with the stress and strain.

First, think about coping skills you’ve used in the past. Perhaps you love to experience nature, listen to music, watch old movies, play board games, chat on the internet, read mystery novels or follow sports. Whatever you like to do, try to find ways to incorporate those pleasures into your life now. If your mobility is compromised, there are a wide range of assistive devices available specifically to facilitate activities like these.

Next, consider who in your network of friends, neighbors and family might be able and even eager to help. Honestly, if you’re trying to deal with this disease by yourself it’s not going to work very well. Understand that involving others in the errands, routines and hassles of daily life will not only help you, but will provide a tangible sense of camaraderie -- and should lesson the stress of your primary caregiver, too.

Your physician will also be able to provide you with anti-anxiety and sleeping medications. Feel comfortable asking for this. It’s important to get a good night’s sleep and fatigue has a negative effect on everyone’s ability to copy with the next day. Reducing your anxiety level will go a long way to helping you deal with the stress you’re experiencing.

A number of studies suggest that good psychological health may extend your lifespan with ALS, and we know for certain that it improves quality of life. Don’t assume you have to live with stress and anxiety; finding realistic and effective ways to reduce your tension will make every day a little bit better.

Each issue we feature a leading neurologist specializing in ALS responding to a question. If you would like to submit questions for a future Q & A, please send your questions to Amber Walters. Please understand that we won’t be able to address all questions and we won’t be able to respond to individuals personally.