Living with, not despite, Multiple Sclerosis

A diagnosis of multiple sclerosis is not something you can just “shrug off.” You are bound to feel a great deal of uncertainty and fear, and you may be angry and frustrated. But life with MS is possible and feasible! 

Multiple sclerosis (MS) is an inflammatory disease of the brain in which, for immunological reasons, there is a loss of myelin, a substance that surrounds our nerve fibers – and these fibers can also be damaged. As a result, signals can no longer be transmitted correctly between nerve cells. The disease process is thought to be triggered by the body's own immune cells, which ultimately leads to the destruction of nerve fibers and cells. The first signs of multiple sclerosis appear in most people between the ages of 20 and 40, although this varies, and with improved life expectancy, MS is also being newly diagnosed in people over 50. The symptoms of multiple sclerosis are highly variable. One reason for this is that the breakdown of myelin occurs in different regions of the brain, which in turn control different functions of the body.

Sensory disturbances (sensory symptoms) and disturbances of muscle function (motor symptoms) are common. The first group includes visual disturbances, numbness, tingling, and other unusual sensations, as well as lightheadedness and dizziness, and difficulties achieving optimal sexual function in both sexes. Motor symptoms include difficulty walking or maintaining balance, tremors, weakness, stiffness, constipation, and problems controlling urine and stool (incontinence).

All of these symptoms are often difficult or impossible to predict, and episodes (known as relapses) can occur out of the blue. These usually subside within days or weeks, leading to partial or complete recovery (remission). However, in some cases, remission may not occur, and the impairment may remain. In general, there is great variability between individual patients in terms of the severity, duration, and frequency of relapses and remission. This means that your individual case cannot be compared with that of other patients. 

Multiple sclerosis is a multifaceted disease that can progress differently in each person affected. While the majority of patients experience a relapsing-remitting course characterized by acute deterioration followed by improvement (remission), approximately ten percent have a progressive form of the disease that is accompanied by steady – sometimes barely noticeable – deterioration. Learn about the different forms of MS and familiarize yourself with the various treatment options. Even though multiple sclerosis is currently incurable, there are several ways to positively influence its course and thus your quality of life. The relapsing form of multiple sclerosis in particular can now be treated very effectively. Together with other medical advances, this has meant that patients with MS can now live to almost the same age as those without the disease.

Despite major medical advances, there is currently no medication that can cure multiple sclerosis. However, there are ways to positively influence the course of the disease in order to enable you to enjoy the highest possible degree of independence and quality of life.

In the vast majority of cases, once MS has been diagnosed, basic/long-term therapy is recommended to slow down the progression of the disease: nowadays, the tendency is to use highly effective drugs at an early stage. Your neurologist will discuss the best therapy for you and work with you to determine an individual treatment approach. Many patients find it irritating that they have to take medication and tolerate side effects even though they have relatively few symptoms. Regular treatment can also make the disease a greater focus of their lives, which means additional stress. However, high adherence to therapy is essential for optimal effectiveness, which is why you should always follow your doctor's recommendations.

In the last decade, doctors recommended interferon-beta or glatiramer acetate for relapsing-remitting MS, or newer oral therapies such as dimethyl fumarate and teriflunomide. Today, more highly active drugs are used at an early stage, such as natalizumab, fingolimod, ocrelizumab, cladribine, or alemtuzumab. If secondary progressive MS with disease activity is present, the (German) guidelines recommend siponimod, interferon-beta, or cladribine, or CD20 antibodies such as ocrelizumab.

In addition to medication, exercise and physical activity have become established as ways in which you can influence MS yourself. Exercise also has a positive effect on your mood, well-being, and zest for life. So, stay active wherever you can: take the stairs instead of the elevator, walk or ride your bike instead of taking the car or bus. Get involved in sports clubs and take up a new sport you've always dreamed of trying. Of course, you should not lose sight of your MS and respect your limits. It is best to ask your neurologist and also find out about physiotherapy, occupational therapy, and speech therapy services. 

Many patients with multiple sclerosis experience phases in which they feel very depressed and anxious. If you notice that this is beginning to limit your everyday life and your zest for life, then it is time to discuss this with your doctor or neurologist. You may also experience increased exhaustion and chronic fatigue, which you should also discuss with your doctor. Do not hesitate to mention any other symptoms that are affecting your quality of life – do not be ashamed of your worries and fears but maintain an open and honest relationship with your doctor and your family. This is the only way to ensure that you receive the best possible help.

Learn about multiple sclerosis and try to network with other people affected by the disease. Good places to start are the national MS societies, and in many cities, there are also MS networks that meet regularly. Often, simply getting to know other patients can alleviate your own fears and show you new ways of dealing with the disease.

Expert advice from Dr. Judith Bellmann-Strobl (specialist in neurology), head of the University Outpatient Clinic for Neuroimmunology, Charité Universitätsmedizin Berlin.

Further reading

• T. J. Murray & Nancy J. Holland: Multiple Sclerosis: A Guide for the Newly Diagnosed.
• Rosalind Kalb: MS for Dummies.
• Multiple Sclerosis Trust (UK). URL: https://mstrust.org.uk/ [as of 06/15/2025]

First published on January 30, 2017
Last updated on October 15, 2025