#T4TD – sickness behaviour

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This is a first in a new series of ultrashort blog posts called “Thought-4-the-Day” (#T4TD) to make you think about your MS. 

Did you know that MS-related fatigue could be caused by sickness behaviour

Sickness behaviour is a coordinated set of adaptive behavioural changes that occur in response to inflammation and/or infection, which includes fatigue or lethargy, depressed mood & motivation, reduced social exploration, loss of appetite, sleepiness, reduced concentration & attention and brain fog.

If you recognise these symptoms you need to ask if your MS is active? Many people with MS notice an improvement in these symptoms when they start effective disease-modifying therapies.

CoI: multiple

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

8 comments

  • Oh dear, ‘sickness behaviour’ is an awful term! It sounds like a (slightly) more polite version of ‘pulling a sickie’. Many who struggle with MS fatigue also struggle with the suspicion that people think we’re putting it on. ‘Sickness behaviour’ sounds like something you decide to do because you just can’t be bothered. I know that’s not what it means, but it jolly well is what it sounds like, and that is not helpful.

    I wish I had a better idea, but perhaps others do?

  • Exactly my experience. I was shocked when my neurologist attributed my ongoing cognitive difficulties and fatigue to inflammation since not a “relapse”. However Mavenclad has been golden for this. I feel good for the first time in a couple of years (after a six week crash that I believe was a viral reactivation). This was not my experience with previous DMTs.

  • I was shocked when my neurologist suggested inflammation as a cause of my ongoing (not relapse) fatigue and cognitive issues and suggested a switch to Mavenclad.

    Other than a six week crash starting week 10 (which I believe now was a viral activation but i was super discouraged at the time) it has been golden. Not my experience with other DMTs.

    Hypothetical question – if the reactivation of the virus occurred when immune system was depleted but naive B cells were being produced, would that mean these baby B cells would actually be able to fight the virus?

    • Re: “baby B cells” are naive B-cells that are ready to be educated by new antigens (viruses) and make high affinity and avidity antibodies.

  • So is this a physiological thing? Caused by MS activity? And it has nothing to do with ‘secondary gains’ from physical incapacity / symptoms? Could the secondary gains become a psychological normal?

  • You can’t win! There doesn’t seem to be any solution to this either?
    That gave me a warm fuzzy feeling – N0T
    I think we are all sick of being sick; sick of talking about it, sick that there is no cure and sick of side effects of dmds; which only stave off the inevitable and cause as many problems as they cure…in my humble opinion
    I’m sure there is an element of sickness behaviour?
    Isn’t that just inevitable with incurable degenerative illnesses?!
    Let’s ponder what more we can do rather than just avocate taking a non curing dmd…
    Like find the cause and then a cure.
    Hope,not half baked ruminations is the elixir
    As if we aren’t depressed enough already….we would like to be alive, rather than just living to feather the pharma coffers…

  • Funny that, behaving sick when you’re sick…

    You can’t win! There doesn’t seem to be any solution to this either?
    That gave me a warm fuzzy feeling – N0T
    I think we are all sick of being sick; sick of talking about it, sick that there is no cure and sick of side effects of dmds; which only stave off the inevitable and cause as many problems as they cure…in my humble opinion
    I’m sure there is an element of sickness behaviour?
    Isn’t that just inevitable with incurable degenerative illnesses?!
    Let’s ponder what more we can do rather than just avocate taking a non curing dmd…
    Like find the cause and then a cure.
    Hope,not half baked ruminations is the elixir
    As if we aren’t depressed enough already….we would like to be alive, rather than just living to feather the pharma coffers…

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