MS, mood swings, and waterproof mascara.

Waterproof mascara has become my valuable ally against MS mood swings. When my eyes begin to water out of anger or frustration, waterproof mascara keeps me from looking like a raccoon. Wearing it allows for a quicker recovery when life with MS becomes overwhelming.

The littlest things can irritate me now. Last week, just the sight of our cluttered kitchen table drove me over the edge. My husband and son ran for cover as I hurled random papers and half-filled water bottles into the trash. Although our kitchen table really looked like it belonged on an episode of Hoarders, I still hate that I got so upset over the mess.

Mood swings may be an invisible symptom of MS, but coping with them is often as challenging as living with the visible symptoms. It is helpful to know what triggers feelings of anger, frustration or sadness. Being prepared can help when it comes to handling emotions.

Irritating situations trigger my mood swings. Like finding no accessible entrance to my son’s soccer game. (Soccer moms apparently do not need ramps.) Taking a few deep breaths or counting slowly to 10 sometimes helps me calm down.

It’s not just me

Dr. Barbara Giesser, clinical professor of Neurology at the David Geffen UCLA School of Medicine, assured me that mood swings are common in MS. They are caused by neurological changes, the stress of living with an unpredictable illness, or a combination of these factors. She said the disease itself may damage emotional pathways of the brain, resulting in increased irritability, sadness or anger.

Charlotte *, 17, said she struggles with feelings of irritability and anger and is often upset over the smallest thing. “No one really understands what I feel like every day,” she said. “Sometimes my family says I am just being dramatic when I go to my room and close the door. Even though MS sometimes makes me feel alone, when I’m upset I just want to be by myself,” she explained. It’s a challenge getting others to understand her changing moods. She often writes in a journal and listens to relaxing music to cope with her mood swings.

Sheri * has lived with MS for 10 years. Balancing the challenges of MS with the demands of raising a family often depletes her energy. She is well aware that her mood quickly changes when she becomes fatigued. “My fuse is much shorter than it used to be and I get really moody when I’m tired,” she told me. Sheri takes a prescription medication for her fatigue, and also uses relaxation techniques to help her cope with changing moods.

Sometimes it’s a medication

Soon after starting one medication, I felt like I was being followed by a dark cloud. My whole world became gloomy. I told my doctor about my mood change and we decided to switch treatments. I was grateful when the dark cloud disappeared. But as a sleep-deprived new mom, I would have been even more grateful if the doctor had figured out how to make my son sleep through the night!

Sheri also had trouble finding a treatment that didn’t worsen her mood. She described being in a constant state of rage while taking one medication. Her anger lessened considerably after starting on something different. People with MS can react differently to different medications, so if changes in mood or behavior occur, speak up! Several MS medications list anxiety, depression and mood swings as potential side effects.

Dr. Giesser pointed out that it is important to learn whether the mood swings are related to depression, anxiety, fatigue or something else. Some people benefit from individual or family counseling, while others benefit from prescription medications. Today there are effective treatments for mood swings, depression and many other MS symptoms.

Moving can make a mood move

Yoga, tai chi and other forms of exercise are known to help persons with MS manage mood swings. Meditation and relaxation techniques can reduce stress. Christine * heads for the pool whenever she is sad or angry. “Focusing on the movements of my body when I swim quiets my mind,” she said. Christine notices her mood has often improved after a swim. “Swimming distracts me. I usually forget about MS for a little while,” she said.

I try not to blame MS every time I get upset. My MS is not responsible for every bad mood, but it is oddly comforting to know that sometimes it’s MS that makes me freak out over a cluttered kitchen table. Taking a few deep breaths is sometimes enough to keep my tears from coming, but I still wear waterproof mascara just in case.

* People shared their stories with me, but asked for privacy. All the names have been changed.

Kimberly Zolotar was diagnosed in 1995. She lives in California with husband Greg and son Alex, and works as a legal secretary. She is also becoming a waterproof mascara expert.