the relationship between life stress and relapse is complex, and is likely to depend on factors such as stressor chronicity, frequency, severity and type, and individual patient characteristics such as depression, health locus of control and coping strategy use. Little is known about how these factors, individually or in combination, are related to MS disease activity. Viral infections are also likely to precipitate relapse in MS, and significant life-stress may further enhance this relationship. The nature and strength of these interrelationships have strong clinical implications. MS patients are particularly vulnerable to a deteriorating cycle of stressful life events, illness episodes and disability. Timely multidisciplinary care interventions aimed at both minimizing psychological distress and physical symptoms may halt this downward reciprocal cycle.
As people with MS already know, the connection between MS and stress isn't just about what happens in the brain that might allow stress to trigger a relapse. It's about what happens in the life of an MS patient: stress triggers relapse and disability; disability triggers stressful life changes (job loss, relationship difficulties, depression); stress triggers another relapse and disability. It's a deteriorating cycle.
The tricky part is getting "timely multidisciplinary care interventions." I don't think there's a practitioner involved in my treatment who is tasked with coordinating multidisciplinary care. I don't think it's my primary care doc; I see him maybe once or twice a year. I think it's up to me: I'm the only person who's in a position to provide the information to each practitioner about what's going on with the others. I'm comfortable with this kind of self-advocacy, and I think I'm doing an okay job. But I don't have any medical expertise, and my ability to advocate for myself may be compromised at a time when I'm most in need of multi-disciplinary care interventions.
Whose job is this?