How do you counsel a person with MS?
Not to make this about myself, but I once had a psychologist berate me for not opening up. The problem, however, wasn’t that I was unwilling to talk it was that the situations and circumstances that shape my daily life were the real issue, at least in my opinion. Maybe that’s a form of evasion, but it’s also an honest reflection of how complex these experiences can be.
A recent study on psychological well-being found that internalized stigma plays a powerful role in worsening mental health and reducing participation in physical activity among people with multiple sclerosis (MS). Internalized stigma occurs when someone absorbs and believes the negative stereotypes about their condition. The study showed that stigma strongly predicts higher levels of depression, anxiety, and stress, while also correlating with lower happiness. Among several models tested, internalized stigma consistently emerged as the most robust predictor of psychological distress surpassing even the effects of external, or “enacted,” stigma.
The researchers also found that people who rated their physical and mental health lower on the SF-12 scale (a measure of perceived health status) were more likely to experience stronger feelings of self-stigmatization. This suggests a mutual relationship between perceived health and stigma where poor self-perception of health reinforces negative beliefs about oneself, and vice versa.
Although the overall statistical model narrowly missed significance, internalized stigma was also shown to be a significant negative predictor of weekly physical activity. Psychological barriers such as fear of judgment and feelings of incompetence may contribute to reduced exercise participation. These findings align with previous studies showing that stigma can create a self-reinforcing cycle of avoidance, low self-efficacy, and sedentary behaviour.
But there are ways to begin tackling this. Consider finding a tailored mental health programme, it’s important to connect with a psychologist who not only understands MS but also fits your personality and communication style. Joining an expert-supported physical activity programme can help too; there are many available now, especially after COVID-19. Finally, seek community connections for emotional support, not necessarily online forums, but real-world spaces like book clubs, support groups, or even casual tea and coffee evenings.
Abstract
Sci Rep. 2025 Oct 24;15(1):37306.
A mixed-methods cross-sectional study on the associations between internalized stigma, physical activity, and quality of life in people with multiple sclerosis
Cristina Montesano , Sonia Angilletta , Marco Alessandria , Goran Kuvačić , Giulia Liberali , Laura Guidetti , Andrea De Giorgio
Multiple sclerosis is associated with psychological distress and stigma, which are related to psychological well-being and engagement in health-promoting behaviors. The aim of this study was to examine the association between stigma, psychological well-being, and physical activity, while also exploring relationships with perceived health status and sociodemographic/clinical variables in people with multiple sclerosis. One hundred and twenty-seven participants with multiple sclerosis completed an online survey assessing depression, anxiety and stress (DASS-21), stigma (SSCI-8), happiness (OHQ-8), perceived health status (SF-12) and physical activity (IPAQ-Single Item). Regression models were used to determine the predictors for the psychological outcomes and the level of physical activity. In addition, an open-ended question, analyzed using qualitative content analysis, was used to explore participants’ perceived needs to improve their quality of life. Internalized stigma significantly predicted higher levels of depression (OR = 1.57, 95% CI [1.27-1.94], p < 0.001), anxiety (OR = 1.24, 95% CI [1.03-1.49], p = 0.021), stress (OR = 1.47, 95% CI [1.15-1.87], p = 0.002), and a lower level of happiness (OR = 0.36, 95% CI [0.24-0.56], p < 0.001). Internalized stigma was also associated with lower weekly physical activity (OR = 0.50 [CI95% = 0.31-0.83], p = 0.007). In addition, the qualitative analysis revealed a strong demand for expert-guided physical activity, psychological support, and person-centered care. Internalized stigma was associated with both the psychological well-being and health behaviors of people with multiple sclerosis. An integrated care approach may support not only psychological well-being but also physical activity, contributing to a higher quality of life.
Source: multiple-sclerosis-research.org