STRESS AND MYASTHENIA GRAVIS (MG)
Most myasthenia gravis patients learn very quickly that
emotional stress and excitement affects their MG. Stress
causes many physical changes in ones body and uses up
energy. The end result of tense muscles caused by stress
can be similar to the effect of vigorous exercise it may
exacerbate your symptoms of weakness. Much of the
literature cautions people with myasthenia to limit their
stress and avoid conflicts, but you might well ask, How? when life is by nature stressful and
full of conflict. Indeed, stress and conflict can be positive forces such as the challenges that
bring about personal growth or the good stress that you feel when youre happily excited.
Without stress and conflict, life would be boring. The answer perhaps should lie not in
eliminating stress in your life, but in learning better coping skills to deal with it.
While the sources of individual stress can be varied and personal, some common sources of
stress in the person with MG can be:
1. MG symptoms and the accompanying frustration and anger when your body cant do
what you want to do when you want to do it.
2. Anxiety from continual worry that new symptoms may appear; anticipation of day to day
fluctuations in strength, or a fear of crises. Anticipation of medication side effects
such as diarrhea or potential long term side effects of steroids can also cause anxiety.
3. Dissatisfaction with personal appearance. Drooping eye lid(s), weight gain (fluid
retention), weak facial muscles (causing an inability to smile), and slurred speech can
cause loss of confidence, lowered self esteem, and avoidance of social contacts.
4. Significant changes in lifestyle, such as having to quit your job, going back to school,
giving up caring for the home, yard, and children. These are the things that are part of
your identity. When you lose them, you may feel depressed and cheated at times.
5. Interpersonal relationships may be strained as you (and your family) try to cope with the
limitations of MG and changes in your lifestyle. The person with MG may believe
their status and family role has become less important and even feel like a burden on
the family.
6. The range of emotions you may feel from time to time (a few herein mentioned were
frustration, anger, guilt, depression, fear and anxiety) may be difficult to handle.
Emotions which run rampant or mood swings can cause family members to walk on
eggshells around the person diagnosed with myasthenia gravis.
7. Feeling stigmatized by MG or believing that one is somehow different from others. This
can lead to withdrawal from social activities and a sense of remoteness from family,
friends and co-workers.
8. Lack of understanding about MG, when family members and friends find it difficult to
understand why weakness can vary daily or even hourly (especially when you look
well), it can leave them feeling cheated and resentful. When MG is a mystery to you,
it can leave you fearful of the unknown.
Here are a few constructive steps one can take to minimize stress:
First, realize that its okay sometimes to feel frustrated, scared, angry, and depressed.
All of us do. Accepting your illness doesnt mean you have to like it. It only means
that you realize your body has some limitations, and denying it wont make it go
away, so you might as well work at having the best life you possibly can. In other
words, concentrate on all that you can do, all that you have, and all that you are (which
certainly is a lot!) rather than concentrating on what you cannot do.
Avoid self-pity. It builds Stress, zaps your energy, and doesnt help you. As Abraham
Lincoln once said, Most people are about as happy as they make their minds up to
be.
Take charge of your life. You control our own behavior and attitudes, and can work
on developing more positive behavior.
If youve always been an overachiever and you are still pushing yourself too hard,
learn to slow down. You may be able to do almost everything you used to do if you
balance your day with periods of activity sprinkled with little periods of rest.
If you have always been an underachiever and an inactive person, resist using MG as
an excuse for doing even less. When you use your diagnosis as an excuse too often
when you dont need to you run the risk of reducing your credibility with your family.
Because the weakness is often invisible to others, they find MG hard to understand
anyway. Try to remain active and involved with your social groups, finding activities
which are within your limitations.
Know yourself. MG affects everyone differently. While some people are severely
weak and fatigue rapidly, other MG patients are working full time, jogging and
playing racquetball. It is important for you to learn what your own capabilities and
physical limitations are. Venture trying new activities. Pace yourself; know when to
slow down or when youve had enough. Get enough rest and sleep.
If family members dont understand MG, try to involve them in your treatment,
encourage them to ask your doctor questions, take them to MG meetings so they can
learn more about this muscle weakness disorder. The same applies to your friends.
Many MG patients conceal the fact that they have a problem from others, and thats
okay. Its not always appropriate to broadcast it, particularly when it could jeopardize
a job. But if you want to explain it to some of your close friends, it may help reduce
your stress. Remember: A friend is someone who knows you well . . . . and likes you
anyway!
If you dont understand MG very well, dont be afraid to ask questions about anything
and everything that concerns you. Between appointments with your doctor, make a
list of your questions and symptoms that you want to mention. This can help prevent
the stress of Why didnt I remember to ask about . . . .? Many anxieties and fears
about MG are unfounded, and learning more about myasthenia gravis can put your
worries at ease.
Learn how to express your emotions constructively with your family members and
close friends. Communicating your thoughts can aid mutual understanding and
support, and bring you closer together at a time when you need it most.
Consider others more and yourself a little less. Love more. Love can be as healing as
potent medication.
Laugh more; it relieves stress. Learn to laugh at yourself, so you dont take yourself
to seriously.
Avoid loneliness. Seek out compatible friends. Take the initiative; join clubs or take a
stimulating class. Participate in MG activities where the support from other people
with myasthenia can erase that feeling of being alone with this disorder.
Take time each day to make the most of your personal appearance. Good grooming
habits, pretty makeup, an attractive and easy hairstyle, and flattering clothing which
conceals or distracts the eye from weight gain all go a long way. For diet tips which
can help minimize fluid retention, ask your nurse or dietician.
If your health permits, get regular exercise. Exercise helps work off stress. Start out
slow with an early evening walk or a game of croquet on the lawn. Its pleasant time
spent with family, too.
Develop hobbies and interests such as reading, needlepoint, exotic cooking, or
painting. Immersing yourself in a hobby helps dissipate tension.
Look into stress management classes or go to your library for books or tapes on
relaxation techniques. A few techniques include meditation, yoga, or visualizing
restful scenes.
Seek professional counseling when your self-concerns or family problems threaten to
overwhelm you. All of us need extra help at difficult periods in our lives.
These behavioral tips are not magic, but with practice, they can help you to reduce stress and become happier. So make the effort it will be well worth it.

I had to look up the support group for myasthenia gravis (MG) so I could figure out if I could help. WishKittie's suggestions are great.

I'd do a pain/numb picture with a journal to help you find the patterns of comfortable stress. This is important to know to help keep your facial muscles from going into "acute alert" during a natural change in stress level.

I have had Bell's Palsy three separate times, shingles in the jaw with post shingles pain, so I had to learn how to physically reduce the impact of the sudden changes due to stress.

Learn your flow motion with your facial expressions, I stand in front of the mirror and see what's working and what's needing a little or lot of extra support. I move my tongue to loosen up the sounds (otherwise the nasal tone tunes in fast).

Where I feel weakness, I relax and test the sensation. This makes it easier to choose whether to move from right to left or left to right.

Best wishes, and hope you have a good day.