The importance of assessing life stress exposure in multiple sclerosis: A case report

This case report describes associations between childhood adversity, adult stress exposure, and Multiple Sclerosis (MS) to highlight the intersection between mental health and neurological illness in persons with MS (PwMS). We focus on a high-adversity, high-resource patient who self-referred to mental health services for depression and suicidal ideation, without ever being screened for past or current stress exposure. MS and common comorbid symptoms (e.g., fatigue, depression, suicidality) may be affected by adversity and compounded by pandemic-related stressors, including socio-political and economic sequelae. This case illustrates the potential benefit of screening for lifetime stressors as a mechanism to improve case conceptualizations, enable referrals to mental health specialists to promote coping and resiliency, reduce future MS morbidity, and illuminate stress as an important research focus that deserves further exploration in PwMS.