The majority of us are feeling really stressed out. According to the American Psychological Association’s latest survey, out this past winter, America’s overall stress level has increased for the first time in 10 years. High anxiety contributes to all kinds of health problems, from headaches and gastrointestinal issues to obesity and asthma. But if you have multiple sclerosis, stress can wreak even more havoc; it can trigger relapses and permanent brain lesions.

There are 400,000 Americans diagnosed with MS, a chronic autoimmune disease of the central nervous system. The University of Chicago Medicine website notes that the exact cause of the disease remains unknown, but researchers do know that MS causes a person’s white blood cells to attack their myelin (a fatty substance that is insulation for nerve fibers). That damages nerve impulses traveling to and from the brain and spinal cord. Resulting symptoms range from mild to severe and include vision problems, balance difficulties, pain, fatigue and cognitive issues.

Eighty-five percent of people with the disease have a type called relapsing-remitting MS. Patients with RRMS have flare ups of MS and periods of stability in between flare ups. Relapses or flare-ups are episodes of new or worse symptoms.

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Emotional stress can trigger these symptoms, according to numerous studies. But it’s not a straight line from point A to point B. “We’re finding it’s continuous stress that activates the immune system, keeping it on hyper-alert,” explains Dr. Dennis Boudette, professor and chair of neurology in the Oregon Health & Science University School of Medicine in Portland.

On the other hand, sudden short-term stress, such as a traffic jam or being late for a meeting, sets a different reaction in motion. “That’s when the anti-inflammatory hormone cortisol kicks in,” Boudette says. “Without inflammation, relapse is less likely.”

The long-term stress connection was driven home with research conducted in 2002 at the University of Pittsburgh. Scientists followed 50 women with MS for one year to see whether major life events affected the activity of their disease. The scientists discovered that almost half of all major life events — such as divorce, death in the family or job loss — were followed within six weeks by an MS flare-up.

There’s more evidence. Over the course of one year, researchers in the Netherlands looked at 73 patients with MS. During the study, 70 of the patients had major stressful events happen in their lives. The scientists found that stress more than doubled the rate of relapse during the four weeks that followed their anxiety-triggering event. Results of the study were published in 2003 in the British Medical Journal.

It’s not just negative stressful events (such as death or infidelity), but positive ones, too (such as a wedding, birth of a child or a new job) that can up the chance of an MS relapse, reports a 2012 study by Northwestern University that tracked 121 MS patients over the course of four years.

No one can avoid stressful events; it’s a part of life. But there’s good news: You can learn to deal with anxiety, and in the process, ward off relapses, according to the same Northwestern University research. During their study, half the MS patients received stress management therapies (which included relaxation exercises, problem-solving techniques and social support), and the other half did not. The scientists took brain MRI scans and discovered that the stress management techniques helped to significantly reduce relapse and lesions.

Think you’re too reactive to be calmed down when stress hits? It turns out even highly sensitive people can reduce their reaction to stressful events. “By nature, some of my MS patients are just more prone to catastrophizing and getting anxious than other people dealing with the same situation,” says Dr. Andrew Newberg, director of research for the Marcus Institute of Integrative Health at Philadelphia’s Jefferson Hospital. “But we’ve found even those naturally fretful patients can be taught techniques to calm their anxiety.”

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Here are some of Newberg’s suggestions:

Meditation. “This practice has been researched widely, and there’s strong scientific evidence showing meditation affects areas in the brain that can help individuals respond to stress more effectively,” Newberg says. There are free meditation apps available.

Regular exercise. Newberg recommends 30 minutes daily of strenuous exercise. “But realistically, it’s dependent on an MS patient’s abilities,” he says. If exercising on your own is difficult, Newberg suggests working with a physical therapist in a pool where the sensation of weightlessness is a big help.

Healthy diet. “When people are stressed out, whether they have MS or not, a common reaction is to eat emotionally — often indulging in calorie-laden snacks and processed foods, Newberg says. “But this kind of diet can cause inflammation in the gut, which in turn, can lead to a stress-induced flare-up.” What’s the best diet? Newberg suggests eating as much of a plant-based diet as possible, avoiding or at least limiting red meat, and reducing sugar and gluten.

Get a good night’s sleep. “You’ll have more energy to deal with stressful events if you’ve gotten a good night’s sleep, preferably 7 to 8 hours a night,” Newberg says. If you have difficulty sleeping, the American Sleep Association offers these tips: Maintain a regular sleep schedule (going to sleep and waking the same time); reserve bed for sleep and sex (no television, computers, or reading in bed); exercise before 2 p.m.; set your bedroom thermostat a little cooler; and if you’re a clock-watcher, hide the clock.

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“Ultimately, one of the best strategies for dealing with stress is identifying what’s making you anxious, and then creating a concrete plan to do something about it,” Bourdette says. “For example, one of my MS patients was an attorney in a stressful law practice. The only way he could reduce his anxiety was to change firms. Sometimes you have to make a big life change to reduce stress — but it’s worth it.”

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What’s the Connection Between Stress and Risk of MS Relapses? originally appeared on usnews.com