This presentation was part of the 2023 Holistic Health and Wellness Forum for MS held on May 17 in Southfield, Michigan.

Evan Smith, PhD at the University of Michigan Medical Center knows that finding motivation can be difficult with a neurologic disease. Do you have a difficult time motivating yourself? Have you had a new diagnosis, a recent relapse or change in severity of your disease? Read on to earn how to boost motivation to help you live a happier life with MS.

YOU are the world’s foremost expert on YOURSELF -Dr. Evan Smith

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Live your values

The best way to motivate yourself to undertake lifestyle change is to identify your why and act from your values. Your values will serve as a guide to navigate obstacles on your MS journey. Values are concepts about who we are and what you hold to be meaningful. They are a framework to approach daily living and might include creativity, independence, kindness, respect, or trust. They are individualized preferences and are not good or bad. They are generally consistent but can change and grow over time.

Evolution is important and reevaluating your values regularly over time is important. Acting in accordance with our values allows people to thrive. Not acting from our values causes suffering. Values give us hints about our motivation.

Questions to ask yourself to live your values

On a scale of 0-10 how confident am I that I’m able to do an activity and how important is doing that activity to me?

0 is not important where 10 is critically important. If you’re 7/10 on both questions then you’ll likely try the activity once.

Goals are the map to lead the meaningful life you want to live.

A life well lived includes many aspects

Building values around each of these aspects of life is important.

  • Health and how you engage with your health
  • Nutrition
  • Movement
  • Family roles and responsibilities
  • Cultivating support networks
  • Education and work
  • Spirituality and believing in something greater than yourself

Take action and navigate barriers

Practice daily even if it’s just for five minutes. Use support networks of family, friends or others with MS like the Yoga Moves MS community to set goals, share wins and keep up your motivation.

Try the ADAPT method to manage fatigue

Seventy percent to 90% of people with MS experience fatigue making it one of the most common and intrusive symptom in multiple sclerosis.

  • Awareness – Become aware of your physical energy, and emotional energy. If we overuse one we will end up fatigued. Mix and match to find the right balance
  • Delegate – Delegate tasks to your family or friends in your network. Choose a functional approach over a rigid approach to do the best you can and prepare in advance for varying levels of energy.
  • Align – Patterns in our life crop up as short term and long term coping strategies. Short term strategies lead to unintended consequences. Fatigue requires rest which means we’ll be doing a lot less in our life and we may get in the habit of under-doing to always conserve energy or the boom and bust cycle where we use up all our energy and burn out (which can amplify MS symptoms.)
  • Prioritize – Choose the activities that are most important to you and spend your limited energy doing them first.
  • Time-based pacing – To get he most out of an activity without burning out, listen to your body and alternate activity with rest. Intentional rest allows for less susceptibility to burnout and allow you to do more in a day.

Barriers to full participation

  • Pain – Consult your health team to see what can be done and incorporate a mindfulness practice into your daily routine.
  • Low mood – Seek counseling or a support group. Talk to your health care team about medications that may help improve persistent low moods.
  • Limited access – The word is still not totally accessible to those with limited mobility or those who need to use the toilet frequently or need to rest often. Call ahead when you can to assess accessibility and plan for breaks.

Set SMART Goals for yourself

  • Specific – Identify who needs to be involved, where and when will it happen?
  • Measurable – Progress is not linear, but progress is important. Record your progress over time.
  • Action oriented – Think of the first three steps then take action on the very first small action you can take towards accomplishing them.
  • Realistic – Balance optimism and navigating barriers ahead of time.
  • Time frame – Chose a realistic time frame and give yourself a buffer to minimize stress and plan for unexpected obstacles that may arise.

A well-lived life with MS requires daily practice

Identify your goals, the barriers to achieving them and how they align with you values. Set monthly SMART goals that will get your 1% closer to the life you want to live.

There are many resources to tap into like support groups, events, and podcasts. MS is characterized by psychological and physical disconnection. We must reconnect with ourselves and our community.

To help with reframing your mindset Dr. Smith recommends reading The Happiness Trap, a book by Russ Harris, the founder of Acceptance and Commitment Therapy.

Dr. Evan L. Smith (he/him) is a Rehabilitation Psychologist and Clinical Assistant Professor in the Department of Physical Medicine & Rehabilitation (PM&R), Division of Rehabilitation Psychology and Neuropsychology (RPN). He serves as the attending psychologist in the University of Michigan Multiple Sclerosis (UMMS) Center, a Comprehensive Center for MS care as designated by the National MS Society. His clinical role focuses on providing evidence-based psychotherapy services with patients and families living with MS, chronic health conditions, and disability through an interprofessional team-based approach. He has partnered with the NMSS in several roles, including serving as a member of the Mental Health Steering Committee, the Psychosocial Wellness Research Subgroup and as the UM Training Director for the NMSS Clinical Psychology Mentorship program. Dr. Smith is passionate about expanding access to care, serving historically marginalized/underserved communities and is the Co-Director of the PM&R RPN Health Equity and Antiracism Taskforce (RPN-HEART).