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Illustration by Dave Cutler

The many dimensions of wellness

Wellness is a holistic effort.

by James Townsend

Wellness is about more than simply managing a disease. Rather, it is a lifelong journey to achieve our full potential as human beings. The National MS Society recently convened 60 experts and conducted a nationwide survey to learn about the wellness needs of those living with multiple sclerosis. The effort confirmed that there are many interconnected dimensions of wellness, including physical, occupational, social, emotional, intellectual and spiritual components. Read on to learn how people can apply these aspects of wellness to their own lives.

Physical wellness
Lauren Munhoven, 31, of Ketchikan, Alaska, had her first severe MS attack in 2008. She took disease-modifying therapies (DMTs) to limit her relapses but still experienced symptoms ranging from vertigo, loss of hand dexterity, and numbness to optic neuritis and foot drop. She attempted to improve her overall health with weight-control diets, but it wasn’t until 2015 that she made a new determination to incorporate physical activity into her life.

Lauren Munhoven and her daughter, Madeline. Photo courtesy of Lauren Munhoven

Lauren Munhoven and her daughter, Madeline. Photo courtesy of Lauren Munhoven

“I started walking and attending fitness classes,” Munhoven says, “and in December I started running.” Today she runs two to four times a week, and has not had a relapse since she began to exercise. “At first I was afraid that I would stress my body too much, but the truth was that I had to let go of the fear and get out of my comfort zone.” That said, it’s important to modify physical wellness to one’s abilities—and limits.

For example, Munhoven’s regimen isn’t possible for Phoenix-area resident Clay Cotton, 69, who was diagnosed 25 years ago and who has used a wheelchair for the last 10. But he has found a level of exercise that benefits him. “Because MS can cause progressive contraction of muscle tissue, stretching is extremely important,” he says. “Just stretching my fingers and biceps—everything I can, all day long—helps relieve some of my painful symptoms.”

Physical wellness also includes regular medical care, weight control and proper nutrition. Though there is no “MS diet” with substantial clinical proof of efficacy, a diet that incorporates lean protein, healthy fats, adequate fruits, vegetables, fiber and fluids, and limits sugar and processed foods is often recommended. “I used to think eating healthy was frozen, prepared diet foods,” says Munhoven. “Then my personal trainer taught me about healthy nutrition—eating real and fresh food, and enough of it. It has made all the difference.”

Occupational wellness
Shannon Auge, 39, a San Diego-area resident diagnosed in 2004, had worked as a bookkeeper for the same company for 17 years. “I was really good at it, and it fed me intellectually. But as my symptoms increased, my doctor noticed that I was beginning to have cognitive impairment. At first I was able to push past most limitations, but eventually I had to quit,” she says.

“The job had provided a large portion of my sense of self-worth, and so at first I felt some embarrassment and shame from suddenly being out of the workforce, but it forced me to ask, ‘What else am I good at?’ ” she says. Auge increased her volunteer work at her church, mentoring teens. “Teens love their parents but need another adult to love and trust.”

It helped Auge, too. She discovered, as many people do, that when she was able to contribute her unique skills, talents and knowledge to her community—regardless of whether she was being paid—she felt a renewed sense of purpose. After a year of volunteering, the church asked her to become a part-time employee.

Though Auge has been on the church staff for nearly six years now, she averages about six hours per week and still has plenty of time to volunteer, and believes volunteering is a great way to make meaningful contributions to others. “The reward,” she says, “is no longer in the paycheck but in the importance of the work being done.” (For more of Auge’s story, see “Forging a new identity.”)

Social wellness
Being involved and connected with others socially is also vitally important for well-being and overall health.

“Because MS can be a potentially isolating experience, we have about 1,200 self-help support groups around the country, mostly peer-led, that provide an important connection for people living with MS,” says Kathy Costello, an MS nurse practitioner and associate vice president, healthcare access, at the National MS Society. “The groups decide on topics of interest, and have speakers and activities to meet the needs of that particular group,” she says. “We also have MSconnection.org, where people develop online chat groups, and MS Friends, where people can talk one-on-one with others who have MS.”

For her part, Munhoven has discovered the perfect way to engage socially. “Since I began this exercise regimen, six more of my friends, all mothers like me, have joined the workout group,” she says. “It helps so much to have friends on board sharing my interest and enthusiasm.”

Emotional wellness
“MS can bring on a variety of emotional challenges, such as depression, anxiety or heightened stress,” Costello says. Managing stress, developing coping strategies and building resilience can help people deal with the unpredictable nature of the disease.

Photo courtesy of Connie Kirchner

Connie Kirchner. Photo courtesy of Connie Kirchner

Connie Kirchner, 60, of Mount Joy, Pennsylvania, who was diagnosed in 2004, knows these challenges well. Like Auge, she had to leave her job as her symptoms progressed. “I lost my purpose. On top of it all, I had depression. I had a really rough couple of years,” Kirchner says.

Costello points out that many people, like Kirchner, experience depression as a result of the changes that MS can bring, but it can also be a symptom of the disease itself.

“However,” adds Kirchner, “I began writing to get things off my chest—little stories, letters to the editor, Facebook postings. Mostly I complained about things, like how hard it was to get around in rain or snow, or how tough it is to be a woman who uses a wheelchair because no clothes fit right. But I always put a little humor in there, and people began responding positively, saying how much they appreciated what I was writing.

Once I discovered writing as a creative outlet I was able to foster a more positive outlook, and now I manage my depression well with medication.”

What’s more, Kirchner found that the connections she made from writing “blossomed into a social network.” Now she gets out more, attending church and exercise programs, and illustrating how working on one dimension of wellness—improving emotional well-being through her writing—can have positive effects on other aspects, such as developing her social and physical wellness.

For more on developing coping strategies in the face of MS or other challenges, visit Resilience: Addressing the Challenges of MS.

Intellectual wellness
Mentally stimulating activities can lead to enhanced creativity and new learning, while reinforcing the ability to think objectively and independently.

“Work—whether paid or volunteered—in addition to providing many other benefits, also can be mentally stimulating,” Costello says. So too can reading, learning a new hobby or taking a class.

Photo courtesy of Clay Cotton

Clay Cotton. Photo courtesy of Clay Cotton

For Clay Cotton of the Phoenix area, even being able to connect with others by telephone or Skype has served him well. “I have found,” he says, “that talking with my good friends every so often, and especially my wife, about ideas and philosophy has really contributed to my intellectual well-being.”

Spiritual wellness
For Munhoven, running provides a perfect way to stay attuned to her spiritual well-being, find meaning and connect with a sense of something larger than herself. Spirtuality is not necessarily related to religious worship. “I run alone sometimes, and use the time to clear my head, regroup and thank God for putting me here and helping me stay ahead of my disease,” she says. “When I need to push through, I will think how lucky I am to have the life I do. Having gratitude, I find, is important.”

Cotton says that becoming physically disabled by MS has been something of a spiritual education for him. “Perhaps the most powerful thing I’ve learned is that we must go beyond the limitations we carry inside, our self-definitions and fears. Meditation is one thing that has helped me to become my nicest, best self, and learn how to be in peace and presence with what is. That, my friend, is spiritual growth!”

James Townsend is a freelance writer and editor in Boulder, Colorado.
Spring 2017

To find help managing symptoms, call an MS Navigator at 1-800-344-4867.

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