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It is common for multiple sclerosis symptoms to come and go. Many patients living with MS do not have visible symptoms, or their symptoms may only last for a few hours. Employers, friends, and family members may not understand how MS symptoms can relapse, and it can be very frustrating for those with MS to hear that they should be fine because they don’t look sick.

Living with MS means understanding symptom outbreaks and being able to explain the disease and its symptoms to outsiders. If you suffer from MS or know someone who does, here are tips on how you can cope with and explain common symptoms of MS.

Symptom 1: Fatigue

Fatigue is the most common symptom of MS. Patients will sometimes call it a “fog” of sleepiness. It can be caused by sleep-deprivation (usually caused by nocturnal symptoms such as bladder dysfunction), medication side-effects, depression, or by the amount of energy it takes to complete daily tasks while suffering from MS.

How to Cope

If employers or friends don’t understand your diminished energy, don’t make excuses, like “I didn’t get enough sleep last night” or “I just need to drink some coffee.” Instead, explain to them how you’re suffering from fatigue caused by MS or by the medication that you’re taking. This way, it’s clear that you’re not being lazy but rather are experiencing a symptom flare-up.

After explaining to them what’s going on with you, offer them alternatives. Instead of traveling to the office every day, which may exacerbate your fatigue and make you feel worse, consider visiting an occupational therapist to see if you can work from home. You can also better manage your fatigue at work by taking breaks when you need them and switching to a healthier diet to get those nutrients that will keep you naturally energized.

Symptom 2: Numbness

This is one of the first symptoms patients will experience. The numbness or tingling in the face and/or limbs can come and go and change in severity. The loss of feeling in limbs and extremities can have a huge effect on one’s ability to move. Often, it will only be a mild numbness, but sometimes it can feel as if your limbs are on fire.

How to Cope

Unfortunately, there is no medication as of yet to combat the numbness, although acupuncture and changes in diet can often help. Cooling packs can also help relieve the burning sensation. Others have also suggested mini-meditation to help reduce the numb sensations, as some people’s numbness gets worse when they’re stressed.

If people don’t understand the numbness you’re experiencing, try describing the sensations in vivid detail and show them your coping methods. Showing an outsider what you use to help alleviate symptoms can help them better understand what you’re going through.

Symptom 3: Depression

Because of the degenerative process of the disease, depression is a very common symptom among those with MS. These depressive episodes can last for a few hours or as long as a few months. They are marked by a lack of interest in social activities, a loss of appetite, fatigue, sleep disturbances, agitation, and suicidal thoughts.

How to Cope

Do not alienate yourself simply because you have MS. Talking with your friends and family members about your disease and your feelings about it can help you work through your difficulties and also help them to understand what you’re thinking and feeling.

There are also many MS support groups all around the country – and the world – that you can join to discuss how your disease is affecting your life. Lastly, if you start to think self-harming thoughts, visit a psychotherapist, who will be able to help you work through your emotions.

Symptom 4: Cognitive Function

Half of those diagnosed will experience some sort of cognitive change during the progression of the disease. Memory loss, lack of attention, and visual-spatial perception are some of the common lapses in cognitive function.

How to Cope

If you are experiencing cognitive changes and they are affecting your daily routines, visit a health professional in order to find out where your cognition is lacking and how you can remedy it. There are also certain foods you can add to your diet that can help improve memory and cognitive function.

Memory games and puzzles can also exponentially help improve functioning, and you can invite friends and family members to play with you. Inviting outsiders to help you combat symptoms will teach them how to better help you the next time you have a relapse.

Symptom 5: Sexual Function

While MS does not affect the fertility of men and women suffering from the disease, both men and women experience a lack of sexual interest, inability to perform, or may experience uncomfortable or painful sensations during sex. This is one of the most difficult symptoms, especially for couples and families.

How to Cope

Communication is key when it comes to any sexual relationship. Open up and discuss your discomfort or lack of interest. This may be an opportunity to expand your sexual repertoire, so offer up other activities that you and your partner can engage in that are romantic and comfortable for both of you. There are also medications available to help combat performance issues, so check with your doctor to find one that works best for you.

These five symptoms are some of the most common experienced by those suffering from MS, but they are not the only symptoms. If you suffer from MS or know someone who does, learning about the symptoms and the progression of the disease can better help you understand what kind of life changes are on the way.

Daryl H. Bryant has been successfully managing his MS for 14 years and is the author of MS – Living Symptom Free: The True Story of an MS Patient, a book that covers every aspect of living with multiple sclerosis, from common MS symptoms to the things doctors don’t tell you about MS. Today, Daryl is living a happy, healthy, and successful life, despite his MS, and he writes a weekly blog on how to manage MS symptoms.