‘Married …with Children’ Icon Christina Applegate, 54, Insists She’s ‘Not Tired,’ But Coping With ‘Profound Fatigue’ Amid Multiple Sclerosis

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In the podcast, Applegate explains, “People don’t get it. They don’t get how it feels … It’s not tired.

“I really hate that, when someone’s like ‘Oh, you’re tired today’ … No. ‘Are you fatigued today?’ … No.”

She continued, “‘Do you you feel like you’re on horse tranquilizers?’ … Yes. And that is one of the, the plagues of what we have.

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“And honestly, I’m the one over here asking you guys that question because I don’t know what to do right now about that feeling.”

Fans weren’t shy to express their gratitude on how happy they are that Applegate is so open with her MS journey, with one commenting, “Love this podcast and how real you are about the MS experience … for so long I masked it to make everyone else around me comfortable, but you have helped allow me to be real and raw about it which is SO much healthier.”

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Another commented, “The amount of times I’m told to just ‘have a big sleep’…. I get people want to offer help but sometimes they just have no idea that some extra shut eye will not fix this.”

A third wrote, “People will say, so how are you feeling? And honestly, all they want to hear is ”good’ or better!’ They don’t really know what to do with ‘well, I feel like s**t for 90 percent of every day’ other than ‘well, you look great!’

“It’s definitely a case of ‘You don’t get it until you actually GET IT,” a fourth supporter of Applegate commented.

Making light of her situation, even more, Applegate responded to the comment, “You feel like you’re carrying weights through water or quicksand,” with sharing a “new fun symptom” she has— “When I walk all my toes feel like I am being stung by bees.”

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Another fan commented, “I FEEL YOU!!!! I’m done explaining how it feels, because some people just don’t get it.

“I’m sooo over it! I have multiple chronic illnesses and explaining myself over and over is f**king draining!!! THANK YOU SO VERY MUCH FOR BEING REAL AND HONEST ABOUT IT!!!! Sending love and prayers. We got this. We are strong!”

According to the National Multiple Sclerosis Society, “About 80% of people with multiple sclerosis live with fatigue. Fatigue may be the most common symptom in people who otherwise have few activity limitations.

“Fatigue can interfere with your ability to function at home and work. We don’t know what causes MS fatigue, but there are ways you can manage it.”

The National MS Society explains that fatigue is one of the most widespread and disruptive symptoms of MS, affecting most people with the condition. Unlike everyday tiredness, this type of fatigue can come on suddenly, occur even after restful sleep, worsen as the day progresses, and be intensified by heat, making it difficult to keep up with daily responsibilities and maintain quality of life.

Since MS is not easily measured, fatigue is often misunderstood, even though it is not simply caused by depression or physical limitations. While its exact cause remains unclear, the society emphasizes that fatigue can be better controlled through individualized approaches such as conserving energy, staying physically active in safe ways, managing sleep and temperature, and using therapeutic and psychological supports.

Christina Applegate’s MS Journey

Multiple sclerosis is a potentially disabling disease of the brain and spinal cord. The disease causes the immune system to attack cells that form the protective sheath that covers nerve fibers in the spinal cord. The disruption leads to communication problems between the brain and the rest of the body.

Once the protective barrier is damaged, the spinal cord struggles to send messages to arms, legs, and other parts of the body to function normally.

Applegate began experiencing symptoms of the condition long before she had answers. She actually said she felt off balance during a dance sequence that occurred way back in season one of her dark comedy “Dead to Me.” She later noticed her aptitude for tennis started to fail.

“I wish I had paid attention,” she previously told The New York Times. “But who was I to know?”

It took several years of worsening tingling and numbness in her extremities before her diagnosis arrived while on set. This life-altering realization wouldn’t stop Applegate from finishing her portrayal of Jen Harding, but she did need a break. Production of the final season ceased for about five months as she began treatment.

“There was the sense of, ‘Well, let’s get her some medicine so she can get better,’” Applegate said. “And there is no better. But it was good for me. I needed to process my loss of my life, my loss of that part of me. So I needed that time.”

Applegate admits she’ll never fully “accept” her condition, but she did learn how to work with it. And she’s previously talked about how the show was a cathartic outlet and safe space.

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“I had an obligation to Liz [Feldman] and to Linda [Cardellini], to our story,” she said of the show’s writer and her co-star respectively. “The powers that be were like, ‘Let’s just stop. We don’t need to finish it. Let’s put a few episodes together.’ I said, ‘No. We’re going to do it, but we’re going to do it on my terms.’”

Applegate wasn’t able to work as hard or as long or in the heat without her body giving out, but she found pride in her self-sufficiency. With the help of some adjustments to the schedule, she powered through. Nicole Vassell, a writer for The Independent, says other programs should learn from the way Applegate’s “physical changes [were] seamlessly incorporated into the show.”

“This is the first time anyone’s going to see me the way I am,” Applegate said. “I put on 40 pounds; I can’t walk without a cane. I want people to know that I am very aware of all of that.”

In a later episode of the “MeSsy” podcast, Applegate shared that she has since lost the 40 pounds naturally, without using any weight-loss medications. She joked that the weight came off as a result of stomach problems linked to the medication she takes while managing her MS.

Understanding Multiple Sclerosis

Multiple sclerosis causes the immune system to attack cells that form the protective sheath that covers nerve fibers in the spinal cord. The disruption leads to communication problems between the brain and the rest of the body.

Once the protective barrier is damaged, the spinal cord struggles to communicate to the body’s arms, legs, and other parts to function normally.

The National Multiple Sclerosis Society lays out the different types of multiple sclerosis:

• Clinically isolated syndrome (CIS) is when an individual experiences a single neurological episode lasting 24 hours or less. CIS is what MS is diagnosed as until there is a second episode.
• Relapsing-remitting MS (RRMS): The most common MS among the million people battling the disease in the US, RRMS is marked by sudden flare-ups, new symptoms, or worsening of symptoms and cognitive function. The condition will then go into remission for some time before reemerging with no known warning signs.
• Primary progressive MS (PPMS): These individuals have no flare-ups or remission, just a steady decline with progressively worse symptoms and an increasing loss of cognitive and body functions.
• Secondary progressive MS (SPMS): This almost transitional form of MS progresses from RRMS to PPMS.

In addition to balance issues, numbness, and tingling in the limbs, as Applegate experienced, other common MS symptoms include vision and bladder control problems. Mood changes and mental and physical fatigue are other symptoms people living with MS may experience, according to the National Institute of Health.

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The National Institute of Neurological Disorders and Stroke explains this disease as: “An unpredictable disease of the central nervous system, [MS] can range from relatively benign to somewhat disabling to devastating, as communication between the brain and other parts of the body is disrupted.” Investigators of the disease believe it to be an autoimmune disease.

Many people fighting MS experience muscle weakness and difficulty with coordination and balance, so it’s absolutely incredible and encouraging that Applegate was able to present an award in front of so many people at the Emmys.

Currently, there is no cure for MS, although some people treat the disease using chemotherapy, medications, or steroid drugs.

Mental Health: The Basics

The term mental health refers to both our emotional and psychological well-being. Our mental health can affect how we think, feel, and behave. Certain triggers like stress, traumatic events, or change in your physical health can affect mental health. It’s really important to keep tabs on your mental health and, if necessary, seek treatment. This doesn’t necessarily mean traditional therapy because while it may be really helpful (even life-changing) for some, that doesn’t mean it’s for everyone.

Problems with mood and overall mental well-being can be attributed to several factors. For some people it’s genetic, while others may be experiencing a response to some sort of stressor or past trauma.

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In order to keep your mental health in check, it’s important to be aware of signs which can be subtle that there is something affecting your mind. These signs include:

• A change in eating or sleeping habits
• Losing interest in people or usual activities
• Experiencing little or no energy
• Numb and/or hopeless feelings
• Turning to drinking or drugs more than usual
• Non-typical angry, upset, or on-edge feelings
• Yelling/fighting with loved ones
• Experiencing mood swings
• Intrusive thoughts
• Trouble getting through daily tasks

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These symptoms can be wide-ranging and vary a great deal from person to person. Everyone experiences grief differently, for example. However, if you are feeling unusually sad, on-edge, or like you’re no longer interested in activities you used to love, know that there are many treatment options available and many different healthy ways to help you cope.

Coping With Grief Related To Health Problems & Depression

Dr. Scott Irwin, a psychiatrist and Director of Supportive Care Services at Cedars-Sinai Medical Center, says it’s crucial for patients to talk to their care team about their mental health.

“We all get depressed from time to time, have a sad day, feeling down and blue – that’s part of normal human emotion, part of normal life,” Dr. Irwin explained.

“Some of us, when we’re dealing with difficult things such as a diagnosis of cancer, may be sad or down or blue more often. And sometimes it gets to the point where that depression can be a little bit overwhelming, and we help them through therapy, through non-medication interventions.”

There are many ways to address mental health issues as a cancer survivor. Options may include:

• Meditation
• Practicing mindfulness
• Talking with a therapist
• Joining a support group
• Medication, such as antidepressants

Medication

When doctors and patients together decide that medication is necessary, it’s important that doctors choose wisely.

“I often try to choose medications with the lowest side effect profile,” Dr. Irwin said. “If patients are getting hormonal therapy, there’s particular antidepressants that we can’t use because they may lower the effectiveness of that hormonal therapy and so we choose antidepressants that don’t impact the cancer care.”

This shows how important it is to have communication between everyone you’re seeing, so they can be on the same page about your treatment and options.

Dealing With Grief Related to Health Problems

Another way doctors can tailor mental health medications for their patients is through genetic testing.

Psychiatrist Dr. Lori Plutchik says genetic testing through companies like Genomind can help doctors understand how likely it is a patient may respond to different types of psychiatric medications.

“Doing the genetic testing has absolutely transformed the landscape of psycho-pharmacology,” Dr. Plutchik told SurvivorNet. “It’s something that I highly recommend for anybody who is taking medication, whether they are being treated for cancer, or not.”

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Dr. Plutchik also explained that genetic testing can be specifically helpful for cancer patients because it may help avoid trial and error when it comes to choosing a mental health medication that does not interfere with their cancer treatment.

“So, a person who is dealing with this and may have to go on chemotherapy has already enough on their plate that they don’t really want to start dealing with trial and error with medications,” she said. “So, it gives me information about which medications are likely to work without having problematic side effects, and it also gives information about interactions between any of the psych medications that we choose and the chemotherapy agents that they may be taking.”

Support Groups

Whether you’re coping with an illness, an emotional problem, or life transition, a support group can be a place where people in the same boat, or a similar situation, can come together.

But maybe you’re a little unsure or skeptical about joining a group. What will it be like? Are you expected to share your story?

Dr. Amy McNally, gynecologic oncologist with Minnesota Oncology, tries to reassure her patients that chances are, they’ll derive some benefit.

“I think in a support group you’re going to find women who are in similar situations but yet can share their unique stories,” she says.

“Just being there is worth it. You don’t have to share a thing. You can just sit and listen, or you can be part of the conversation and offer your thoughts. And it can be different every time you go, it’s your choice as to how or whether to participate and what you decide to get out of the group.”

McNally thinks it can be helpful and comforting to be around people who know what you’ve been through, or are going through, and that in and of itself is reason enough to try it out.

Therapy

“People that are struggling with coping with the experience, coping with body image should reach out to their doctors, find a therapist in the community,” says Dr. Irwin.

A patient navigator or social worker can also help connect you with a mental health professional that you can talk to to help process your emotions.

“It’s about meeting the individual patient where they are and their feelings, how they’ve always dealt with their body image, what the body image changes mean now in their lives and their relationships, and how they can move forward given the new reality,” Dr. Irwin said.

Mindfulness

Jon Kabat Zinn, founder of the eight-week stress-reduction program, Mindfulness-Based Stress Reduction (MBSR), a course that has entered the mainstream of health care, scientific study, and public policy, describes mindfulness as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.”

Mindfulness is often suggested for cancer patients to reduce high levels of anxiety and distress associated with diagnosis, treatment, and anticipation of possible disease recurrence.

Both the American Society of Clinical Oncology and the Society of Integrative Oncology recommend meditation as part of a multidisciplinary approach to reduce stress, depression, and mood disturbance, and to improve the quality of life in cancer patients. But the question remains: does it really work? We think it does.

5 tips for practicing mindfulness:

• Choose one daily activity to practice mindfully (e.g. eating your lunch, brushing your teeth or taking a shower). During this activity notice your breath and activity of your mind for a few moments.
• Take a pause throughout your day. During your day, find a moment to stop and take 5 deep breaths with your eyes closed.
• Kindly acknowledge a moment you’re experiencing a difficulty, by putting your hand on your heart and saying, “Feel my pain. How can I be kind to myself in this moment?”
• Get curious about your emotions. Experiment with welcoming your emotions as they come, instead of pushing them away.
• Become aware when you’re in a rush. Ask yourself, “Do I really need to hurry?”

Meditation

Regularly meditating allows people to start to become more aware of the emotions in the physical body and the thoughts running through the mind, to acknowledge their thoughts as they arise, and then gently let them go.

Shannon Masur, a colon cancer and Lynch Syndrome survivor, describes this as “when a thought comes in, to feel it, feel the fear, but let it go after a few seconds.”

All of this is said to result in an overall reduction in stress and anxiety in the body. It may also help patients to control problems such as pain, difficulty sleeping, tiredness, feeling sick and high blood pressure.

For help getting started with meditation, here’s a guided session to try.

Overall, don’t forget to prioritize your mental health if you’re facing cancer. You might feel like your mind is the least of your worries while fighting the disease, but it’s important to know just how big of an impact your mental well-being can have on your health as a whole.

“Actually, there’s data that if you have extra stress or depression that you may not recover or you have a higher risk or recurrence,” Dr. Irwin said. “So… in treating the depression, we’re actually impacting the cancer care outcomes.”

Contributing: SurvivorNet Staff

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