41 msfocusmagazine.org coping with a chronic illness, and if it is blocked, further psychological well-being will be limited. It is a natural process to experience grief followed by a period of adaptation. Coping and adapting to the challenges of MS,especiallytheemotionalones,isimperative, but studies suggest that time may have a large role in your ability to do that. Higher rates of resiliency, or one’s capacity to tolerate and adapt to the fluctuating challenges of living with MS, are correlated with an older MS population. This suggests that with time, resilience increases, both from the experience gained in responding to the adversities of living with the disease, and from being able to grieve changes that are re-experienced when symptoms remind one of their loss of former functioning. As the pain of grieving gradually eases over time, one is able to begin to make positive adaptations to whatever changes have occurred. The capacity to mourn the losses caused by MS and experience post-traumatic growth are key factors to coping well over time. Although psychiatric conditions are high among individuals living with MS, many do not exhibit clinically significant levels of anxiety, depression or other serious mental disorders. And if you do, it is the ability to maintain orresume psychological functioning in the face of adversity that is the key resilience factor. This does not mean that you neverexperiencenegativeemotionsorthoughts in response to pain, loss, or suffering. These experiences are common (and necessary) and are likely part of the resiliency process itself. In a resilient process, these painful states are temporary, orspecific to particularchallenges experienced. They may be experienced deeply or intensely, but they eventually fade to return again when a challenge re-emerges. The ability to react, respond, and shift betweenfeelingsofpainorloss,andtocontinue to engage and make meaning promotes resiliency. Post-traumatic growth involves resiliency, but also includes: • A willingness to find ways to appreciate life • Developing increased personal strength or growth in one’s relationships • Rediscovering or redefining purpose and meaning in life. Thus, as we age with MS (or without it), it appears that our capacity to be challenged by limitations and suffering is effected by our ability to experience what feels “wrong,” different, or painful, and to also gradually experience what still remains “right” or meaningful. This seems to be a protective factor that keeps us on a steady course of active and engaged living. Thus, the grief, loss, pain, depression, anxiety, and other challenges of MS – whatever distress the disease brings – need to be met and responded to. In time, the ability to continue to adapt and develop both personal meaning and purpose continues to enrich and expand us, which promotes psychological well-being even as we enter later stages of life.