While the primary symptoms described on this page (more and less common) are the direct result of damage to the myelin and nerve fibers in the CNS, the secondary symptoms are the complications that can arise as a result of these primary symptoms. For example:

• Bladder dysfunction can cause repeated urinary tract infections.
• Inactivity can result in loss of muscle tone and disuse weakness (not related to demyelination), poor postural alignment and trunk control, decreased bone density (and resulting increased risk of fracture), and shallow, inefficient breathing
• Immobility can lead to pressure sores.

While secondary symptoms can be treated, the optimal goal is to avoid them by treating the primary symptoms.

Tertiary symptoms are the “trickle down” effects of the disease on your life. These symptoms include social, vocational and psychological complications. For example, if you are no longer able to drive or walk, you may not be able to hold down your usual job. The stress and strain of dealing with MS often alters social networks and sometimes fractures relationships. Problems with bladder control, tremor or swallowing may cause people to withdraw from social interactions and become isolated.

Depression is fairly common in people with MS. Depression may be a primary or a tertiary symptom as it can be caused by the disease process itself or triggered by the burdens discussed above.