Multiple sclerosis often affects adults in their most productive years, with recurrent frightening symptoms that cause uncertainty and challenges a person's self-esteem. Emotional changes, depression, psychiatric syndromes, and cognitive deficits may be seen and will affect the person's ability to stay employed and to be active in the community. How the patient deals with these stresses depends on many factors including his or her coping skills, the patient's support networks and resources, and their personal coping skills.