Immediate reactions to diagnosis

Getting a diagnosis of MND was a terrible shock for almost all the people we talked to. This might be mixed up with all kinds of other emotions, including anger, grief, disbelief or denial. However, a few talked about ‘taking it in their stride’, particularly if they had already suspected it might be MND, and some felt able to focus quickly on ‘making the most of the time that I had left’. Over time, most people came to the view that developing a positive attitude was the best way forward, though some took longer or found it harder than others to reach that point, and some were still struggling. (See ‘Philosophy, attitude to life and messages for others’ for more about how people’s thinking developed). Here we focus on people’s first thoughts after diagnosis.

Several people’s first reaction was despair, and a period of depression. Some talked of being ‘flattened’ or ‘in pieces’, and feeling the future looked ‘dark’ or ‘bleak’, before reaching a calmer or more positive state.

He knew it would be bad news when they asked his wife to be present. He felt his world had…

Age at interview 40

Gender Male

Age at diagnosis 39

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When he finally got a diagnosis after 7 years, he felt hopeless and that there was no point going…

Age at interview 55

Gender Male

Age at diagnosis 51

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One man described how despairing he felt between getting the diagnosis and seeing a specialist. He stressed how important it is for people to have another appointment soon after the diagnosis to ask questions. At first he was too shocked to think what to ask.

There was a delay between the diagnosis and seeing an MND specialist. All he could think about…

Age at interview 60

Gender Male

Age at diagnosis 59

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Several people said they felt almost numb when they were given a diagnosis. Some just could not take in what they had been told, or did not really want to. A few even went straight back to work or went shopping after the appointment.

He couldn’t take in how serious the diagnosis was. He had to ring the doctor to ask what he’d…

Age at interview 45

Gender Male

Age at diagnosis 43

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Some people found avoiding thinking about it too much helped them cope – as one man said, ‘I’m a person that’s a bit like an ostrich, I bury my head in the sand.’ Some could not believe the diagnosis was correct – one man said his young daughter would say, ‘I’m going to keep fighting this. I haven’t got it. We’ll find out what it is and then I’ll get better.’

She thinks her father was in denial about the diagnosis until he lost his speech. He said they…

Age at interview 49

Gender Female

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He does not want to read about life expectancy. He deals with MND by making believe it’s not…

Age at interview 73

Gender Male

Age at diagnosis 68

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A few people who had waited a long time for a diagnosis felt a certain relief at finally getting an answer. One man whose wife had MND said it was, ‘A tremendous shock on that particular day, but obviously I suppose you can call it pleased that we had got a definite diagnosis.’ Another man said knowing what he was facing helped him fight it.

He was so relieved at finally getting a diagnosis that he laughed. He was told he would not live…

Age at interview 62

Gender Male

Age at diagnosis 53

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A few people had already suspected it was MND, sometimes because they had been doing a lot of reading and researching their symptoms on the internet, and sometimes because they had professional knowledge of neurological conditions. For some people this meant they were quite calm about the diagnosis.

He was pretty sure what the diagnosis would be, so it didn’t come as a ‘nasty surprise’ and he…

Age at interview 58

Gender Male

Age at diagnosis 56

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They knew it might be MND before it was confirmed, so they had time to plan how to deal with it…

Age at interview 55

Gender Male

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Others said that even though they had guessed it might be MND, hearing it was still a shock, especially those with a family history of MND who had close personal experience of the condition and what it would mean for them (see Interview 22 – Liz’s story, Interview 34 – Ken’s story and Interview 39 – Liz’s story). On the other hand, one woman with a family history explained her pragmatic attitude to the diagnosis she didn’t want to hear’ ‘I knew that the sooner I was diagnosed, then I could start making the most of the time that I had left, rather than wasting it pretending it isn’t going to happen.’ (See ‘Possible causes of MND’ for more information about the inherited or familial form of MND).

An occupational therapist who had worked with people affected by MND in the past described her reactions to her own diagnosis.

She suspected it was MND and wanted the doctor to tell her straight. For a few days she couldn’t…

Age at interview 39

Gender Female

Age at diagnosis 38

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While this woman did not want to be alone, others withdrew into themselves and did not want to be with others or talk. One man moved into the spare bedroom for 6 months. Some people felt angry and asked ‘why me?’ One woman was surprised that she had not really felt angry, although she did feel disappointed and frustrated. Others said it was like going through the different stages of grief, grieving for the loss of their health and independence, and the loss of future hopes and plans.

It was like going through a grieving process after diagnosis, especially when she thought about…

Age at interview 39

Gender Female

Age at diagnosis 38

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Some people were also immediately worried about becoming a burden on others, especially close family. (See ‘Impact on family carers’).

He says he has never felt worried or upset by the diagnosis. What saddens him is feeling that he…

Age at interview 80

Gender Male

Age at diagnosis 80

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Views were mixed on the best way to be told the diagnosis. Some wanted a straight, honest approach, while others found this too blunt. As several people pointed out, there is no easy way to break such bad news, but doctors need to be sensitive to each person’s needs and state of mind. Some people said it is possible to be honest and gentle at the same time. In particular, people talked about whether or not it helped to be given detailed information at this point about how long they could expect to live with MND. (See also ‘Information needs’). Several said they thought hearing the diagnosis could be worse for relatives than for the individual themselves. One woman said she was shocked but her husband just said ‘hey’ and shrugged, because he felt there was nothing he could do about it. (See Interview 23 – Mike’s story).

The consultant neurologist told him to go home and put his affairs in order. It seemed blunt but…

Age at interview 59

Gender Male

Age at diagnosis 55

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She was prepared for the diagnosis and the professor was kind and reassuring. She told her every…

Age at interview 58

Gender Female

Age at diagnosis 55

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There is no nice way to tell people they have MND – it will always be ‘a hammer blow, however…

Age at interview 40

Gender Male

Age at diagnosis 39

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Being present at her mother’s diagnosis was devastating. For the next week she felt as if they…

Age at interview 40

Gender Female

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He was told he might live 3 years. His wife was across the room from him and was crying with…

Age at interview 45

Gender Male

Age at diagnosis 42

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This man was in fact diagnosed with PMA (progressive muscular atrophy). Others who were told they had PMA or PLS (progressive lateral sclerosis) described some relief at this news, especially if they had previously been given a diagnosis of MND – as one couple said, ‘It’s like a big reprieve.’ (See footnote on less common types of MND).

They went out to celebrate when she heard she had PMA.

Age at interview 54

Gender Female

Age at diagnosis 52

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Being told he had PLS gave him extra strength to fight it.

Age at interview 60

Gender Male

Age at diagnosis 57

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However, some found it hard to adjust to a different diagnosis. The wife of a man who was told he did not have long to live explained how that affected their decision-making. When they discovered he had PLS and had much longer life expectancy they regretted their previous choices.

Everything turned on their belief that Barry did not have long to live, not knowing he had PLS…

Age at interview 54

Gender Female

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Most people had someone else with them when they heard the diagnosis, and were glad to have the support. Others went on their own, and one woman said she would have preferred to be alone as it was so unpleasant for her daughter.

She wishes her daughter had not been invited to come with her, as the diagnosis was a great shock…

Age at interview 72

Gender Female

Age at diagnosis 72

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Footnote: less common types of MND diagnosis

A few people diagnosed with MND will be told they have a less common form of the condition such as PLS (primary lateral sclerosis) or PMA (progressive muscular atrophy). PLS affects only the upper motor neurones, and PMA only the lower motor neurones. The first symptoms of these forms are very similar to other more common forms of the condition, so in the early stages it can be difficult to distinguish them. In PLS, legs, hands or speech can be affected as well as sense of steadiness in walking, and in PMA it is usually hands or legs. People with these forms generally live longer than people with more common forms of MND, but they share many of the same problems of increasing disability. For further information about the symptoms and progression of these forms, see our resources section for links. This page also explains how to join an email forum for people with these forms.

Path to diagnosis of MND

Diagnosing motor neurone disease is often a difficult and lengthy process. This is for several reasons. Firstly, MND is comparatively rare. Secondly, it affects each...