As we become more adept at measuring the neurologic deficits in MS, we are developing more effective measures of the broad psychosocial effects of the disease. These include emotional stresses, depression, cognitive changes, and decreasing activities in the family and community. In about half, cognitive changes will develop and, in some, the changes will occur early. Employment rates decline and the economic costs to the family and the health care system mount as the years go on. How well patients cope with the stresses on their personal lives, their relationships, and their families depends on many factors beyond the physical changes, such as their coping skills and their network of supportive people and resources. As we learn more about the changes occurring in the nervous system, we also are learning more about the psychological and social aspects of the disorder. Approaching the management of patients and their families with the broad view that recognizes both the neurologic and the psychosocial aspects of the disease results in more effective care for those with MS.