About a year and a half ago, I started dropping coffee cups. It was the first sign that my psoriasis was getting to me on a deeper level, and it was the first time I really felt worried about my condition. Even though the anxiety-fueled jitters and restlessness are now more or less controlled, they're still always with me.
Unfortunately, as a person with chronic psoriasis, I am not alone. According to the National Psoriasis Foundation, almost one in five of those with psoriasis struggle with anxiety. Often, depression is in the mix as well. Wherever you fall on the anxiety-depression spectrum, it's important to know that you don't have suffer alone and help is there when you need it. You just need to know where to look.
Understanding the Psoriasis-Anxiety Connection
You don't need to have an M.D. after your name to understand that the stress of living with a long-term skin condition can lead to anxiety and even depression. Psoriasis can be highly stigmatizing and extremely difficult to get under control.
But there may also be a biological connection as well. The proteins the fuel the inflammtory reponse in your skin are also linked to mood disorders, creating a vicious cycle that perpetuates stress and anxiety, according to research published in the Journal of Clinical and Aesthetic Dermatology. Flares can trigger anxiety, which can in turn trigger more flares. And your life is stuck in the middle of all it.
If you have psoriasis and find yourself anxious a lot of the time, don’t just dismiss it as a done deal, says Mohammad Jefferany, M.D., associate professor of psychology at Central Michigan University in Mount Pleasant, MI.
He says you’ll know it’s time to take action if you find anxiety interrupting the rhythm of your normal everyday behaviors. For me, that moment came when I ran out to buy a long sleeve shirt to cover my arms before meeting my son’s new girlfriend—even though it was incredibly hot outside. That may seem like a small thing, but the thought of her seeing my skin made me incredibly uncomfortable. Being sweaty seemed a small price to pay, but it's one I shouldn't have had to pay at all.
How to Manage Anxiety About Your Skin
The first step is simply to tell your derm how you're feeling. It's really important to speak up since untreated anxiety and depression can impact your response to psoriasis therapies, says Dafna Gladman, M.D., a senior scientist at the Krembil Institute in Toronto.
Your doctor may then opt to step up your psoriasis treatment. That's because reducing your overall inflammation could also lessen the biological response related to your stress, improving your mood. According to findings published in the journal Nature Reviews Immunology, elevated levels of inflammatory proteins may deplete some of the key mood messengers in your brain such as serotonin and dopamine.
If you're not already working out regularly, expect your derm to encourage it now. Exercise is not only good for anxiety, but it can also help your psoriasis. Just 20 weeks of exercise and improved diet can reduce psoriasis in people with active disease who also happen to be overweight or obese, according to a study published in the British Journal of Dermatology,.
Still need more support? Your doctor may refer you to a psychologist or therapist who can teach you coping strategies. Some practice cognitive-behavioral therapy (CBT), a form of psychotherapy that’s been shown to be highly effective for anxiety. Medication may also be an option.
And depending on where you live, you may even have another option: seeing a psychodermatologist. Practitioners in this growing field are dermatologists with special interest and expertise in the psychological component of skin disease. Start your search for this kind of specialist through The Association for Psychoneurocutaneous Medicine of North America (APMNA) website.
Insurance coverage will vary depending on your plan and which dermatologists are covered in your area.
Regardless of whether a dermatologist, a primary-care physician, or a psychodermatologist is helping you with your anxiety and psoriasis, the most important thing is that you’re addressing the issue in the first place. It's smart self-care. And if you’re anything like me, when your psoriasis is under control, so is your anxiety.