5 Ways Psoriatic Arthritis is an Invisible Illness

Patient Expert

Psoriasis is a condition that is often visible, unless you wear makeup or clothing that covers it. Psoriatic arthritis, however, isn’t always so noticeable. In fact, many times it can be classified as an “invisible illness.” Sure, psoriasis is a symptom that you may have with psoriatic arthritis, but there are many other aspects of the condition that are completely invisible to the world.

Before I was diagnosed with psoriatic arthritis, I didn’t understand it. I didn’t understand the symptoms, or how someone could look well but still be sick. When we consider what it means to be “sick,” we often picture someone laid up in a hospital bed, not a working mom raising three children or an active teen trying to obtain a college scholarship. Looking back, I don’t think I could have understood what it means to have an “invisible illness” like psoriatic arthritis without experiencing it.

Here are five ways that psoriatic arthritis can be considered an invisible illness:

1. Joint Pain

Caused by the inflammation in the body, joint pain is not something that you can easily see. Unless you have swelling, skin discoloration, or a grimace on your face, others may not know you’re in pain. Since each body is different, psoriatic arthritis can affect different joints depending on the person. For some, it really bothers their hands, while others have knee problems. Psoriatic arthritis is in the classification of ankylosing spondylitis, which means that many people have spine and back pain as well. Chronic pain can affect everything in your life — your mood, your outlook, even your activities — and presents a challenge that people with psoriatic arthritis deal with every day. Yet an outside observer may never realize it!

2. Fatigue

When we think about why we’re tired, we tend to think that we’re not getting enough sleep, or that we’ve exhausted ourselves from running around all day. With psoriatic arthritis, however, fatigue is much more than just a feeling of tiredness. Bone-crushing fatigue can hit anyone with psoriatic arthritis. Rather than relaxing you, taking a shower can make you feel like you just ran a marathon. Rather than rejuvenating you, leaving your house for some fresh air can instead leave you bed-ridden for several days. Aside from causing you to move slowly or making dark circles appear under your eyes, the symptom of fatigue is relatively invisible.

3. Malaise

I often describe psoriatic arthritis as an illness that makes me feel like I have the flu all the time. Malaise is also an easy symptom to brush off. I’ve often felt terrible when others told me that I look great. In these instances, it takes me a moment to gather myself and not get upset. It’s the perfect example of an “invisible illness” at work. I may feel like I’m going to faint or have to run to the bathroom, but because I can’t see the symptom, it’s easy to dismiss it and not give it the attention it deserves.

4. Obscure Triggers

Each body reacts differently to an autoimmune condition. Stress, toxins, environmental triggers, food — any of these can cause a reaction. As a result, each person with an autoimmune condition has their own set of triggers. Personally, I find that I have an overactive sensitivity to most foods. Eating certain foods will cause me fatigue, pain, or psoriasis. I thus keep an extremely strict diet to help manage my symptoms. People will often think that I’m just being picky or doing it to lose weight, but food is truly a driver for my psoriatic arthritis activity and an invisible manifestation of my autoimmunity. You wouldn’t know it, however, unless you come over after I eat a trigger food and see me laying in my bed for days.

5. Emotional Pain

Being depressed or having a hard time accepting new realities is a big part of dealing with a chronic condition. It’s a symptom that is often overlooked; it is also as difficult to deal with as the condition itself. For myself, my body reacted so strongly that I started having intense anxiety attacks. Plans to go out with friends, doctor appointments — they’d all end up getting canceled because I couldn't leave my house. The emotional issues aren’t typically covered in psoriatic arthritis 101. But it’s a part of the invisible illness, and many people struggle with it daily.

So, the next time someone with psoriatic arthritis tells you that they don’t feel well, don’t judge them based on the way they look. Really listen to what they’re telling you and realize that there’s far more going on than meets the eye.