How psoriasis affects your overall well-being

How psoriasis affects your overall well-being

More than 7.5 million people in the United States live with psoriasis, a skin disease that causes scaly red patches all over the body, including the face, hands, elbows and knees. Nearly 6 out of 10 people with psoriasis have mental health problems such as depression and anxiety related to their illness.

One study found that psychiatric disorders are more common in people with skin conditions compared to those with cancer, brain disorders and heart problems combined. And another found it women are much more likely than men have these problems.

Because the symptoms of psoriasis are so visible, having this disease means dealing with the stigma associated with it. People with psoriasis can feel misunderstood or even made fun of by their peers and struggle with mental health issues that can be far more distressing than any physical symptoms.

Fear of rejection leads to isolation

“Most people with psoriasis experience anxiety and worry when it comes to their self-image,” said Mina Guirguis, MD, a clinical psychologist at the Emotional Wellness Center for Skin Disorders. Guirguis specializes in psychodermatologya branch of medicine that focuses on the effect of skin conditions such as psoriasis on mental health (and vice versa).

Guirguis said much of the anxiety people with psoriasis experience is related to what others will think of them. “Essentially, others will either accept them for who they are or not,” she said. Fearing rejection, many choose to withdraw rather than face this fear. “Often they will isolate or hide their skin condition,” Guirguis said.

This fear of rejection can seep into the daily life of a person with psoriasis, influencing every decision they make, especially when it comes to social interactions. “They might turn down an invitation from colleagues to socialize after work,” Guirguis said. “They may find excuses not to go to the beach or put themselves in any situation where their skin condition could get unwanted attention from others.”

For people with psoriasis who are in a relationship, the damage the disease does to their self-image can make it difficult for them to get close to their partner. “They may reject advances from their partner because of the feeling of being uncomfortable showing their bodies and the possibility of being rejected,” Guirguis said. “That in itself negatively affects the relationship and pushes them further away.”

Stigma, misunderstandings surround psoriasis

Unfortunately, the anxiety people with psoriasis feel about how others will react to their condition isn’t always unfounded. They mental health problems they often arise from the way people who do not understand the disease treat or abuse them.

In a 2018 item on skin disorders and self-esteem published in the International Journal of Women’s Dermatology, a woman with psoriasis shared the story of being rejected from donating blood by a nurse who accused her of having ringworm from a highly contagious. She also described being forced by her boss at the bakery where she worked to wear long-sleeved shirts even on the hottest days after a customer accused her of purposely “shedding the skin” on her cake.

In the same article, another woman said she was in an abusive relationship for nearly a decade because her abuser told her no one else would ever love her with “all that stuff” on her skin. Both women have become patient advocates of the National Psoriasis Foundationhelping others to cope with the physical and mental effects of the disease.

Sharing information to end stigma

Information is key to erasing the stigma around psoriasis. Helping people in everyday life understand this psoriasis is not infectious or contagious, for example, can go a long way in changing the way people look at the disease and those affected by it. When we know better, we do better.

Guirguis believes it is also the responsibility of healthcare professionals to help people understand skin conditions like psoriasis and their impact on mental health. “I think mental health professionals along with dermatologists need to educate the public and correct any misconceptions about the disease,” she said.

Mental health professionals and dermatologists can also come together to help treat psoriasis holistically by addressing both the physical and psychological effects. When physical symptoms are successfully treated, mental health often improves.

Self-acceptance and honesty are key to coping

When it comes to coping with psoriasis, Guirguis is a firm believer in coming to terms with the disease. “I often advise patients to work on accepting their skin condition,” she said. When people with psoriasis are able to accept their condition instead of hiding it, she said, they’re able to build their self-esteem and confidence.

“Acceptance of one’s condition and situation will help the patient free their mind from worrying about how others will perceive them and whether or not they will be accepted by others,” Guirguis said. Encourage people with psoriasis to seek out a mental health professional who can help them work toward self-acceptance.

Some people with psoriasis can find exercise useful for improving their mood, especially if they are dealing with depression. And a review of nine studies found that physical activity can improve conditions such as heart disease and type 2 diabetes that often occur alongside psoriasis, providing a benefit to overall well-being.

Coping methods that reduce stress may also benefit the well-being of people with psoriasis. Calming practices such as yoga, mindfulness and meditation they have all been shown to improve physical and mental health.

Sharing your struggles with psoriasis can also be very healing and creates the possibility of connection with others.

“Engaging in honest conversation is always a start,” Guirguis said. “Share with others how your skin condition affects your emotional as well as physical health. You won’t be able to truly make all your loved ones understand what you are experiencing, but you are opening their mind to understand your struggles.

This resource was created with support from BMS.

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