From self.com
Real people explain how they cope
Psoriatic arthritis and mental health are deeply connected. Because the condition is so unpredictable, you may never know exactly how you’re going to feel when you wake up in the morning, which can trigger really complicated feelings of anxiety, depression, and even guilt.
Psoriatic arthritis, a chronic inflammatory condition that affects about 30% of people with psoriasis, causes joint pain, stiffness, and swelling, as well as immense fatigue that can make the simplest tasks feel impossible, from brushing your teeth to chopping up vegetables for dinner. Especially in the midst of a flare, you might have to quickly change your plans to accommodate your condition or prioritize rest when your symptoms are hard to deal with.
How does psoriatic arthritis affect mental health?
Understandably, managing all of this can affect how you feel about your body and your life, and the weight of these emotions can be a lot to navigate on your own on top of already painful symptoms. In fact, about 33% of people with psoriatic arthritis reported being at least mildly anxious and 20% experienced mild depression, according to a 2020 review of studies involving more than 31,000 people with psoriatic arthritis published in the journal Clinical Rheumatology.
So we asked people who have psoriatic arthritis (PsA) about how they take care of their mental well-being when day-to-day life starts to feel isolating, frustrating, or overwhelming. Here are some psoriatic arthritis strategies that make a true difference for them.
1. Consider talking with a therapist about your psoriatic arthritis if you don’t already.
Jocelyn Hall, 35, who was diagnosed with psoriatic arthritis when she was 28, says her symptoms are well-managed and she is able to remain active thanks to medication. But she still feels anxious knowing there is a risk for unpredictable flare-ups. Plus, she sometimes feels judged by co-workers who don’t understand why she has difficulty moving some days, like when she has trouble carrying heavy plates at her job in a restaurant.
To process her emotions, she finds it helpful to talk with a therapist, who encourages her to think about being kinder to herself during stressful times. “She helps me maintain good expectations for myself, not ones that push me too far,” Hall tells SELF.
For Meaghan Ingram, 28, who was diagnosed with psoriatic arthritis at 26, the symptoms go beyond physical pain. “When I’m in a flare and I can’t move, the depression hits pretty hard and fast,” Ingram tells SELF. She has worked with a therapist who incorporated cognitive behavioural therapy (CBT)—which involves reframing unhelpful thoughts and changing thinking patterns—in their sessions.
Now Ingram practices acceptance and commitment therapy (ACT) strategies on her own, using The Happiness Trap book (Amazon, $8). This form of psychotherapy teaches her to observe and sit with her thoughts without trying to fix them. “It's about accepting where I’m at in that moment, and not trying to be anything else,” she says.
Even though it can be helpful, finding a therapist is a tricky process for many people, and it may not be accessible for everyone. If you have insurance, you can contact your provider for mental health professionals in your area. Websites like Open Path, Inclusive Therapists, and Thero.org include directories of therapists who accept reduced-fee payments if you don’t have insurance or don’t want to use your insurance benefits. And finally, you can check the Association for Behavioral and Cognitive Therapies for a therapist that specifically practices CBT.
2. Connect with other people who have psoriatic arthritis.
Psoriatic arthritis support groups can be invaluable, according to the people we talked to. “The thing that's gotten me through this change in my life has been the community that I've found online,” Ingram says. “There’s just something so special about being able to really connect with people that understand my day-to-day, what I feel, and what I’m going through.”
She found psoriatic arthritis support accounts on Instagram and Facebook by searching for hashtags like #arthritisawareness. “I’ve met some of the most supportive people in my life through Instagram,” Ingram says. Psoriatic Arthritis Warriors and Ingram’s own account are two helpful resources. Arthritis charity CreakyJoints is another community for people who have arthritis that publishes first-person experiences, in addition to a podcast with advice from other people with the condition, such as how to advocate for yourself at the doctor’s office.
3. Reconsider what kind of movement limits psoriatic arthritis pain and makes you feel your best.
Being active can help reduce the joint stiffness caused by psoriatic arthritis and give your mood a boost, but you may need to adjust what that looks like for you. Movement, no matter how small, shouldn't spur joint pain or make you feel worse.
“A big change for me was separating movement from exercise,” says Ingram. “I spent a lot of my life looking at exercise as a hard-core workout. When my body started to have a very hard time with that, I felt lost, especially because exercise helps relieve my anxiety.”
It took some time for Ingram to reframe her thinking, but she eventually realized that moving her body gently helps her feel better overall. “Setting realistic movement goals tends to be a really easy way to defuse some of that anxiety that I’m feeling when I’m having a bad day,” she says. During a bad flare, Ingram might just do some stretching in bed. “If that’s the best that I can do, that’s still movement and it makes me feel good that I’ve accomplished something that day,” she says. If she feels really mobile, then she might lift weights or swim.
On really tough days, music can also be a game changer. “I put on a good song and try to move to it, in whichever way feels good in that moment,” Ingram says. “It's very difficult for me to hold on to a bad mood when I’m listening to Motown or funk music.”
4. Do something for yourself each day if you can.
“I’m a big believer in doing small things that make you feel a little bit better about your day,” Deanna Kizis, 51, who was diagnosed with psoriatic arthritis three years ago, tells SELF. The specific gesture can be unique to you; maybe you decide to treat yourself to the fancier ice cream at the grocery store or you spend five extra minutes to deep-condition your hair. As long as it’s something that prioritizes your happiness, try to give it space in your schedule as a part of your psoriatic arthritis self-care.
For Kizis, picking flowers from her garden and finding the perfect spot for them in her home is a simple reminder that she’s deserving of beautiful things, even if her headspace is trying to tell her otherwise. “I’ve reminded myself that I’m worth a pretty flower in the middle of my day, and I’m showing myself that I’m worth a little bit of extra attention,” she says. “Little things like that really mean a lot to me, and I suggest them even to friends who don’t have chronic illnesses, but who are going through a hard time.”
5. Set boundaries with your family and friends regarding psoriatic arthritis fatigue, stress, and anxiety.
You may feel awkward asking for an accommodation, like requesting ergonomic office supplies, or explaining to your friend that you need to reschedule your plans because you’re in pain, but knowing that you’re protecting your body (and therefore your mind!) can be really empowering.
For example, Kizis’s boyfriend is very active and the two love riding bikes together. But sometimes they bike too far and Kizis is in pain by the time she gets home. Now the couple uses an app to monitor how many miles they’ve biked so they know when it’s time to turn around. “If he didn’t understand that I couldn’t keep up, then he just wouldn’t be the fella for me, you know?” Kizis says.
Bottom line: There is no single way to look after your mental health, but small, intentional changes can make a big difference over time when you’re living with the side effects of a chronic condition like psoriatic arthritis. As Ingram says, “It’s definitely a long process, and a personal process—and one that you have to be patient with yourself with.”
https://www.self.com/story/psoriatic-arthritis-mental-health
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