From everydayhealth.com
It’s not just your body that can feel tired when you live with psoriasis — you can become emotionally worn out, too
It’s common for people who have psoriasis to experience prolonged physical fatigue, especially if they have sleep apnoea and depression — conditions often linked to psoriasis that can cause exhaustion — or are taking certain psoriasis medications that can cause sleepiness, according to the American Academy of Dermatology. But psoriasis can also lead to emotional exhaustion and other psychological issues.
Here are some aspects of psoriasis that can cause emotional fatigue, and what you can do about them.
What Can Cause Emotional Fatigue When You Have Psoriasis
Living with any chronic disease can lead to emotional fatigue, notes Apple Bodemer, MD, an integrative dermatologist at UW Health and associate professor of dermatology at the University of Wisconsin School of Medicine and Public Health in Madison.
According to the National Institute of Mental Health, chronic health illnesses such as cancer, heart disease, or diabetes can increase your risk of developing stress, depression, or other mental health conditions.
The risk of experiencing emotional fatigue from psoriasis can be more likely in people who’ve been managing the condition for a long time, says Dr. Bodemer. “Some people will develop psoriasis as early as their childhood or teenage years,” she says.
Some other factors that can increase your risk of emotional fatigue:
Psoriasis is a lifelong condition. While there are ways to manage psoriasis, there is currently no cure. “That’s a really heavy load to carry emotionally when you get diagnosed with something and you’re told you’re going to have this for the rest of your life,” explains Bodemer.
Flares can crop up unexpectedly. “We can help dampen the flares and take away some of the symptoms, but there’s always a chance that it could come back even if you do get completely clear,” says Bodemer. Living with that unpredictability can lead to emotional fatigue, she explains.
Treatments weren’t as good in the past. “The medications that we had many years ago weren’t as effective as the ones we have available today,” says Bodemer. People who’ve been living with psoriasis for 20 or 30 years used to have to try treatments that didn’t work or stopped working after a time, which meant switching medications and going back and forth. “That level of uncertainty about a chronic condition can cause significant emotional distress,” she notes.
It’s often a visible condition. Psoriasis can cause patches of skin to become inflamed, red, or flaky. (In skin that has more pigment, these lesions can appear brown or purplish, with scales that can look silvery or white, says Bodemer.) Psoriasis commonly affects elbows, knees, and scalp and can even appear on the face, “so a lot of patients don’t want to wear short sleeves or shorts in the summertime because they’re self-conscious,” she says.
You have to explain or answer questions constantly. For people who have psoriasis, engaging in mundane activities like going to the grocery store, can lead to strangers staring, moving away from them, or coming up to them and asking what’s wrong with their skin. “They might be afraid or think it’s contagious, or they might just be genuinely curious,” says Bodemer. “But when you’re dealing with a lifetime of that sort of focus on abnormality of your physical body, that can be emotionally exhausting, invasive, and traumatic.”
The myth and stigma about psoriasis being contagious is something that you may also encounter in the workplace, or even among your family and friends, which can also contribute to a sense of emotional fatigue, notes Mohammed Jafferany, MD, a professor of psychodermatology, psychiatry, and behavioural sciences at Central Michigan University College of Medicine in Mount Pleasant and executive secretary and member of the board of directors at the Association for Psychocutaneous Medicine of North America.
It can impact your romantic relationships. During a flare with visible skin lesions, some people may be reluctant to go out and engage with new people, says Bodemer. “That can be especially difficult when people are in the typical dating period of their life,” she notes.
Even if you are already in a relationship, you may feel uncomfortable showing your skin or engaging in intimate relations. And if you don’t have the support of your romantic partner — if they don’t want to go with you to social events when you have visible skin symptoms, for instance — that can have a devastating effect on emotional well-being, says Dr. Jafferany. “The attitude of family members counts a lot,” he notes. “If it is negative, then it has negative consequences such as feelings of shame, guilt, depression, anxiety, and being socially isolated.”
What You Can Do to Minimize Emotional Fatigue When You Have Psoriasis
If emotional fatigue from psoriasis is an issue for you, here are some strategies that may help.
Try to reduce stress. Living with psoriasis can increase your risk for stress, but stress can also increase psoriasis, according to research. “When we are stressed, we go into the fight or flight mode of our nervous system … [our bodies] release the same hormones as if a tiger was chasing us,” she explains. But when stress is chronic, those hormones that are designed to save us from a predator get turned against us, and we end up in a situation where we have chronic inflammation, which may worsen psoriasis inflammation.
Find a psychologist who specializes in treating chronic illnesses. Psoriasis is a skin condition, but your treatment team should also include other experts, such as a mental health professional, who will work with your dermatologist, says Jafferany. He notes that research has shown that depression, anxiety, and even suicidal ideation are common in patients with psoriasis but that many people only see a dermatologist. “The dual treatment of mental health and skin health combined helps … [both] your physical and mental health,” he says. “We always advise patients to go see a psychologist or therapist or counsellor.”
A study in the March 2022 edition of the journal Psoriasis: Targets and Therapy found that after just six weeks of cognitive behavioural therapy sessions, in addition to standard treatment, participants had significant improvement in the severity of their psoriasis as well as less anxiety, depression, and stress.
Consider mindfulness-based stress reduction. This technique involves meditation, tuning in to each area of your body from head to toe, and engaging in breath exercises.
“I’m a big fan of mindfulness-based stress reduction, or MBSR,” says Bodemer. “This is a really powerful tool that can help people navigate stresses in their life, whatever they might be.” She notes that breath work is easy to do and may be especially useful for people who don’t want to meditate or who are experiencing a flare and aren’t comfortable enough in their body to do a “body scan” by tuning in to each part of the body to check in and relax. “These are tools people can use in the moment when they’re in a social situation and somebody asks the question, ‘What’s that on your arm?’ Then you can take a few deep, conscious, measured breaths … so that you can come into the interaction in a more calm state,” she says.
A review published in October 2022 in the journal Dermatology and Therapy found that meditation and mindfulness, along with traditional treatment such as medication, may be useful in improving both psoriasis severity and the psychological effects (and quality of life) of psoriasis.
Find a psoriasis support group. “Connecting with other people who have this condition and are dealing with some of the same things, just having that community can be really powerful,” says Bodemer. Check out the National Psoriasis Foundation (NPF) for in-person and online support options.
Get some positive perspective. With advances in treatments such as biologic medications, people who have psoriasis can be symptom-free the majority of the time, says Jafferany.
Lean on your loved ones for support. Support from family and friends is an important part of managing the emotional fatigue of psoriasis. Having loved ones reassure you that the disease isn’t contagious, that they will stand by you and help you find the right treatment, and offer similar types of encouragement can give you strength to cope, says Jafferany. “Those kinds of comments and support are very important for the patient’s well-being,” he notes.
The NPF offers some tips and resources for friends and family who are supporting a loved one living with psoriasis or psoriatic arthritis.
https://www.everydayhealth.com/psoriasis/how-to-handle-emotional-fatigue-from-psoriasis/
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