Psoriasis, Sleep, and Mental Health: What’s the Connection?

From healthcentral.com

A new study has uncovered a strong link between psoriasis, REM disturbances, and depression—suggesting the condition is anything but skin deep 

If you have psoriasis and struggle to sleep at night, your issue might be more than skin deep. New research reveals a strong connection between psoriasis, sleep problems, and mental health—with each condition potentially worsening the others. Psoriasis itself causes an overactive immune system to produce inflammation and rapid skin cell build-up, leading to itchy, uncomfortable patches that can disrupt sleep. “Stress, injury to the skin, allergens, certain medications, even infections, can all trigger a psoriasis flare,” explains Veena Vanchinathan, M.D., a board-certified dermatologist at Kaiser Permanente in San Jose, CA who is not associated with the study. These same triggers often disturb sleep patterns as well, making sleep management just as important as traditional treatments for managing psoriasis effectively.

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People With Psoriasis Sleep Poorly—and Feel Worse

In the recent study, presented at the American Academy of Dermatology Spring 2025 conference, Tina Bhutani, M.D., a board-certified dermatologist in private practice and volunteer faculty member at University of California, San Francisco, found that poor sleep doesn’t just cause daytime fatigue—it can amplify mental health issues and create a cycle of worsening psoriasis flares and increasing sleep disruption.

Dr. Bhutani and fellow UCSF researchers surveyed 487 people with psoriasis and 69 individuals without the condition, using validated questionnaires to assess sleep quality, depression, and anxiety. Psoriasis patients scored significantly worse across all measures—they had more trouble falling asleep, woke more frequently, experienced more insomnia symptoms, and showed higher depression and anxiety levels.

When examining the relationship between sleep and mental health specifically within the psoriasis group, the researchers found that even after adjusting for factors like disease severity or treatment, greater sleep impairment was significantly associated with anxiety and depression.

“Our results confirm the association between sleep quality and mental health in these patients,” says Dr. Bhutani. “But it’s not just that psoriasis patients tend to have sleep issues and mental health issues separately. The data shows the worse your sleep is, the more likely you are to also be experiencing anxiety and depression.”

Why Psoriasis Might Ruin Your Sleep

It makes sense that the itching and pain from psoriasis patches significantly impact sleep quality. Past research has shown that people with psoriasis are twice as likely to have sleep issues than the general population, with more than 85% of psoriasis patients reporting sleep difficulties. But physical discomfort isn’t the only culprit.

“There’s also research that suggests the heightened inflammatory process—the very thing driving the psoriasis—might interfere with the body’s sleep regulation system,” explains Dr. Bhutani.

Dr. Bhutani first became interested in this connection when one of her patient’s psoriasis dramatically improved after his sleep quality increased. “He had really tough to treat psoriasis and we had basically tried everything,” says Dr. Bhutani. “He came in one day and his skin was practically clear.” The patient’s wife had been treated for sleep apnoea, which had been disturbing both their sleep. Once she received treatment, both got better rest—and his psoriasis nearly disappeared. This case inspired Dr. Bhutani to investigate the sleep-psoriasis relationship further.

A Holistic Approach to Managing Skin Flares

The strong interconnection between psoriasis, sleep problems, and mental health suggests these aren’t simply co-occurring conditions—they’re actively influencing each other. Psoriasis symptoms directly interfere with sleep, and that lack of restorative rest takes a toll on mental health, creating what Dr. Bhutani calls “a potentially vicious cycle” of worsening skin, poorer sleep, and increasing depression and anxiety.

While more research is forthcoming, this study demonstrates why a holistic approach to psoriasis treatment is essential. “As dermatologists, we’re trained to treat skin diseases, but we also need to encourage our patients to seek help for sleep disorders, anxiety and depression, and other associated conditions, like cardiovascular disease and diabetes,” emphasizes Dr. Bhutani.

Beyond medication, making lifestyle changes that improve overall health can have a big impact on your psoriasis. Eating better, exercising more, managing stress, and, yes, improving sleep quality can all lead to fewer flare ups, clearer skin, and a happier outlook on life.

If your psoriasis symptoms are keeping you awake, talk to your doctor about topical treatments that can help soothe the itch and inflammation. After that, make sleep a priority by keeping your bedroom cool and dark to encourage your body to fall asleep and sticking to a regular schedule. “A consistent sleep schedule, same bedtime, same wake up time—even on weekends, can help you get higher quality sleep,” says Dr. Bhutani.

https://www.healthcentral.com/news/psoriasis/psoriasis-sleep-and-mental-health-connection?ap=nl2060&rhid=67ec2b8321f52bf01b0cca01&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGchiJjMoK5Mt6msMeIKLwRGhTe0k4H-66Kp_aBqVGjJ1WWpAYIo4sGKf43UE4Zv9gSLozlVi6vJPEjrbWjTbY_IEAm_JDNqBvKBGMxFY3q0URtcBw

Childhood Trauma Can Increase Your Risk of Psoriasis—Here’s Why

From healthcentral.com

A groundbreaking new study found a relationship between high stress early in life and higher rates of the inflammatory skin disease 

It's not exactly breaking news that mental health and psoriasis are closely linked. The skin disease leads to higher rates of anxiety, for one, and mental health conditions, like depression, can be a risk factor for psoriasis. But a new study out of the University of Birmingham in the UK brings us closer to understanding how, exactly, mental health affects your risk of developing psoriasis.

The researchers found that people with a history of childhood trauma, be it emotional, mental, or physical, were at a greater risk of developing psoriasis later in life. “Anecdotally, we understood that there was some connection between stress and conditions such as psoriasis,” says Lara Wine Lee, M.D., an associate professor of paediatrics and dermatology at Medical University of South Carolina in Charleston, SC, who was not a researcher on the study. “I think that this [study] supports giving more thought to mental health in psoriasis patients.”

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The Connection Between Childhood Abuse and Psoriasis

The retrospective study used data from primary-care providers in the UK; the researchers first identified people who’d experienced abuse in childhood and compared them with those who didn’t have a reported history of abuse, analysing who among both groups developed immune-mediated inflammatory disorders. The more than 200,000 patients exposed to childhood trauma were at an increased risk of developing both rheumatoid arthritis (39% higher risk) and psoriasis (16% higher risk).

The connection seems rooted in the immune system. For context, psoriasis causes the immune system to malfunction, triggering an inflammatory response and the abnormal production of skin cells, leading to build-up on skin that appears as itchy patches or plaques. Chronic stress—the type you experience in an abusive household—can also trigger an inflammatory response which may interfere with immune-system function over time, according to Joht Chandan, Ph.D., a lead author of the study and a clinical professor of public health at the University of Birmingham in the UK. This creates the perfect conditions for psoriasis to develop.

The findings are in lockstep with what experts already suspected. “Stress is pro-inflammatory, meaning that as people experience stress, there is inflammation in the body,” says Jeffrey Cohen, M.D., who wasn’t involved in this study, but who researches the relationship between psoriasis and other medical conditions as the director of the Psoriasis Treatment Program at Yale Medicine. “Inflammation can then be seen in the skin—and, through the activation of specific pathways, can lead to skin conditions like psoriasis.”

Why Psoriasis May be Sensitive to Childhood Trauma

The findings, which looked at a variety of inflammatory diseases like irritable bowel syndrome and lupus, found an especially strong correlation between childhood abuse and an increased risk of developing psoriasis and rheumatoid arthritis.

Interestingly, rheumatoid arthritis is different from psoriatic arthritis, which appears in 30% of psoriasis patients. But both psoriasis and rheumatoid arthritis patients tend to have elevated levels of specific inflammatory markers that, incidentally, also tend to be higher in people with a history of early-life trauma, according to Dr. Chandan. Also, “it’s possible that the specific tissues affected by these conditions—the skin and joints—are more vulnerable to the long-term effects of immune dysregulation driven by early adversity,” he says.

Dr. Wine Lee, for her part, also thinks that the methodology of the study (which looked at past data using medical codes) may have led to rheumatoid arthritis being a highly impacted disease. “I wonder if some of those rheumatoid arthritis patients actually are psoriatic arthritis patients—and whether they’re talking about inflammatory arthritis in general,” she says. In other words, since it relies on coding (which doesn’t always allow for nuance), then there’s a chance different types of arthritis were either conflated with others or grouped under a single medical code.

The reliance on coding also leaves some gaps in the research, meaning some cases of childhood abuse may not have been included if they went unreported or weren’t severe. Plus, according to Dr. Chandan, they were limited in doing follow-up research with patients and therefore couldn’t account for inflammatory diseases that arose later in life. So, the findings don’t show the full impact of childhood trauma on medical conditions.

How This Could Change Psoriasis Care

For one, it points to the need for more research about how mental health can affect your risk of developing other diseases. “I think we do a really poor job considering how either trauma, stress, mental health, or comorbidities contribute to disease control,” says Dr. Wine Lee. “And I'd just love to have a better idea of how to incorporate it into my treatment plans.” After all, what kind of mental-health support is needed? And for how long? No research has looked at these questions—or determined the answers—quite yet.

But in adding to the growing understanding that mental health and skin conditions are very closely linked, these findings can still lead to greater awareness—which can benefit both patients and providers in the long run. “If a dermatologist is aware that individuals with psoriasis and eczema are at an increased risk of depression, they may more readily detect signs of depression,” says Dr. Cohen. “This, in turn, can lead to appropriate referrals and care for individuals in need.” Meanwhile, people who have a history of mental-health concerns or high stress might feel more empowered to talk about early symptoms or seek professional help from a dermatologist, “which can facilitate earlier diagnosis and treatment,” he says.

Ultimately, the goal may be to supplement traditional dermatology treatments with mental-health therapies, “particularly for patients presenting with early signs of immune-mediated diseases,” says Dr. Chandan. “Integrating mental health support into treatment pathways may not only help manage psychological distress but also potentially mitigate the inflammatory processes that contribute to disease progression.” It may make all the difference in how people live with these diseases.

https://www.healthcentral.com/news/psoriasis/how-childhood-trauma-links-to-psoriasis-risk

The connection between anxiety and psoriasis

From iol.co.za

There is an association between social anxiety and psoriasis. IOL looks at the causes of this relationship.

“According to the National Psoriasis Foundation, it is estimated that about 2-3% of the global population has psoriasis. This translates to approximately 125 million people affected by this condition,” says Murray Hewlett, the chief executive of Affinity Health. 

“While the physical symptoms of psoriasis are well recognised, the emotional challenges, such as social anxiety, are often less discussed.”

Hewlett characterised psoriasis as a chronic autoimmune illness in which skin cells proliferate excessively quickly, resulting in thick, red areas with white scales.

These itchy or uncomfortable spots most commonly form on the scalp, elbows, knees, and lower back.

The condition frequently comes and goes in cycles, with flare-ups lasting weeks or months before improving for a while.

Psoriasis as a chronic autoimmune illness in which skin cells proliferate excessively quickly, resulting in thick, red areas with white scales. Picture: Supplied

Psoriasis comes in several forms, including:

Plaque psoriasis

Guttate psoriasis

Inverse psoriasis

Pustular psoriasis

Erythrodermic psoriasis

Social anxiety disorder (SAD) is a fairly prevalent mental health illness that causes acute fear of social interactions. It usually starts in adolescence and can go into adulthood if left untreated.

People with SAD are very concerned about being judged, embarrassed, or humiliated. This worry can disrupt daily activities, work, school, and relationships.

Several factors contribute to the frequent association between psoriasis and social anxiety:

Visible symptoms: Psoriasis frequently affects visible parts of the body, including the face, hands, and scalp. As a result, psoriasis patients may experience embarrassment and self-consciousness.

Stigma and misconception: People suffering from psoriasis may encounter stigma and misunderstanding from those who believe the condition is communicable or caused by poor cleanliness. This might lead to social isolation and increased anxiety.

Emotional discomfort: Psoriasis’ unpredictable nature can lead to substantial emotional discomfort. Stress can cause flare-ups, prolonging an anxious cycle and exacerbating skin conditions.

Psoriasis can have an impact on ones quality of life. People with psoriasis may avoid social activities, sports, swimming, or wearing certain apparel, resulting in further social detachment and anxiety.

https://www.iol.co.za/lifestyle/health/the-connection-between-anxiety-and-psoriasis-0d4271d9-e136-46cb-b81e-9ad71762ae23

Psoriasis: More Than Skin Deep

From healthcentral.com

The relationship between skin and mental health is a thorny one. Here’s how to navigate it 

As if an unpredictable condition that causes you to break out in an angry rash isn’t enough to deal with, many people with psoriasis also have to face the disease’s mental health repercussions. Think: anxiety, depression, and even a higher risk of suicide than the average population. The connection between psoriasis and emotional and mental well-being is a complex one. It’s not so straightforward as “psoriasis makes you self-conscious”—though that may certainly be a big part of it. The truth is, the disease can influence your brain on multiple levels.

We spoke with dermatology and mental health experts to unpack the layers and learn what you can do to lessen the hold that psoriasis has on your emotional well-being.

How Psoriasis Affects Mental Health

Research has shown over and over again that people with psoriasis have higher rates of anxiety and depression than those without the skin condition. With that also comes higher instances of suicidal ideation and substance use disorder.

Chronic health conditions in general can really impact mental health because they're all-consuming, says Ariel Zeigler, Ph.D., a licensed clinical psychologist at Clarity Therapy in New York City. “It’s something you have to deal with every day,” she says. “You may never feel healthy or recovered, and that is what takes the biggest toll.”

But unlike a bone or joint condition, a skin disorder can be difficult (and at times, impossible) to hide. “Even if you want to go out into the world and pretend you don't have an illness, that’s out of your control,” Dr. Zeigler notes. “And anxiety thrives in the lack of control.”

Social anxiety, in particular, is huge with psoriasis, says Evan Rieder, M.D., a board-certified dermatologist and psychiatrist at Weiser Skin in New York City. “When psoriasis is severe in an area with exposed skin like the hands, face, or neck, people can have lots of fear and anxiety about being in social situations because of the public scrutiny,” he says, adding that improvements in psoriasis treatments in recent years have seemed to help a bit—”we used to hear it more before we had really amazing treatments”—but there’s still a decent amount of social stigma and ignorance that cause anxiety in people with psoriasis.

The Inflammation-Anxiety Link

While the unpredictability and visibility of psoriasis can cause enough complicated emotions, there may also be a deeper link between the disease and how you feel.

“There is some data [like this research review in Dermatologic Therapy] to suggest that some of the same inflammatory mediators that may be upregulated in depression and anxiety may be involved in flares of psoriasis as well,” Dr. Rieder says. Translation: The inflammation that causes your skin to get red and rashy may also affect your brain and make you more prone to developing things like anxiety and depression.

“We’ve seen in other autoimmune disorders that chronic inflammation in the body is correlated with more anxiety,” Dr. Zeigler says. On the other hand, research suggests that effectively treating psoriasis with biologic medications can also alleviate symptoms of anxiety and depression. Dr. Zeigler says that she sees this happening in her patients, too. “From my experience, yes, when psoriasis is treated, it helps mental health.”

The thing scientists still don’t know, though, is whether the reduction in inflammation (thanks to effective medication) directly improves mental health, or whether it’s the fact that effective treatment clears the skin, and this in turn alleviates some of the social pressure and worry.

Either way, it’s clear that managing psoriasis can substantially improve mental health, too. Still, it’s no magic bullet, Dr. Rieder notes. “When people are living with psoriasis for a long time or have a tendency towards anxiety, they may develop social anxiety or avoidant behaviours, and that’s something much more difficult to attack,” he admits.

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What You Can Do to Feel Better—and When to Get Help

Beyond treating psoriasis—and staying on top of management for the long haul—there are some other things you can do to improve your mental health. Dr. Rieder tells his patients to start with focusing on four lifestyle habits: Mindfulness, exercise, sleep, and social connection.

Practice Mindfulness

Both Dr. Rieder and Dr. Zeigler emphasize the power of mindfulness. “It’s all about staying in touch with the present moment,” Dr. Rieder says. A lot of things can accomplish that, so do whatever works for you. For example, yoga, going for a walk in nature, or listening to a 10-minute guided meditation on your phone count as mindful activities. Dr. Rieder recommends other common anxiety-reducing techniques including deep abdominal breathing, progressive muscle relaxation, or using guided imagery—you can use free YouTube videos to do it. “Those are evidence-based, risk-free ways to decrease stress in the moment,” says Dr. Rieder.

“With mindfulness, practice is your best friend,” Dr. Zeigler says. You don’t have to dedicate a ton of time a day; it can be five minutes or even a 30-second breathing exercise. The more you practice, the better your body will be at going to that place automatically the next time you’re anxious and need to recentre yourself.

Exercise and Sleep

Taking care of your body can have huge benefits for your mental well-being. “We know it’s incredibly important to decrease systemic inflammation, and it’s also good for brain health and releasing endorphins,” Dr. Rieder says. He recommends at least 30 minutes of cardio three times a week. It doesn’t have to be anything intense—simply going for a walk is great. He also suggests making sure you get adequate sleep. The National Institutes of Health recommends all adults get seven to nine hours each night, depending on what makes you feel well rested.

Social Connection

“We know people with active social lives and a good support network of close friends and family generally do better health wise,” Dr. Rieder says. “People who have social contact even if they don't want to do it, do much better in terms of mental health outcomes.” If you’re having trouble getting out of the house to physically spend time with others, use technology to stay connected as best as you can. If you need a support network, tapping into certain communities (online or IRL) can really help—whether it’s for people with psoriasis or centred around a hobby of yours.

“If you’re incorporating all those things and still feel not doing well, that would be time to see a mental health provider,” Dr. Rieder says. For starters, tell your dermatologist. They can refer you to a mental health professional (like a psychiatrist or therapist) who can help you work through the complex emotions of psoriasis.

“Therapy is so effective in the reduction of anxiety,” Dr. Zeigler says. If you’re feeling anxious or depressed, or avoiding social situations you’d otherwise want to join in on, those are signs you could benefit from speaking with someone.

Group therapy can be really helpful, too, even if it’s via an online support group, Dr. Zeigler says. However, she cautions that some people may find it fuels their anxiety instead of helps. “Some people really like that experience of knowing someone else is going through something they are but it can also perpetuate anxieties, depending on the person.”

Also, know that medication is a very valid option, Dr. Zeigler says. “It has so much stigma, but medications can be so helpful.” And you don’t necessarily need to be on it forever; it can be a temporary tool to take the edge off and help you get through a particularly difficult time. Ultimately, the combination of therapy and medication can be really powerful. If you’re on treatment for psoriasis, make sure to discuss tell both your mental health provider and dermatologist all the meds you’re taking so that they can prescribe you a treatment that plays well with your other medication.

Above all else, know that you do not have to struggle alone. So many people with psoriasis feel its impact on their mental health. Whether you try some tactics on your own or seek help from a professional, you can (and deserve to!) feel good and live a joyful life.

https://www.healthcentral.com/condition/psoriasis/psoriasis-more-than-skin-deep

Signs and symptoms of stress damaging your skin: Don't ignore acne breakouts, wrinkles, dry skin

From moneycontrol.com

Talk of modern-day existence of tight deadlines and multiple responsibilities, one thing that has entrenched itself in our life is stress. It demands our attention, and if left unchecked, it can cast a shadow on everything we do, even how we respond to the reasons for it in the first place. Stress is known to be linked with various health conditions, including heart diseases, migraines, multiple sclerosis, seizures, and our mental health. What's more, it is damaging even to our skin!

When stress is triggered, the brain responds by releasing hormones like corticotropin-releasing hormone (CRH), glucocorticoids, and epinephrine. Interestingly, these chemicals affect the body's largest organ: the skin, a rapid stress detector.

Recent clinical observations have further substantiated the correlation between psychological stress and the development or exacerbation of various skin ailments. Here are some indicators that demonstrate the impact of stress on your skin and scalp:

Stress impact on scalp and hair health: Stress-induced hair loss, often temporary, can affect both your scalp and hair health. Telogen effluvium, a type of hair loss, can be triggered by physical or emotional stressors. Typically, your hair goes through two phases: growth (anagen) and rest (telogen). Most of your hair is usually in the growth phase, with a smaller part in the rest phase. However, when your body undergoes stress, such as due to health issues, hormonal changes, or certain medications, much of your growing hair could suddenly shift to the resting phase. This can result in excessive hair fall and eventual hair loss.

Stress effect on skin hydration: Chronic stress weakens the skin's protective shield. Research confirms that stress disrupts the skin's lipid barrier, a crucial component holding the cells together. This disruption causes your skin to lose moisture, making it dry and susceptible to dryness. This can leave your skin feeling rough and uncomfortable.

Inflammation and acne breakouts: Stress, it is said, plays host to acne. But how does it work? When you are stressed, your body releases cortisol, a stress hormone. This is a signal to your skin's oil glands, telling them to kick it up a notch and produce more sebum (oil). This surplus oil teams up with inflammation, allowing acne to take centre stage.

Wrinkles and stress correlation: Your skin cells help your skin to look youthful. When you're under constant stress, these cells start to tire out faster. This leads to premature ageing signs like wrinkles and fine lines appearing sooner than expected. You can say that stress is a fast-forward button for ageing, making your skin look older than it should.

Rosacea flare-ups and stress: Skin conditions, like psoriasis, eczema, and rosacea, can get worse when you're stressed. Stress causes inflammation and confuses your skin's defences. This leads to your skin reacting to the stress causing  more redness, itching, and discomfort.

Reducing stress impact on skin:

Continuous exposure to stress can take a toll on your skin's well-being. Nevertheless, you can get rid of  these skin-related symptoms by effectively managing stress through relaxation techniques, meditation and self-care. Besides, adopting a health-conscious lifestyle, which consists of a nutritious diet and regular physical activity, can also help  to the regulate stress hormones within the body.

https://www.moneycontrol.com/europe/?url=https://www.moneycontrol.com/news/health-and-fitness/signs-and-symptoms-of-stress-damaging-your-skin-dont-ignore-acne-breakouts-wrinkles-hair-fall-dry-skin-11306531.html 

5 Affirmations for When Psoriasis Attacks Your Confidence

From healthline.com

Everyone’s experience with psoriasis is different. But at some point, all of us have likely felt defeated and alone because of the way psoriasis makes us look and feel.

When you’re feeling down, give yourself some encouragement and seek out emotional support in any way you can. Consider the following five affirmations to boost your confidence and improve your well-being.

1. Say something positive about your body

For me, hating on psoriasis used to mean hating on my body because it’s where the psoriasis lives and shows up. Since becoming a mom, my mindset about my body has changed completely.

I remind myself that my body is strong. I’m amazed with what it’s capable of doing. Thinking this way doesn’t change the fact that I still have psoriasis to deal with, but it shifts the focus. Rather than thinking of my body in a negative light, I can see it as something that I want to celebrate.

2. I’m not alone in this journey

When you’re feeling down about a flare, talk to your psoriasis people. They can be your go-to friends who you talk to about your psoriasis, or friends in the psoriasis community who also know what you’re going through.

Finding and connecting with others living with psoriasis has made having this disease so much more manageable than when I was first diagnosed. The genuine sense of togetherness and support can help lift up a miserable, flare-filled day.

3. I choose to feel happy

Often, our brains will automatically seek out and focus on the negative aspects of a situation rather than the positives. We can counter this by actively choosing to be happy.

You can also take it a step further and remind yourself of that choice by wearing something that makes you happy. It can be a bright yellow scarf, your favourite tie, or even your power lipstick. Whatever it is, put on something that can visually prompt you of your choice toward happiness.

4. I release the emotions, attitudes, and habits that no longer serve me

This is a positive way of focusing only on the things that you have control over. We have no control over the fact that we have psoriasis, but we can control how we react to it and treat it. Embracing a new mentality can release the power that psoriasis has on our emotions.

5. Go for a walk

While this isn’t exactly an affirmation, this is still about making a change. The only difference is that the change is to your physical location.

Take a break from focusing on your flare, and go out for a walk. It doesn’t have to be far or fast, but it gets your endorphins flowing. Plus, the change of scenery will be good for your mindset.

The takeaway

Psoriasis is a daily challenge, but incorporating positive affirmations into your everyday routine can be an emotional asset to your overall well-being. These are just some to get you started, but you should choose and create the ones that feel the best for you.

https://www.healthline.com/health/psoriasis/moderate-to-severe/affirmations-for-psoriasis-confidence?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2023-01-24&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e 

Is There a Connection Between Social Anxiety and Psoriasis?

By Susan Navarez

When psoriasis appears, it may trigger feeling of embarrassment, anxiousness and depression in a person. It causes massive resentment in the sufferer, forcing him to isolate himself from the society. The patient begins to feel the pangs of stress and anxiety with the onset of psoriasis and having to avoid the society.

Diagnosis of psoriasis is invariably followed by psychological issues. According to a study published in the International journal of Molecular sciences, 46% of the psoriasis patients were diagnosed with social anxiety while 38% of them were diagnosed with depression.

Although scientists aren't fully aware of the connection between psoriasis and social anxiety, some studies have shown a strong connection between mental health and psoriasis. Psoriasis, which is a common inflammatory and proliferative disease of the skin, is genetically determined. And studies have found that psychological stress can exacerbate the disease.

There is strong clinical proof that stress plays a pivotal role on the onset and exacerbation of psoriasis.  Research conducted on psoriatic patients says 60% of the patients affirmed that stress was a causal factor for their psoriasis.

Psoriasis acts as a double-edged sword. It can lead to stress itself, and in turn, stress can worsen psoriasis. Most Psoriatic patients said that they faced stress and anxiety due to social stigma associated with it and the cosmetic disfigurement resulting from it. It then precipitates their psoriasis.

Another study showed that a person's age during the onset of psoriasis can contribute majorly towards mental health problems such as social anxiety and depression. The study revealed that people developing psoriasis before the age of 18 years experienced social anxiety in context to stigmatization. However, people developing psoriasis after 18 years of age experienced social anxiety in context to the disease affecting their appearance, which in turn, affected their self-worthiness.

How Social Anxiety and Psoriasis Are Interlinked

Social anxiety, also known as social phobia, is a chronic form of anxiety in which social interaction causes overwhelming fear and anxiousness. A person suffering from psoriasis and co-occurring social anxiety tends to avoid social gathering, family or friends due to feeling of embarrassment and shame.

According to the National Institute of Mental Health, the signs of social anxiety can include:

. Avoiding social gathering

. Fear of being judged

. Feeling of dreaded fear

. Feeling conscious and embarrassed in front of people

. Physical symptoms including accelerated heartbeat, trembling and blushing

. Avoiding eye contact

. Speaking in a very feeble voice

. Fear of interaction with people

According to National Psoriasis Foundation, prolonged stress can lead to severity of psoriasis symptoms and increase the itchiness.

A person enduring psoriasis might find it embarrassing to go to public gatherings due to visible scar. They have the fear about being ridicule by people. By avoiding social gathering for prolonged period of time, the person might develop symptoms of self-isolation, social phobia and depression. This creates a vicious cycle of mental stress and anxiety and can snowball into a bigger issue if not intervened at the right time. It spirals into bouts of mental anxiety until becoming a full-blown psychological case.

Research suggests that psoriasis is an independent disease that occurs on its own, but it has the potential to develop anxiety. Anxiety, in turn, can exacerbate symptoms of psoriasis. The APA defines anxiety as persistent and excessive worries that refuses to go away despite no stressor causing the worry.

How To Manage Emotional Health and When to seek help

People grappling with psoriasis are often actually avoided by people or discriminated in the society. Therefore, educating society about the disease and its psychological consequences on the patients is important. There are therapies that go a long way to deal with it. Intervention programs such as group therapy and family counselling evidently help people suffering from psoriasis in building a supportive network of family and friends and provide motivation.

Cognitive behavioural therapy (CBT) is another effective therapy to deal with co-occurring psoriasis and mental health issues. It helps to develop positive attitude and better thinking process. CBT also focuses on bringing a change in the behavioural pattern of the patient.

https://ezinearticles.com/?Is-There-a-Connection-Between-Social-Anxiety-and-Psoriasis?&id=10521492 

Here’s How Psoriasis Can Affect Your Entire Body

From self.com

It can impact a lot more than just your skin 

Psoriasis is a chronic skin condition at its core—but there’s a lot more happening beneath the surface. Psoriasis —which affects an estimated 7.5 million people in the US—is the result of an overactive immune system, which causes chronic inflammation. While we most often see the effects of this inflammation in the skin, it can also travel to other areas of the body, potentially affecting the nails, eyes, joints, heart, and more.

Read on to understand exactly what happens when you have psoriasis, how it might affect your body beyond the skin, and some treatment options that can help.

What’s happening with your immune system?

When your body needs to respond to an infection, an injury, or a substance that threatens your health in some way (like an allergen), your immune system should kick in to release various cells that fight potentially harmful invaders and protect the body. These cells travel to the affected area and start the healing process, causing inflammation. Here’s the problem: When your immune system is in overdrive, as is the case with any autoimmune condition, including psoriasis, it continues to pump out a large number of inflammatory cells, even when there’s no true threat to the body happening.

In people with psoriasis, it’s thought that there’s a faulty immune response that mistakenly identifies healthy skin cells as threatening, which causes the repair system to malfunction. This kicks off an overgrowth of new skin cells, which is what causes the hallmark psoriasis rash. The majority of people with psoriasis have plaque psoriasis, in which the “rash” appears as scaly patches, or plaques, on the skin’s surface.

This rash is just one visible sign of inflammation, but a doctor can measure inflammatory markers in your blood, Benjamin Ungar, MD, an assistant professor in the department of dermatology of Icahn School of Medicine at Mount Sinai, tells SELF. People who have psoriasis are more likely to have other autoimmune conditions as well, including certain forms of arthritis and inflammatory bowel disease (IBD). In fact, 25% of people with autoimmune diseases have more than one type—often a skin condition among them, research shows.

And constantly having higher-than-normal levels of inflammation can wreak havoc on everything from your joints to your arteries, potentially leading to confusing body-wide symptoms.

Psoriasis and your cardiovascular health

Having moderate-to-severe psoriasis ups your risk for cardiovascular health issues and metabolic diseases, like high cholesterol and obesity, Dr. Ungar says. While there’s not a clear-cut reason why psoriasis may play a role, research suggests that systemic inflammation in the body is associated with a build-up of plaque and cholesterol in your arteries, which can eventually block healthy blood flow and put you at risk for heart disease.

Because of these potential health risks, it’s a good idea for people with psoriasis to have annual blood pressure and cholesterol readings, and talk with their physician about any family history of heart disease, Samar Gupta, MD rheumatologist and associate professor of medicine at the University of Michigan Medical School, tells SELF. Beyond these check-ups, focus on what’s in your control, such as working closely with your care team to find the best treatment for your psoriasis and adopting heart-healthy habits like eating a nutritious diet and exercising regularly in some way, he adds. Getting proper sleep and prioritizing stress-reducing habits are key too.

Psoriasis and your joints

About 30% of people with psoriasis develop psoriatic arthritis, an inflammatory condition of the joints, tendons, and ligaments, according to the National Psoriasis Foundation. Most people are diagnosed with psoriasis first, though it is possible to develop the symptoms of psoriatic arthritis—such as joint pain, lower back pain, and swelling in fingers, toes, and feet—before psoriasis, says Dr. Gupta.

While certain inflammatory markers associated with both conditions may show up on a lab test, it’s still not clear exactly why psoriasis and psoriatic arthritis are so strongly linked, says Dr. Gupta. What is known is that psoriatic arthritis can affect anyone of any age who has psoriasis.

That said, there are some specific risk factors that heighten your likelihood of developing psoriatic arthritis. You might be more prone if you have severe psoriasis, have psoriasis on the scalp, or have a family history of psoriatic disease, explains Dr. Gupta. Joint injuries and viral or bacterial infections may also be potential triggers in people who are genetically predisposed.

Psoriasis and your digestive system

If you have psoriasis, you can be up to five times more likely to have IBD, research suggests. On the flip side, people with IBD also seem to be more likely to develop psoriasis.

We can’t really say that psoriasis causes IBD or vice versa, but the association between the two is worth mentioning. The possible reason for the link once again circles back to chronic inflammation, since IBD—including Crohn's disease and ulcerative colitis —are also autoimmune conditions. Symptoms—like unexplained bloating, cramping, abdominal pain, blood in your stool, and diarrhoea—that happen frequently or last for more than just a few days are worth mentioning to your doctor so you can get a work-up.

Psoriasis and your eyes

Psoriasis can affect the skin around your eyes in an obvious way, since you may experience flaking and itchy rashes, but the underlying inflammation from psoriasis or psoriatic arthritis can also cause eye inflammation, Dr. Hejazi says. Again, it’s unclear why, exactly, this happens, but psoriasis-specific inflammation can also potentially affect the cells in the eyes. In fact, about 65% of people with psoriasis will have eye inflammation at some point in their lives, per research published in the Journal of Family Medicine and Primary Care.

This means you could end up with uveitis, inflammation inside the eye that might involve redness, pain, and blurred vision. If you have these symptoms, it’s important to see your doctor, who can refer you to an ophthalmologist. “Uveitis can lead to permanent eye damage” when left untreated, Dr. Hejazi says.

You’ll also want to look out for pink eye (medically known as conjunctivitis), a common and uncomfortable eye condition that causes redness, tearing, and even discharge from the eyes. It’s important to note that viral or bacterial pink eye is very contagious, so the possibility of getting it from another person—rather than from inflammation due to psoriasis—is probably more likely.

Psoriasis and your nails

You may not think of your nails that often, but psoriasis and psoriatic arthritis can affect your nail health and the skin around it. Basically, the immune system tells new skin cells to grow too fast under and around the nails, which can lead to a bunch of uncomfortable symptoms. “The nails can begin to lift up,” Dr. Hejazi explains. “When the nail health is compromised in conditions like psoriasis, there is increased risk of fungal nail infections,” which often leads to thickening of the nail and white or yellow discoloration, he adds.

With nail psoriasis, you might also see nail pits, a series of dents and divots in the nail itself, or have brittle nails that crumble. The best way to figure out what’s going on if you have these symptoms is to make an appointment with your derm, who can take a small sample of the nail to either confirm or rule out an infection, which will guide proper treatment, Dr. Hejazi says.

Psoriasis and your mental health

Psoriasis is a highly stigmatized condition, which can have a big impact on the self-esteem and mental health of the people living with it. According to the American Academy of Dermatology (AAD), 86% of people with psoriasis say they’re embarrassed by their skin’s appearance, 81% have depression or other emotional issues stemming from their condition, and 66% feel isolated or alone. “Many patients with psoriasis are extremely self-conscious about their skin, because psoriasis often affects very visible areas of the body such as the scalp, face, hands, elbows, and legs,” Dr. Hejazi points out. “I have several patients who refuse to wear short sleeves or shorts as it may expose their rash.” All of that can heighten feelings of anxiety and depression when it comes to psoriasis, she says.

On top of that, there may be a reaction happening in the body that potentially predisposes people with psoriasis to have mood disorders. An important pathway, called the gut-brain-skin axis, connects the microbiome of bacteria in your gut, the inflammation (or lack thereof) in your skin, and your mental state, Dr. Gupta says. The ways they impact each other are complex and not super straightforward, but the gut microbiome has been found to play an important role in facilitating communication between the immune system and the brain. Normally, good bacteria in your microbiome help produce neurotransmitters, like serotonin and dopamine, which are necessary to regulate mood. In people with psoriasis, there sometimes seems to be a miscommunication that results in an unsuccessful transmission of those “happy hormones” from the gut to the brain, which can possibly set the stage for higher levels of anxiety and depression.

How to minimise the effects of psoriasis

When it comes to treating psoriasis, the sooner you get a diagnosis and begin your treatment journey, the better. There are a number of medications that can help reduce inflammation throughout your body—so you can start feeling better quickly. If one doesn’t work for you, there will be plenty of others to consider.

Treatment options that target the entire body include oral immunosuppressant medications, which work by tamping down an overactive immune system, and injectable or infusion medications called biologics, which target specific parts of the immune system to block the faulty reaction that causes psoriasis, according to the AAD. Both biologics and oral immunosuppressants essentially reduce chronic inflammation, which also can reduce the effects of psoriasis beyond the skin. On top of that, topical medications and managing your psoriasis triggers—stress is a big one—can help keep your flare-ups in check.

https://www.self.com/story/how-psoriasis-affects-your-body