Any disease that has symptoms visible to others can cause emotional anguish. Psoriasis is such a condition that affects the skin. According to the Mayo Clinic, the disease alters the normal life cycle of skin cells, causing them to rapidly accumulate on the skin’s surface. The buildup of extra cells causes thick, silvery scales to appear with dry and itchy red patches that can sometimes be painful.
Psoriasis is a chronic, persistent disease and fluctuates in severity. Although there is no current cure, treatment is focused on slowing down the rate of skin cell growth, non-prescription cortisone cream is helpful and limited sunlight exposure is also recommended. Types of psoriasis include:
- Nail psoriasis – A condition that affects toe and fingernails with pitting, abnormal growth and changes in color; the nail may even crumble
- Erythrodermic psoriasis – This condition is characterized by a red, peeling rash that covers the whole body and can burn intensely
- Psoriatic arthritis – In addition to psoriasis symptoms, the joints become swollen and painful, any joint may be affected and the disease can cause permanent deformity
- Pustular psoriasis – An uncommon form with pus-filled blisters appearing after skin becomes red and sore. May be accompanied by fever, chills, itching and diarrhea
According to the National Psoriasis Foundation, people with psoriasis are twice as likely to develop depression as compared to the general population. Doctors postulate that the very changes that cause psoriasis are also responsible for depression; the stigma and visible signs of psoriasis can trigger depression.
Depression greatly reduces a person’s ability to cope and, when combined with psoriasis, the mental health condition can induce suicidal thoughts or attempts. Depression symptoms include sleep disturbances, fatigue and lethargy, lack of energy, loss of interest in things formerly enjoyed and lack of concentration.
Dr. Jerry Bagel, a Columbia University dermatologist, asks his patients consider if they routinely wear long sleeved clothing when going out or if the feel afraid to wear black clothing that may highlight flaking. The answers let him know if patients feel isolated or stigmatized by the plaques and flakes.
Psoriasis patients suffering from depression take antidepressants at a much higher rate than those without psoriasis. Bagel says the best method of improving quality of life is to manage the psoriasis with recommended treatment. Patients who can do so report a better quality of life and are able to work with little absenteeism. Treatment includes: phototherapy, ointments, systemic drugs or biologics made from natural sources. Patients using biologics report lowered depression levels. It is not known whether the improvement is attributed to an improvement in the psoriasis or due to changes in the body.
If you or a loved one suffers from depression and have questions or need information, please call the Florida Depression Helpline at any time.