A Clinical Look at the Insecurities of Psoriasis

Psoriasis is a chronic disease that causes skin symptoms such as scaly and itchy patches. But the impact of psoriasis goes beyond physical symptoms. People living with psoriasis are more likely to struggle with mental health issues.

In turn, these mental health issues can have a negative impact on their physical health.^1-3

Psoriasis and mental health

Psoriasis can affect how you handle stress. It can affect your relationships and your social life. People living with psoriasis are almost 2 times more likely to have symptoms of depression. They are also more likely to have anxiety, thoughts of suicide, and schizophrenia.^2,4

Many of these mental and emotional effects resulting from the day-to-day reality of living with psoriasis. People with psoriasis often face stigma and shame. But there also may be deeper causes at play. Researchers have looked at inflammation and attachment style as possible sources of the link between psoriasis and mental health issues.^2-5

Inflammation

The link between mental health and psoriasis may involve inflammation. The scaly patches (plaques) on your skin during a psoriasis flare are signs of systemic inflammation. This means your whole body is inflamed.^2,3

Doctors test for inflammation by looking for certain proteins in your blood. These proteins are called pro-inflammatory markers, and they are signs of inflammation throughout the body. Many of the same markers found in people with psoriasis are found in people who experience depression, anxiety, or schizophrenia.^2-4

So, psoriasis and mental health may share a similar inflammation-related root cause. This may explain why many people have both psoriasis and mental health issues.^2-4

Attachment style

"Attachment style" is a phrase that mental health professionals use to describe how you relate and connect to people. A 2021 study of 105 people with psoriasis asked participants to describe themselves using one of the following terms:³

• Secure. You have no problem being emotionally close to others.
• Preoccupied. You want to be emotionally close to others, but you think others may not want to be close to you.
• Fearful. You are uncomfortable with getting emotionally close to others.
• Dismissing. You do not care to have emotionally close relationships.

The results showed that people with psoriasis tend to have higher rates of a preoccupied attachment style. This style of attachment is often seen in those who feel insecure or anxious. People with this attachment style also have a strong desire to fit in.³

In the study, having a preoccupied attachment style along with depression was related to lower quality of life and higher disability. This seems to be true no matter how severe a person's psoriasis is. In fact, attachment style and depression are better predictors of low quality of life and disability than psoriasis symptoms are.³

Preoccupied attachment style also has been linked to other health conditions. These include chronic pain, ulcers, and heart attacks.³

How does this affect psoriasis treatment?

Including mental health screens in your psoriasis treatment plan may improve your overall health. If necessary, you can seek out treatment to cope with depression and anxiety. Counseling could also help you understand your attachment style and how it affects your life.

Treating mental health issues early will help both your psoriasis and your ability to enjoy your life.^2-4