How Is Depression Linked To Psoriasis?
Reviewed by: HU Medical Review Board | Last reviewed: July 2016. | Last updated: September 2019
Everyone goes through periods of feeling sad sometimes, but people with depression may feel sad most or even all of the day, for long stretches of time. Depression can have an impact on all of a person’s feelings, thoughts, and behavior. It can make a person lose interest in activities that are usually enjoyable, and make it hard to carry out everyday activities like working, eating, and sleeping well.
Depression is a mental health condition that is quite common, but can be quite serious if it is not treated. The condition is also known as clinical depression or major depressive disorder1.
What are the symptoms of depression?
Depression is more than just a bad mood; people with the condition usually have a set of symptoms that persist for a long time. Some common symptoms of clinical depression are1:
- Being in a sad, worried, or “empty” mood that won’t go away
- Feeling hopeless
- Feeling irritable
- Having a low energy level; feeling tired
- Having trouble sleeping and trouble getting up in the morning
- Feeling restless or jittery
- Having trouble with concentration, memory, or decision making
- Losing interest in activities you used to enjoy
- Moving or talking slowly
- Having thoughts about death or suicide
If a person experiences some of the symptoms listed above every day or most days for more than two weeks, then it is important to talk with a healthcare provider who can help figure out if clinical depression is the cause2.
How is depression linked to psoriasis?
Living with psoriasis can be difficult, not only because of the physical pain and discomfort its symptoms can cause, but also because its symptoms can be very visible to others and can make the patient feel self-conscious, embarrassed, or isolated2. A challenge for some individuals living with psoriasis is that many other people may not understand the condition, and may have misunderstandings about its causes and symptoms. Psoriasis is a chronic, lifelong condition with symptoms that are often unpredictable, and it can be difficult to find treatments that are consistently effective3. This can also cause feelings of helplessness, frustration, and uncertainty.
Feelings of helplessness, frustration, and uncertainty can stem from the unpredictable nature of having a chronic health condition that doesn’t go away4. Having frequent flare-ups, and not being able to find an effective treatment for all of your symptoms can also add to feelings of being overwhelmed.
The emotional impact of psoriasis
Because living with psoriasis can affect a person’s emotional health, people with the condition are at a higher risk of developing mental health conditions such as clinical depression. The emotional stress of living with psoriasis can be the main cause of depression for some patients. However, new research findings suggest that depression may also be linked to the same inflammation that causes psoriasis skin symptoms. For example, researchers believe that depression can actually make inflammation worse and that inflammation itself can cause depression5. This may be the reason that people who have inflammatory conditions of any kind are more likely to develop depression.
It is important to note that not all people with psoriasis develop depression. Researchers think that this may be because some people are naturally more prone to the kind of depression that is caused or made worse by inflammation.
How common is depression among people with psoriasis?
Studies have shown that people with psoriasis are about twice as likely to develop depression, and people with both psoriatic arthritis and psoriasis are at an even higher risk. One study found that around 17% of patients with psoriasis had symptoms of clinical depression2.
It might seem reasonable to expect that having more severe psoriasis would be linked to a higher chance of depression, but this does not seem to be the case3. The same study found that the patients with severe psoriasis were not more likely to develop depression that people with milder forms of the condition4.
How is depression treated?
It is important for people with depression to seek help as soon as they can because the condition is very treatable with antidepressant medications and counseling/therapy (or a combination of the two)1. Antidepressants are medicines that adjust the balance of chemicals in the brain that affects emotions and moods. There is also a wide range of different types of counseling and therapy that patients can try out in order to find the one that works best for them2.
For people with psoriasis who are depressed, studies have shown that treating psoriasis effectively with the usual treatments can often greatly improve symptoms of depression, with or without the use of antidepressants or counseling at the same time. In fact, many experts recommend that controlling the psoriasis is one of the best ways for a patient to improve his or her overall quality of life, including mental health5.
Other patients may need to treat their psoriasis and depression with medications at the same time. Studies have suggested that this can be effective in speeding up recovery and lengthen the time between flare-ups because treating the inflammation can have a positive impact on both psoriasis and depression for some people. A recent study reported that a type of medication called a cytokine inhibitor (infliximab, for example) that is used to treat psoriasis also had the effect of reducing some patients’ symptoms of depression.
Read tips on dealing with the emotional impact of psoriasis.