The Impact of Plaque Psoriasis on Mental Health

Linking depression and psoriasis Depression is a common related condition of psoriasis, and I am part of that statistic. I am thankful that I do not struggle with chronic depression, but it has definitely been known to come and hang out for extended periods of time throughout my life. Sometimes these periods are connected to a flare or stressful time in my life, but other times it seems to sneak in and take over for no apparent reason. I refer to these times as being in a “funk”. I know it is cliché, but for some reason it makes me feel less stigmatized by calling it a funk instead of acknowledging the clinical aspects of depression. My family has a history of mental illness, including depression and bipolar, so I am well versed in the knowledge that depression is, in fact, a chemical imbalance and not something I can “snap” out of, but I still feel a burden of shame and responsibility during these times. It is similar to psoriasis in that way—it is a disease that I didn’t ask for, that I didn’t do anything to catch, yet I feel completely embarrassed by it. Finding a treatment that works Again, similar to psoriasis itself, I have encountered failed medications when trying to treat my depression. Right after my first son was born I was thrown into a long period of depression. Instead of being able to enjoy what was one of the most amazing times of my life—getting to know my son—I felt insecure, hopeless, and fatigued beyond anything I had ever experienced. My wife encouraged me to reach out to a doctor, so I made an appointment, only to be told when I got there that there was a glitch in my insurance and they couldn’t see me. I always think back on that time and think, wow, how can you turn someone away that is there for depression? Luckily I persisted and made another appointment. I was given a low dose of medication and sent on my way. The depression medicine seemed to work pretty well for a few months. At my follow-up my fatigue was still disruptive to my life, so they added a second medication that was supposed to enhance the first. That is when things went downhill fast. I became irritable, irrational, and just not myself. I felt like the Hulk; I was always ready to rage. I scared myself, so I ended up stopping the medicine cold turkey (I do NOT recommend this and encourage anyone considering a medication change to talk to their doctors.) I felt completely isolated. Just like my skin, it seemed that everything “wrong” with me was untreatable. I would find things that worked for a little while, but I always braced myself for the imminent disappointment. Also, the part that is harder about the depression is that it is more difficult to gauge progress compared to my skin symptoms. Calling in the professionals From then on I was too scared to try anything else and took a more holistic approach to managing my symptoms. Now I have a great counselor that I see during these times that has helped me tremendously. I know not everyone can manage their depression with just cognitive and behavioral therapy, and I recognize that it might not always work for me in the future, but I am glad I at least have some foundational methods in place and a support system that can recognize if I am not doing well. Understanding that depression was related to my psoriasis helped me look at treatment in a better way. I wouldn’t brush off another comorbidity, such as heart disease, would I? Depression is the same. It is a serious issue that I must take care of the same way as my psoriatic disease. If you are having any symptoms of depression today, I hope you know you are not alone and have the strength to reach out to your doctor. [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site" title="Sign up for emails from {{site-name}}:"] There is so much in our lives that we don’t want to talk about or share with anyone. This includes our closest friends. When living with psoriasis as long as I have, the only thing I can say is that I have been through the wringer and most times I was alone in the wringer alone. Mental health choices with psoriasis I always kept to myself and never wanted to be part of the in-crowd. I was covered in psoriasis from head to toe and had my routine down to a science. I only went out at night to socialize with people. I went to the doctor the same day, every time, each month. I even had my clothes pick out every day because the colors had to go with my psoriasis. I was comfortable being at ease in my own world. How psoriasis affected my mental health Throughout my life, I can recall times being stared at and pointed at. It made me depressed and sad. I felt so alone. I grew up in a small town where no one person had psoriasis. I got turned down for every job I applied for. I never wanted to leave home. At first, I thought it was because of the color of my skin, but it wasn’t. They didn’t like the fact that I had “stuff” on my skin. Someone actually said this to me. Treating my mental health I wanted so much to fit in with society, but I felt as long as I had this skin disease, it would never happen. I tried taking dance, cooking and sewing lessons. Unfortunately, people never saw me as a person, only someone with psoriasis. I always covered up. I made the time to see a therapist, who helped me through some of my anxieties. He told me at the time that because my life had been so taxing, my brain was having a hard time coping. He said I was having too many symptoms at once. That being stressed with no one to talk too and feeling hopeless was just too much for my brain to handle. Advice for improving mental health If you are going through anything in life and just can’t get it right, please see someone to help you cope. Of course, It’s a big step to admit that something is not right with you. My therapist taught me coping skills so I could live a healthier lifestyle. The one thing that we didn’t talk about back in the day was mental stability. It’s something I hear daily now. You never know what a person is dealing with. On the outside, I had it all together but on the inside, I was dying. Offering mental health support Let’s start supporting one another. We shouldn’t put a stigma on anyone or pass judgment. This is why so many people shy away from getting help. If you see that someone is going through something, be their rock and someone they can lend on. Having to deal with a mental illness and working through mental health is hard enough. I am living proof of that. We all need help at times. [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"] “Depression is often anger turned inwards.” These were the words my sparkly new (and first ever) psychotherapist said to me in our first appointment, and these were the words that explained so much about what had happened to me to end up in the place I had ended up. I am a liar I decided that in 2019 my focus is to be a better storyteller. At my first ever writing class I was surprised, quite naively, that we were starting with some writing exercises. I started my letter to 2018 to thank it. I have a lot to be thankful for, I started the year with depression (though I was in denial because apparently, I am the only human who could possibly be immune) and ended the year a happier, more focussed and more honest than the person I was before. Pretending to be okay When I say ‘more honest,’ I don't mean that I was a dishonest person (although I did steal pot Pourri from a gift shop once when I was 5), I was dishonest with myself. I lied to myself a lot. I ignored a great range of emotions that I felt, to make my life more straightforward. The thing is- living with psoriasis means I pretend things are alright A LOT. From a young age I would tell my mum I was ok when I wasn’t, it broke my heart to see her upset when my skin was terrible, so when I could, I hid it. When I get a sore throat...or even find out the kid chatting to me in the playground has a sore throat I feel worried and at any sign of a sore throat starting in myself or my immediate family I experience feelings of fear. Why we need to be honest about our emotions There are two statements I wrote as I reflected on my year, that still resonate with me, many weeks after I wrote them. "Fear is not something to be avoided. It is an emotion to embrace, much the same as love. Emotions tell us something." Emotions should not be repressed- would you stop a child from telling you why they are upset? The thing is, emotions are never silenced when we try to hide them, they turn into something else- and that something is uglier and more sinister. When anger is repressed, it can lead to resentment, and resentment is much harder to get rid off. It's the red wine that's been trampled onto the carpet. Resentment can affect your relationships with others and with yourself. It can break things which should not be broken. It can manifest itself in ways you don't even notice, sideswiping comments to people you care about for example. This can damage your support network, the network of friends and family that help keep you sane. The people who want to help you live a happier life. Being in tune with your environement The thing is, being so in tune with our environment has made us the success that we are today. Our bodies are built to be dynamic and to respond. Just look at our sensing organs; our eyes help us see danger and potential sources of food, our we use touch to find and feel and connect. Our nose can smell food that is full of toxins and protects us from harm, in the same way, it can detect a bacon sandwich from 200m after a heavy night on the beer. Our senses help us navigate our external environment, our brain takes information from all of the senses, to make sense of the outside world. It exists so we can make the next 'right decision.'A challenge that emotions are essential for a successful life too. They tell us about our internal environment. What we feel is right or wrong. Villanizing emotions Some emotions are villainized, and I am guilty of this with my own children. I catch myself using words when we are out in public like ‘Calm down, we can talk about this later.’ Words like ‘stop crying, your overreacting’ or ‘what's the matter with you? You don't have it half as bad as ….” These are all examples of situations which teach us it is not ok to cry in public, nor is it ok to scream, rant or tantrum. I threw an armful of blankets on the floor in a shop recently and shouted ‘i've had enough!’ to my toddler who had disappeared for the 400th time into Santa's Wonderland. It did not go down well with the other customers. Our anger, pain, frustration and upset are not acceptable when expressed in public, but why? Children know best When children encounter death, they express all of it: tears, tantrums, anger and the aching of loss. They feel so intensely all of the emotions, and then they move on. They have allowed their bodies to feel, and have expressed those emotions outwardly. When we as adults encounter death, we have to be strong for someone or other. We hold our emotions in. I must not cry- I must be strong for my husband/ wife/ daughter… I can't let my mascara run- I will look a mess. The thing is- If you can't cry at a funeral- when can you cry? Crying in public is a sign of weakness, and men feel this more than most (don't even get me started on the term ‘Man Up’). We try to stop crying as soon as we start. The problem is because we don't allow ourselves to feel, we can carry those feeling of loss for a lifetime. We do not allow ourselves to process our less socially acceptable emotions- and it is in this way that we tell ourselves we aren't happy, nor are we proud to be who we are. Which is essentially, that we are human. So what is next? I propose that we all try to become more human this year. I admit crying in public is hard to initiate, but try not to hold it back the next time you hear a lame excuse like, 'my mascara will smudge' running through your mind. Be brave and bold- let it open up the dialogue you need with yourself, and with those around you. It is normal to feel angry- and you know what? You can go to your doctor because you are angry. Its true- I spoke to a psycho-dermatologist who explained this was a great reason to see your G.P. There are lots of support routes for people living with psoriasis to help them process anger, anxiety and other emotions they feel as a result of their circumstances. They are there because they are important. Depression is more common in those of us living with psoriasis, no one is protected from developing depression, listening and being honest about how you feel is the way forward. As I wrote in my letter to 2018 -“Growth can only come from honesty.” [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site" title="Sign up for emails from {{site-name}}:"],

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