Psoriasis is an inflammatory skin condition, causing irritated skin patches that may be silver and scaly, or pink-red in color and thickened. Patches can be small or cover large areas of the body and can cause significant disfigurement. Some psoriasis patients also suffer form psoriatic arthritis, which in severe cases, can be crippling. Psoriasis is a chronic disease with remissions and flare-ups. The combination of a disfiguring skin condition and disabling arthritis causes many patients a significant amount of psychological distress.
Depression
Depression is common among psoriasis patients. In one study, published in "Dermatology" in 2007, one-third of patients were found to be suffering from depression. Depression is thought to be related to the person's perception of his illness rather than to objective measurements of disease severity, as James Levenson explains in an article in "Primary Psychiatry." Younger men were more likely to be depressed than older men. Suicidal ideation is common. One study quoted by Levenson found that 10 percent of patients had recently thought of suicide. Psoriatic arthritis can lead to significant physical disability and impede a patient's capacity to work and function as he once did. Depression is a common response to these limitations.
Self-Esteem
Young people in particular are self conscious about their appearances. Psoriatic lesions can cause others to turn away in revulsion, a devastating experience for an insecure youth. Early experiences of rejection can have lifelong effects on self-esteem. Rejection can occur in places where the body is more exposed, such as at a gym or pool, but can also occur even when the person is fully dressed such as while at work.
As an article in the "International Journal of Dermatology" explains, rejection can lead to a feeling of being stigmatized. Poor self esteem and stigmatization can lead to social withdrawal, avoidance of school and work, and long term detrimental effects on mood and functioning. Support groups of peers can help develop skills to cope with a society that can at times be intolerant.
Stress
Stress is considered to be one of the triggers of psoriatic exacerbations. Worsening symptoms can also cause a high degree of stress. Various psychological methods are used to treat stress including meditation, hypnosis, guided imagery and psychotherapy. As with depression, a patient's degree of stress is related more to her perception of her illness than to the severity of the symptoms. Nonetheless, when a patient does receive effective treatment, her degree of stress generally decreases, and her general quality of life improves, as James Levenson explains in "Primary Psychiatry."
References
- Mayo Clinic: Psoriasis
- "Primary Psychiatry"; Psychiatric Issues in Dermatology, Part 1: Atopic Dermatitis and Psoriasis; James L. Levenson; 2008;15(7):35-38
- "Dermatology"; Role of Depression in Quality of Life for Patients with Psoriasis; Schmitt JM and Ford DE; 2007;215(1):17-27.
- "Developmental Rehabilitation"; "Ur skin is the thing that everyone sees and you cant change it!": Exploring the Appearance-Related Concerns of Young People with Psoriasis; April-June 2007
- "International Journal of Dermatology"; Psychosocial Consequences of Rejection and Stigma Feelings in Psoriasis Patients; Ginsburg IH and Link BG; Aug 1993
