Looking After Your Mental Health

Look after your mental health

Psoriatic arthritis (PsA) can feel like a battle and have a deep impact on the people who suffer from it, including on their mental health.[1] [2]

It’s common to feel frustrated or overwhelmed,[2] and your wellbeing and quality of life may be affected.[2] If you feel frustrated or in pain,[2] it might make you avoid social situations or keep you from getting on with your daily life.[2] In fact, if you have psoriatic disease, studies show you may also suffer from depression, anxiety and stress.[1]

If these symptoms go unrecognised and untreated, they can prevent you from effectively managing your PsA, which could affect both your physical and mental health.[1] Stress can even affect how well you respond to treatment, trigger flare-ups[1] or make the PsA worse.[2][3]

TOP TIP
It’s important to talk - ask your support network for help if you’re worried about your mental health

Watch out for the signs

While anyone may struggle with their psychological wellbeing, it’s more likely for people with long-term health conditions, like psoriatic disease.[1] Depression is more common in people suffering from PsA than those with psoriasis alone,[1] so watch out for the signs, which include:

Trouble sleeping[4]
Feeling sad or hopeless[4]
Low energy[4]
Loss of interest in things[4]
Difficulty concerntrating[2]

However, some PsA symptoms, such as fatigue, aches, pains or joint stiffness, are also common in depression, so if you’re wondering whether what you’re feeling is psoriatic arthritis, or something more, please seek help from a professional.[1] While it can be tricky to speak about your feelings, general practitioners and specialist consultants will be able to help you figure out if you have depression and offer you support or direct you to where you can access it.[4]

If you are having suicidal thoughts, please contact your local healthcare professional immediately or visit an emergency room and let a friend or family member know.

Visit Gamian.eu for mental health support

You may also find information about support networks local to you

Don’t feel daunted reaching out - general practitioners are often the first health professionals people contact about mental health[5]

Remember you’re not alone

Over the duration of disease

  • Approximately 50% of people with psoriasis skin lesions report feeling rejected as a result of their condition[6]
  • People with PsA are twice as likely to suffer from depression than those with psoriasis alone[1]
  • 60% of people report a lack of understanding from friends and family[7]
  • At least 50% of PsA patients experience fatigue[8]
  • Over 50% of people with PsA suffer from at least one other disease,[9] so speak to your doctor if you notice anything new

Do mention it to your doctor if you notice anything new.

The effect of PsA is personal

The connection between chronic illnesses and mental health conditions is well documented,[10][11] but even though these challenges are common in illnesses like PsA, they vary from person to person.[9] For example, one person may struggle with pain, while another may not.[9] Someone else may have moderate fatigue, while another suffers severely,[8] and another still copes with joint pain, fatigue and itchy and uncomfortable skin plaques.[7]

Remember, no matter what your physical psoriatic arthritis symptoms are, it’s just as important to manage your mental health, and seek help when you need it, as it is to manage your treatment.

Think about opening up

It might feel tough to start a conversation with friends, family or colleagues about depression, and you may find the following suggestions helpful:

  • Have the conversation in a setting that makes you feel safe and relaxed
  • Choose to speak to someone who you feel comfortable and safe with
  • Talk while doing something else with your loved one, for example, going for a walk or a drive
  • Ask a healthcare professional to join the conversation – or help you prepare for it – to provide guidance and a neutral point of view
  • Have several short conversations instead of trying to explain everything in one go

If you’re ready to talk about your mental health with others, you’ll find useful tips, including how to start the conversation, what to focus on, tips for your loved ones if you’re the one suffering, and more at breakingdepression.eu.

8 steps to managing your mental health

1. Manage your stress

Obesity and weight gain have been identified as risk factors for PsA,[12][13][14] which could contribute to your stress levels.[15] Exercise is a great way to manage these risk factors, as it not only helps to keep your weight in check,[14] but also reduces the pressure on your joints,[13] boosts your mood by releasing endorphins[16] and lowers inflammation, which could help ease your symptoms.[17]

If exercise is too difficult to manage, then meditation or mindfulness, spending time doing something you enjoy, or talking openly with your friends and family, may all help your state of mind.[18]

2. Be honest

People with PsA who get social support – be it from friends, family, co-workers, or even from fellow patients on a forum – feel better day-to-day, and are likely to be happier.[2] Read the Psoriasis and relationships guide, or take a look at the Connecting with others section on speaking to the people in your life.

3. Take it one day at a time

When you’re feeling low, you might find it easier to deal with the mental health implications of your PsA if you stop worrying about the future and the hurdles you might face. Try to focus on the present moment, rather than the bigger picture.[18]

4. Refresh your knowledge

You might know a lot about PsA already, but whether you’re an expert or someone who’s just found out about psoriatic arthritis, keep yourself educated with the latest news and what’s on the horizon. You can find more about currently available treatments in the What treatments are out there section.

5. Get your psoriasis under control

A life-long condition like psoriatic arthritis may make some people feel as if they’re not in control.[1] With the right support and treatment, your physical and mental health can be managed.[1][19] If your condition improves, your depression might too,[1] so take your treatment as your doctor has prescribed and go back to them if you aren’t getting the results you want.

6. Get some sun

Being outside, even on a cloudy day, exposes you to light, which could help reset your biological clock and help you sleep better.[20] Better quality sleep can help improve your mental health, and light therapy is also used to treat both mood disorders[21] and psoriasis skin symptoms.[22]

Do be careful though, as over-exposure to sunlight could make any psoriasis plaques worse, so it is important to wear sunscreen, including on any psoriasis plaques - speak to your doctor about which sunscreen to use.[23] It’s also important to consult your doctor on the appropriate amount of time to spend in direct sunlight,[23] especially if you’re using certain treatments for skin plaques as some can make you more sensitive to the sun.[24]

7. Speak to people who understand

Visiting forums or patient organisation websites where you can speak to others with PsA and hear from people who have struggled in the same way that you have, may help you feel less alone. In Europe, a good starting point is EUROPSO, a patient advocacy group for all European country-level groups. You can use the website to find local groups and lots of valuable tools and information on how to manage the condition.

8. Seek professional help

Everyone has times where they feel a bit low, but depression is different,[18] and anyone can experience it.[25] If you suffer from a long-term condition like PsA, this could increase your risk of depression,[18] so if your low mood has lasted two weeks or more, if you’re struggling to handle your daily life, or you’re finding it impossible to enjoy the activities you used to love, it could be a sign that you’re depressed.[26]

Make an appointment to see a doctor so that they can see if this is the case, prescribe you treatment for depression, if appropriate, and advise you on other measures that could help.[18] These may include different types of talking therapy:[20]

  • Cognitive behavioural therapy (CBT), which focuses on how your thoughts and beliefs affect your feelings and behaviour and helps you to develop coping mechanisms and retrain your reactions.[27]
  • Interpersonal therapy (IPT), which helps people with depression who may have difficulties relating to or interacting with others, by working through relevant aspects of relationships.[28]
  • Counselling, which involves the counsellor listening to you talk about your difficulties without judgement or criticism, to provide insight and help you find your own solutions to problems.[29]

Some medical treatments for mental health may cause PsA symptoms to flare,[30] so it’s important to ask your healthcare professional for guidance

You may be interested in

Tehke koostööd õige ravi leidmiseks

Sugugi mitte kõigile PsA-ga inimestele ei sobi üks ja sama ravim – arst aitab leida teile sobivaima.

Kas tunnete need sümptomid ära?

Iga inimene on isemoodi, aga klassikalised psoriaasinähud on teile võib-olla tuttavad.

Toimetulek sümptomitega

Nõuanded toimetulekuks PsA peamiste sümptomitega.

*Representative of patient experience

References

WebMD. Do you have depression and psoriatic arthritis? Available at: https://www.webmd.com/arthritis/psoriatic-arthritis/depression-and-psoriatic-arthritis Accessed: April 2022.
WebMD. The emotional effects of psoriatic arthritis. Available at: https://www.webmd.com/arthritis/psoriatic-arthritis/the-emotional-toll-of-psoriatic-arthritis Accessed: April 2022.
Heller MM, et al. Skin Ther Letter 2011;16.
NHS. Clinical depression. Available at: https://www.nhs.uk/conditions/clinical-depression/symptoms/ Accessed: April 2022.
Verhaak PFM, et al. Eur J Public Health 2004; 14(2):134–40.
Ginsburg IH & Link BG. Int J Dermatol 1993;32(8):587–91.
Creakyjoints. Psoriatic Arthritis Is Probably Hurting Your Relationships and Ability to Work, But Too Few Patients Tell Their Doctors About It. Available at: https://creakyjoints.org/about-arthritis/psoriatic-arthritis/psa-healthy-living/psoriatic-arthritis-affects-work-and-relationships Accessed: April 2022.
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Arthritis Foundation. How fat affects PsA. Available at: https://www.arthritis.org/health-wellness/about-arthritis/related-conditions/other-diseases/how-fat-affects-psa Accessed: April 2022.
Kumthekar A & Ogdie A. Rheumatol Ther 2020;7:447–56.
Van der Valk ES, et al. Curr Obes Rep 2018;7:193–203.
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Paolucci E, et al. Biol Psychol 2018;133:79–84.
MIND. What can I do to help myself for depression? Available at: https://www.mind.org.uk/media-a/2935/depression-2019.pdf Accessed: April 2022.
Kerschbaumer A & Aletaha D. Lancet 2020 4;395(10230):1091–3.
CDC. Effects of light on circadian rhythms. Available at: https://www.cdc.gov/niosh/emres/longhourstraining/light.html Accessed: April 2022.
Murphy M & Peterson M. Sleep Med Clin 2015; 10(1):17–23.
Psoriasis and Psoriatic Arthritis Alliance (PAPAA). Psoriasis and the Sun. Available at: https://www.papaa.org/media/2247/psoriasis_and_the_sun.pdf Accessed: April 2022.
National Psoriasis Foundation. Taking Care of Your Skin in Summer. Available at: https://www.psoriasis.org/advance/taking-care-of-your-skin-in-summer/ Accessed: April 2022.
AAD. Psoriasis treatment: a retinoid you apply to the skin. Available at: https://www.aad.org/public/diseases/psoriasis/treatment/medications/retinoid Accessed: April 2022.
Mental Health UK. Depression. Available at: https://mentalhealth-uk.org/help-and-information/conditions/depression/ Accessed: April 2022.
Kennedy S. Dialogues Clin Neurosci 2008;10(3):271–7.
NHS. CBT. Available at: https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/ Accessed: April 2022.
Markowitz JC & Weissman MM. World Psych 2004;3(3):136–9.
NHS. Counselling. Available at: https://www.nhs.uk/conditions/counselling/ Accessed: April 2022.
Medical News Today. What’s to know about psoriatic arthritis flare-ups. Available at: https://www.medicalnewstoday.com/articles/316744#triggers Accessed: April 2022.
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