Depressed with Psoriasis? Youre Not Alone

It doesn’t matter whether the psoriasis is mild or severe; it’s still associated with depression, says Roger Ho, MD, MPH, an associate professor of dermatology at NYU Grossman School of Medicine in New York City.

People with psoriasis may find themselves caught in a vicious cycle. The chronic stress of a health condition like theirs can lead to depression; in turn, stress and depression might trigger or exacerbate psoriasis flares, leading to more stress and worsening depression.

Other People’s Reactions to Psoriasis Can Drive Depression

Psoriasis can cause raised, inflamed patches of dry, scaly skin that can be very visible, especially on the face, arms, or legs — and other people may react negatively, Dr. Ho says, which can contribute to depression. Individuals with psoriasis could be worried that others who don’t know much about this disorder will believe it’s contagious (it’s not) and shy away, Ho says.

Psoriasis Can Lead to Social Isolation and Worries About Related Health Issues

Other factors associated with psoriasis might spark depressive symptoms as well, Ho says.

For example, he explains, psoriasis lesions can be itchy and tender and interfere with your daily activities and functioning, especially when the lesions are on your hands. Dealing with the pain and discomfort can be overwhelming at times and cause you to want to isolate yourself by staying at home.

But that can be counterproductive, because isolation and physical inactivity can increase your risk of depression, notes Sanam Hafeez, PsyD, clinical director of Comprehensive Consultation Psychological Services in Forest Hills, New York.

In addition to dealing with day-to-day psoriasis symptoms, people with psoriasis have a greater risk of a host of other health conditions, including psoriatic arthritis, cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD), and cancer, according to the National Psoriasis Foundation (NPF).

The increased risk of these other health issues can give people with psoriasis even more to worry about, Ho says.

Inflammation Might Contribute to Both Psoriasis and Depression

Biological factors could also be driving the relationship between psoriasis and depression. Psoriasis is the result of an imbalance in the immune system’s activators and regulators. “Maybe the same mediators of the immune system that are central to the cause of psoriasis also play a role in the development of major depression,” Ho speculates.

How to Recognize the Signs of Depression

The fact that depression is a known risk for people with psoriasis makes knowing the warning signs even more important — for patients, their friends and family, and their dermatologists.

As far as symptoms go, depression linked to psoriasis is no different than any other type of depression: “It’s depression,” says Leon Kircik, MD, a clinical professor of dermatology at Indiana University Health Medical Center in Indianapolis and at Icahn School of Medicine at Mount Sinai in New York City.

The signs of depression are the same for people with psoriasis as they are for anyone else, Dr. Hafeez concurs. These include:

• Difficulty sleeping
• Having trouble getting up and out of bed
• Loss of energy
• Lack of interest in leisure activities
• Inability to focus

How to Manage Depression

The best way to treat your depression may be to treat your psoriasis. In fact, research indicates that after a person with psoriasis receives effective treatment, their quality of life improves, Dr. Kircik notes.

Other steps you can take to manage the psoriasis-depression cycle include:

You may find that you need depression treatment from a mental health professional, who might suggest:

• Cognitive Behavioral Therapy This form of therapy works by identifying negative thoughts and feelings and helping you change them to something more positive and functional, Hafeez says.
• Medication Antidepressants prescribed by your healthcare provider might be appropriate, Hafeez says.

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