Depression, anxiety and other mental health conditions are common in psoriatic arthritis. Seek diagnosis and treatment to benefit your overall health.
Coping with a chronic health condition can be exhausting, both mentally and physically. If you're living with psoriatic arthritis, you're likely all too familiar with the unpredictable cycle of pain and, maybe, disability. Once you feel well again, it can be hard to stay positive, knowing that psoriatic arthritis symptoms may return without notice. This pattern may help explain why mental health conditions, including depression and anxiety, are common in psoriatic arthritis.
Fortunately, many effective treatments are available to help, from lifestyle changes to medications and talk therapy. Finding a treatment plan that works for you can benefit your overall health and well-being.
Depression and anxiety are not simply the result of living with the pain and disability of psoriatic arthritis. Research suggests that the chemicals that trigger inflammation in psoriatic arthritis also appear to increase the risk of depression, anxiety and other mental illnesses in people with psoriatic arthritis and those without the condition. In fact, people with psoriasis symptoms are twice as likely to have depression as the rest of the population.
Doctors don't yet fully understand the cause-and-effect relationship between psoriatic arthritis and mental health conditions. It's clear, however, that if you're affected by both, treating both will likely benefit your overall health.
Talk with your doctor if you have persistent feelings of sadness, hopelessness or anxiety. Screening questionnaires are used to pinpoint any mental health disorder. A number of approaches can help you feel better, including:
- Prescription medications. Antidepressants and anti-anxiety drugs are available. Some drugs commonly prescribed for mood disorders, including selective serotonin reuptake inhibitors (SSRIs), may worsen psoriatic arthritis symptoms. Talk with your doctor about the risks and benefits before starting or stopping any medication.
- Cognitive behavioral therapy (CBT). CBT is a form of talk therapy that teaches you how to restructure negative thoughts so that you can respond to them in a more effective way. Research suggests that CBT reduces anxiety, depression, stress and the physical symptoms of arthritis.
- Stress management. Stress triggers an immune system response that increases inflammation and can make your psoriatic arthritis symptoms worse. Finding effective ways to manage stress can help you cope better with psoriatic arthritis. Relaxation techniques such as yoga and deep breathing can be very helpful. A healthy diet, exercise and social support also play an important role in stress management.
- Mindful meditation. This type of mind-body therapy involves focusing awareness on what you're experiencing in an open, interested and nonjudgmental way. The goal is to create distance in your response to certain situations or feelings, helping you react more thoughtfully and calmly. When added to psoriatic arthritis treatment, mindfulness practice can reduce pain and improve your ability to cope with difficult emotions.
Also, ask your doctor about your psoriatic arthritis treatment. People on biologics tend to report fewer depression symptoms.
Talking about your feelings and concerns is a time-honored technique to cope with emotional ups and downs. Communicate openly with your friends, family and doctor.
Support groups can also be a valuable resource for helping you cope. Ask your doctor for help finding a group in your area.
Jan. 08, 2019
- Koo J. Depression and suicidality in psoriasis: Review of the literature including the cytokine theory of depression. Journal of the European Academy of Dermatology and Venereology. 2017;31:1999.
- Ferreira BI, et al. Psoriasis and associated psychiatric disorders: A systematic review on etiopathogenesis and clinical correlation. Journal of Clinical Aesthetics and Dermatology. 2016;9:36.
- Stress tip sheet. American Psychological Association. http://www.apa.org/helpcenter/stress-tips.aspx. Accessed Dec. 11, 2018.
- Ease arthritis symptoms with meditation. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/treatments/natural/other-therapies/mind-body-pain-relief/meditation-eases-symptoms.php. Accessed Dec. 11, 2018.
- Depression. National Psoriasis Foundation. Accessed Dec. 13, 2018.
- Shining a spotlight on the invisible effects of psoriasis. National Psoriasis Foundation. Accessed Dec. 13, 2018.
- Younes SF, et al. Immunohistochemical evaluation of role of serotonin in pathogenesis of psoriasis. Journal of Clinical & Diagnostic Research. 2016;10:EC05.
- Shenefelt PD. Mindfulness-based cognitive hypnotherapy and skin disorders. American Journal of Clinical Hypnosis. 2018;61:34.
- Kilic G, et al. Residual symptoms and disease burden among patients with psoriatic arthritis. Rheumatology International. In press. Accessed Dec. 21, 2018.