Many of us with psoriasis feel down about our skin. The research evidence looking at the link between depression and psoriasis is itself quite gloomy. One recent study conducted in Italy found that over 60% of people with psoriasis have symptoms of clinical depression (Eposito, 2006). Compare that to approximately 10% of people in the general population.
But how do you know if the way you are feeling is clinical depression? We all get low from time to time but feeling low is considered to be clinical depression when five or more symptoms from the following list have been present over a two week period, and at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure*:
- Depressed mood most of the day, nearly every day;
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day;
- Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 of body weight in a month), or decrease or increase in appetite nearly every day;
- Insomnia or hypersomnia nearly every day;
- Psychomotor agitation or retardation nearly every day;
- Fatigue or loss of energy nearly every day;
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day;
- Diminished ability to think or concentrate, or indecisiveness, nearly every day;
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Feeling depressed about psoriasis is tricky because as we all know there is no cure for psoriasis. If someone could wave a magic wand and rid you of this disease then this is likely to be an effective cure for your low mood. Sadly there is no magic wand (or cream or tablet) to cure your skin so what can you do instead?
The symptoms of depression can be treated using anti-depressant medication and/or a psychological therapy. However a treatment that only aimed to improve the symptoms of depression would miss the bigger picture. It would be hard to treat depression without tackling the root cause: psoriasis. It is a Catch 22 situation because we know that treating psoriasis is not so easy. Perhaps equally important is to learn to cope with psoriasis so that it has less of an impact on your mood. If you can’t get rid of it then you need to learn how to live with it. How well you cope with this condition can determine how happy and fulfilled your life is. Learning to identify negative or unhelpful thoughts, changing behaviour and relaxation may be the tools to coping. Look out for tips relating to these strategies in future posts.
If you have read the list of symptoms above and think that you are depressed then please visit your GP to discuss treatment options.
* Taken from the DSM IV – The Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (American Psychiatric Association, 1994) – the current reference used by mental health professionals and physicians to diagnose mental disorders.
Esposito M, Saraceno R, Giunta A, Maccarone M, Chimenti S:An Italian Study on Psoriasis and Depression.Dermatology 2006;212:123-127