Living with psoriasis. Are you MAD?????
21/08/2016 - By Dr. Catherine O'Leary
I developed psoriasis as a young teenager, just what I didn’t need at a time when my body was already going through some huge and alarming changes. I’ve spent my life since in a battle against psoriasis, seeking out new tactics to beat it into submission and most often going undercover; hiding my skin away from the world, pretending to be normal while all the time, under my clothes, I’m plastered with red hot patches of skin, sore, flaking and peeling. It’s been a long, hard campaign and in reality my enemy doesn’t even exist. It’s just me fighting me. At times I’ve felt very low and I’m not alone.
So many people with psoriasis suffer with clinical levels of anxiety and depression. People with psoriasis can even feel suicidal. I understand this. It’s a difficult condition to live with; painful and unsightly and in a world where appearance is so important, it’s easy to feel disgusting and ashamed. It’s hardly surprising this would affect your mood.
A review ‘Psoriasis and Associated Psychiatric Disorders’ was recently published in the Journal of Clinical and Aesthetic Dermatology. The authors reviewed research papers published between 1990 and 2015 looking at psoriasis and mental disorders. The most prevalent psychiatric problems were sleep (more than 50% of people with psoriasis) and sexual disorders (a depressing 71% of people with psoriasis). They also found papers reporting an association with schizoid traits, schizophrenia, substance abuse, bipolar disorder and eating disorders.
Problems with dependency and eating may be understood as coping strategies and of course you don’t sleep or feel too sexy with all that itching and flaking going on, but the connection with bipolar disorder and schizophrenia is less easy to understand.
From closer reading, it would seem that the association with schizophrenia is mainly based on a paper which found that people with schizophrenia have a higher risk for psoriasis rather than the other way around. It’s a bit like saying that a large number of newspapers are published online, but that doesn’t mean that a high rate of online content is newspapers.
Some of the other evidence reported in the review came from a small number case studies where psoriasis cleared up after anti-psychotics were administered.
When psychiatrists talk about schizoid personality or traits the main characteristics are social isolation, intimacy avoidance and restricted affections.
Well duh. It’s hardly surprising to act like this when you are covered in psoriasis.
Ferreira BI, Abreu JL, Reis JP, Figueiredo AM. (2016). Psoriasis and Associated Psychiatric Disorders: A Systematic Review on Etiopathogenesis and Clinical Correlation. J Clin Aesthet Dermatol;9(6):36-43.