Living with psoriasis. Are you MAD?????

psoriasisPsoriasis is hateful.

I developed it 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’ 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.

Whichever way you look at it, having psoriasis can make you feel bonkers at times.  But it doesn’t have to be that way.  I have one, unique life, albeit a life marred by flaking skin, but I want to be happy and enjoy it.  Sure, I would bite the hand off someone offering me a cure, but until that happy day comes, I want to make the most of my life in spite of my skin.  I believe I can.  There are many psychological strategies and techniques to help you cope with your skin.  You can learn these on your own with the many self help resources available online or find a good psychologist to lead the way.

Reference

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.

 

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Searching For A Cure For Psoriasis

I’ve been thinking about how the search for a cure affects our well being. In my twenties I found an ‘alternative’ treatment called Skin Cap. The online community was reporting great success and it contained nothing more harmful than zinc. I bought a few cans and was delighted. It was a spray, easy to use and cleared my skin in record time. I bought several more cans and sprayed away with joy. However it did all seem too good to be true. I was noticing side effects like thinning of my skin and bruising so I wasn’t surprised when it emerged that it contained an unlisted steroid. I stopped using it and had the worse rebound ever. But even worse than the flare in my symptoms was the horrible feeling of being let down and having my hopes dashed. Not surprisingly I became quite low and depressed. I thought I had found the answer to my psoriasis and had been ‘in control’ for the best part of a year. I felt cheated and let down and determined not to fall for a ‘miracle cure’ again.

I have had psoriasis for over twenty years and in that time have tried many ‘cures’. The disappointment I have felt when they fail always affects me deeply and more so than the waste of the money or time. In more recent years I have come to the decision that I won’t invest any hope, time or effort in a ‘miracle cure’ that costs money. I am prepared to try treatments that involve healthy lifestyles like cutting out wheat and processed food and taking vitamins, as I believe that it will probably do me some good even if it doesn’t clear the psoriasis. This is my personal decision but is it the best approach to take? What does the research suggest I should be doing? Should I accept my psoriasis or should I keep trying new potions and searching for a cure?

With this in mind I searched healthcare databases (Medline and PsychInfo) for research looking at acceptance and coping. I found one relevant paper by Zalewska et al (2007) that suggested factors such as higher levels of optimism and a lower conviction of others’ influence on one’s health were linked with acceptance. The authors also stated that a lack of acceptance is associated with poorer medical adherence and delayed clinical improvement. In other words, if I accept my skin as it is, I am more likely to follow doctor’s orders and get better, and I am more likely to accept it if I feel optimistic and don’t think that my health is dependent on someone else.

Whilst not specifically answering my question, this research would suggest that I should be optimistic that something will work (keep trying) and I should have belief in my own ability to cure it (don’t rely on someone else to find the cure for me). Whether or not I should invest any hope or money in a cure remains unanswered. If you know of any research that addresses this question I would be very interested to hear more.

References

Zalewska A,Miniszewska J,Chodkiewicz J,Narbutt J (2007). Acceptance of chronic illness in psoriasis. Journal of the European Academy of Dermatology & Venereology, vol./is. 21/2(235-42), 0926-9959