Stress can trigger, maintain and exacerbate psoriasis. In turn psoriasis can cause high stress levels in the patients. Exploring this fascinating relationship between stress and psoriasis is of utmost importance in the management of psoriasis.
Stress and Skin
Skin and brain have got the same origin in the womb - the neuroectoderm. Skin as the fifth sense organ, is supplied by millions of nerve endings that are directly connected to the autonomous nervous system and the brain.
These all are interlinked and affected by scores of hormonal secretions from the different endocrinal glands in the body. The immunological system mediated by T lymphocytes is also part of this intricate psycho-neuro-endocrino-immunlogical network.
The stress response is affected by all these pathways. It is but natural that the skin, which is profusely supplied by millions of networks from the brain and autonomic nervous system and supplied by micro-blood vessels throughout the body, will be affected by the stress response in more than one way.
Stress and Psoriasis
Psoriasis is more stress sensitive than many other skin diseases. Many stressful events of daily life may exacerbate psoriasis. The disease itself may cause a ‘reactive depression’ in patients which could further exacerbate the disease process.
The way stress affects the psoriasis patient varies from individual to individual; the most common manifestations are psychological depression, anxiety, angry outbursts and obsessional behaviors.
As mentioned earlier, stress has far reaching effects not only on the immune system, but on the neuro-endocrinological systems as well. During the neuro-endocrinal response, it has been shown that the autonomic nervous system release neuropeptides into the skin. The major group of neuropeptides includes Substance P, Calcitonin Gene Related Peptide (cGRP) and Vasoactive Intestinal Peptide (VIP). These neuropeptides are responsible, along with activated T lymphocytes, for the release of various cytokines like TNF-á, interleukins, leukotreins etc.
These are, in turn, responsible for the proliferation of keratinocytes and the vascular changes seen in psoriasis.
Many scientific studies confirm that stress can worsen psoriasis and increase itching. Some people even trace their first outbreak of psoriasis to a particularly stressful event in their life. Thus stress is one of the most important psoriasis triggers.
Psoriasis can cause stress in a number of ways - the stigma associated with the disease, the shame, embarrassment of the skin blemish, the financial strains of lifelong treatment, the commitment for trying out various treatment modalities all weigh heavily on the mind of the psoriasis patient.
Thus stress-psoriasis relationship becomes a vicious cycle which creates a hurdle in proper control of the disease activity.
Tips on Managing Stress in Psoriasis
Stress and psoriasis form a vicious cycle and if patients do not learn to manage their stress, psoriasis control becomes very difficult. Stress management is an essential part of psoriasis management.
When the everyday stress of living with psoriasis is compounded by a stressful event at work, a personal crisis, or an especially hectic time, such as the holidays, the stress can feel overwhelming and lead to further worsening of psoriasis.
There are many ways to alleviate everyday stress in psoriasis. Patients can either chart out their own stress management program or get professional help to plan one suiting their individual needs and problems. Counseling and group sessions with a support group could perform wonders for psoriasis control.
Learning and applying relaxation techniques like progressive muscular relaxation, meditation, yoga, breathing exercises, tai chi etc. will be an additional advantage in managing stress in psoriasis.
Next: How Does Psoriasis Affect Quality of Life?
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