Handling the Psycho-Social Problems in Psoriasis

Psoriasis Stress Management Tips

Jan 5, 2009 Hanish Babu

Handling the psychosocial problems caused by psoriasis is an integral part of proper management of the disease.

Psoriasis is more stress sensitive than most other skin diseases. Many stressful events of daily life may exacerbate psoriasis. A number of studies have proven that psoriasis itself may cause a 'reactive depression' or other psychological problems which could further exacerbate the disease process in patients.

Following is a list of common psycho-social problems affecting quality of life in psoriasis patients and a few guidelines on how to deal with them:

Having psoriatic skin lesions, especially on the exposed parts of the body can cause intense sense of shame and embarrassment. Don’t be embarrassed about your disease. It is not even contagious. 3% out of 100 people around you suffer from this disease.
Psoriasis affected shy away from exposing themselves in public places like beaches and swimming pools. Don't ever turn away from the crowd! While exposing yourself at a beach should not cause any problem, it will be a good idea to talk to the management at the swimming pools before you decide to take the plunge. Also remember that a moderate amount of sun exposure is good for your psoriasis.
Perceived disfigurement can pull people back from public interaction. The danger of becoming introverts and loners at work and home looms large. Boost up your self esteem through positive self talk. Remember, psoriasis is like any other disease, say, diabetes or increased blood pressure. It does not affect your capabilities as an active and effective member of the society. There is no need to lose your confidence over such a noncommunicable, life style disease.
Patients may feel guilty about their disease and withdraw inwards blocking any chance of an open communication with the spouse. Some spouses may feel the lesions ‘dirty’ and shy away from intimate contacts. Communicate with your spouse! It is better to have a few sessions together with a counselor to sort out adjustment problems. Attend group therapy sessions along with your spouse once in a while. Go through the psoriasis educational resources together. Make your partner a team mate in your psoriasis management program.
Parents of patients may be stricken with a feeling of guilt for passing on the hereditary predisposition. Siblings, children and other relatives may show hesitance in touching the patients. Talk about psoriasis and the treatment program with your family members. Make them part of your support group by seeking their opinion and discussing treatment options with them.
Being stared at in public places is indeed the worst thing any person can experience. Don’t be embarrassed or irritated. If they stare too long, just look into their eyes, smile and say, “I have psoriasis, a noncontagious skin problem. This is a very common disease; about 3% of the population has some form or other."
Rejection at public places like swimming pools can cause anger, frustration and depression. If you have severe psoriasis that is evident to onlookers, look for other alternatives for the time being. Once the disease is under control, you can definitely go in for a plunge. Or, if possible, opt for the beach instead. All the same, don’t lose your sleep over other people’s reactions.
Psoriasis of hands and feet may cause difficulty in performing daily chores like picking things up, sewing etc. Walking may become painful due to fissures on the thick, cracked soles. Use plenty of emollients and actively treat the disease. Use soft rubber sandals or soles. Psoriasis topical therapies with keratolytic - tar combinations alternating with salicylic acid - steroid combinations will work well. Topical psoralen solution as a soak followed by UVA/UVB also gives good results.
Treatment options produce extra stress because they are: time consuming, expensive, messy and cause frustrations and side effects. Accept what is inevitable. This is a common occurrence during the course of treatment of any chronic ailments. Psoriasis is not an exception.
Alcohol and drug addictions following depression caused by the disease and its psycho-socio-economical impacts can further complicate things. Avoid any form of addiction altogether. This will only compound the problem. Get hold of yourself. If needed, get professional help. Stick to a regular stress management program. Attend counseling sessions and support groups. Whatever you do, stay away from alcohol and drugs! You can also learn and apply relaxation techniques like progressive muscular relaxation, meditation, yoga, breathing exercises, Tai chi etc.

Reference

Gupta, Madhulika A., Gupta, Aditya K., Haberman, Herbert F. (1987/05). Psoriasis and psychiatry: An update. General Hospital Psychiatry 9(3): 157-166.

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