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Your skin, the largest organ of your body, does more than just protect your internal organs from the onslaughts of the outside world. Your skin, its colour, its texture are all tied to your identity, because it is among the first things other people notice about you. It also functions like an organ of communication, revealing your innermost feelings to everyone around. So when you recollect an embarrassing memory, your skin goes beet red.
So it's natural when something goes wrong with your skin, it affects you at a deeper, psychological level. Imagine having to live 24/7 in a skin that blisters, flakes and sheds. You get used to averting stares and explaining why your skin looks the way it does. Life becomes when you have to live with a visible skin condition like psoriasis.
It is an autoimmune disease associated with a lot of psychological stress and reduced quality of life. But it is a problem that is not just skin deep. Disfigurement among patients due to psoriasis is common. A 2009 study showed that these patients had smaller signal responses to expressions of disgust in others.1
This indicated that the patients have developed a coping mechanism to screen out disgusted expressions in other people which they encounter so often in life. While treating the problem, therapists fail to account for the emotional impact of the disease. It shatters self-confidence and has a deep impact on the mental-health and the well-being of the person suffering from the condition. Following are some of the ways in which psoriasis affects the patient's mind.
Excessive stress
Psychological distress is commonly seen in patients suffering from psoriasis.2 This forms a vicious circle when the stress leads to worsening of the disease symptoms. Daily stressors can, in fact, worsen itch and severity of the disease, and patients who are accustomed to worrying are most sensitive.34
Depression
Around 30 percent of patients suffering from psoriasis have depression according to studies.56 The cosmetic problems and physical disability makes them more susceptible to depression. The visible symptoms of psoriasis make patients more conscious as they invite stares from others.
Higher levels of anxiety
Studies have shown that living with the ailment can cause increased levels of anxiety in patients. They have higher levels of anxiety as compared to hospitalised patients in medical wards and is not a transient phase. A study published in the Journal of Rheumatology in 2014 revealed that those with psoriasis and psoriatic arthritis have higher levels of anxiety and depression than those with psoriasis alone.7
Phobic fears
Phobic fears or phobia is the irrational fear of a thing, a person, a place or a situation. It is found that patients of suffering from psoriasis tend to exhibit more such phobic fears than the general population.8
The stigma associated with psoriasis impacts almost all aspects of a person's life including relationships, professional lives, social lives and leisure activities.This shows that the impact of psoriasis often runs deep. Mental and emotional well-being of the patient will help in his overall convalescence.
References:
1. Kleyn CE, McKie S, Ross AR, Montaldi D, Gregory LJ, Elliott R, Isaacs CL,Anderson IM, Richards HL, Deakin JF, Fortune DG, Griffiths CE. Diminished neural and cognitive responses to facial expressions of disgust in patients with psoriasis: a functional magnetic resonance imaging study. J Invest Dermatol. 2009 Nov;129(11):2613-9. doi: 10.1038/jid.2009.152. Epub 2009 Aug 27. PubMed PMID:19710691.
2. Gupta, M. A., Gupta, A. K., Kirkby, S., Schork, N. J., Gorr, S. K., Ellis, C. N., & Voorhees, J. J. (1989). A psychocutaneous profile of psoriasis patients who are stress reactors: a study of 127 patients. General hospital psychiatry, 11(3), 166-173.
3. Verhoeven, E. W. M., Kraaimaat, F. W., De Jong, E. M. G. J., Schalkwijk, J., Van De Kerkhof, P. C. M., & Evers, A. W. M. (2009). Individual differences in the effect of daily stressors on psoriasis: a prospective study. British journal of dermatology, 161(2), 295-299.
4. Verhoeven, E. W., Kraaimaat, F. W., de Jong, E. M., Schalkwijk, J., van de Kerkhof, P., & Evers, A. W. (2009). Effect of daily stressors on psoriasis: a prospective study. Journal of Investigative Dermatology, 129(8).
5. Weiss, S. C., Kimball, A. B., Liewehr, D. J., Blauvelt, A., Turner, M. L., & Emanuel, E. J. (2002). Quantifying the harmful effect of psoriasis on health-related quality of life. Journal of the American Academy of Dermatology, 47(4), 512-518.
6. Kurd, S. K., Troxel, A. B., Crits-Christoph, P., & Gelfand, J. M. (2010). The risk of depression, anxiety and suicidality in patients with psoriasis: A population-based cohort study. Archives of Dermatology, 146(8), 891 895. http://doi.org/10.1001/archdermatol.2010.186
7. Menter, A., Gottlieb, A., Feldman, S. R., Van Voorhees, A. S., Leonardi, C. L., Gordon, K. B., ... & Beutner, K. R. (2008). Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. Journal of the American Academy of Dermatology, 58(5), 826-850.
8. Palijan TZ, Kovacevi D, Koi E, Ruzi K, Dervinja F. The impact of psoriasis on the quality of life and psychological characteristics of persons suffering from psoriasis. Coll Antropol. 2011 Sep;35 Suppl 2:81-5. PubMed PMID: 22220410.
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