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The emotional toll of psoriatic arthritis

NHS guidance on psoriatic arthritis advises doctors to screen patients for emotional problems caused by the pain and unpredictability of this condition affecting the joints of many people with psoriasis.

Does psoriatic arthritis lead to anxiety and isolation?

Many patients with psoriatic arthritis have feelings of anxiety and isolation. These feelings of anxiety can lead to poor sleep, which can result in more pain and fatigue the next day. Dwelling on the anxiety and fears can lead to feelings of sadness and make you want to be alone, as you stay isolated from family and friends.

Depending on where it is on your body, psoriasis can be an embarrassing disease and a source of anxiety. You may feel like your psoriasis skin condition interferes with your relationships. Perhaps people treat you differently because of the skin condition. New acquaintances may not understand psoriasis and feel frightened by it. Even your good friends or family members may refuse your offers to help them out in the kitchen. In addition, you may avoid relationships or feel like some people avoid you.

When you combine the emotional toll of psoriatic arthritis with the pain and other discomfort you feel, this disease can be difficult to manage on your own. Coping with psoriatic arthritis can increase stress -- and then the increased stress response only worsens the skin condition. There's even some scientific evidence that worrying about your psoriasis may make treatment less effective. This can become a vicious cycle that creates even more problems, including:

  • Difficulty sleeping leading to constant fatigue
  • Inability to exercise leading to poor aerobic and physical fitness
  • Difficulty concentrating from the side effects of medication leading to poor performance
  • Increased irritability from lack of sleep or medication side effects
  • Withdrawal from favourite activities because of low energy
  • Changes in appetite due to medication
  • Depression

Is depression common with psoriatic arthritis?

Depression is common with chronic pain. People with chronic pain often become very depressed and withdrawn -- so much so that they spend more time away from other people. Instead of focusing on their personal lives or the lives of their loved ones, they become increasingly focused on their pain and suffering, which is very real. The many appointments with health care providers to try to find relief, combined with the cost of these attempts, add to the frustration of chronic pain.

Common signs of depression may include:

  • Disturbances in sleep patterns
  • Loss of interest in usual activities
  • Weight loss or gain (5% of body weight)
  • Fatigue
  • Impaired thinking
  • Thoughts of dying or suicide
  • Depressed thoughts or irritability
  • Mood swings
  • Staying at home all the time
  • Avoidance of special friends
  • Difficulty concentrating
  • Difficulty getting out of bed
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Agitation, or, in contrast, a general slowing of intentional bodily activity

If you have any of these signs, talk with your doctor about depression diagnosis and treatment. Often depression is temporary. If needed, there are many excellent depression medications and other forms of therapy that may help greatly.

WebMD Medical Reference

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