Ways to make a positive change
There are active steps you can take if psoriasis or psoriatic arthritis are taking a toll on your emotional well-being.
- Acknowledge your feelings. It is natural to feel anger, despair, guilt and other powerful emotions when you have psoriasis. Your skin has changed and that is difficult to control. It is okay to allow yourself to have feelings and emotions associated with your psoriasis.
- Share your feelings with others: another person with psoriasis, a family member, a counselor or staff at the Psoriasis Foundation. Each of us needs someone who will validate what we say and have empathy for what we are going through.
- If your feelings are out of control or you just can't cope, do not hesitate to seek the guidance of a mental health professional. This is very appropriate and is not a sign of weakness.
- Take responsibility for treatment choices and don't give up on psoriasis control. It is much easier once deep feelings have been acknowledged and aired. However, your path to coping with psoriasis may not include medical treatments. The decision to treat or not treat is up to you.
- Educate yourself thoroughly about the nature of psoriasis and learn to talk about it factually. It is important to say that you have psoriasis. It is a medical term. If you call it something else, you unintentionally degrade yourself and the serious impact of your medical condition. You can explain to people that psoriasis is not contagious, that it is chronic and that it can occur at any time. Encourage people to understand—not wonder about—what is wrong with you.
Disarming the villain
Just as the mind influences the body, the body influences the mind, according to John Y. M. Koo, M.D., a dermatologist and psychiatrist at the University of California at San Francisco Medical Center. In the case of psoriasis, this interaction can be a knife that cuts both ways. The individual who discovers that stress flares psoriasis also may experience stress from problems caused by psoriasis.
One way to interrupt this cycle is to disarm the villain Dr. Koo calls "D2H2"—distortion, disappointment, hopelessness and helplessness. These feelings may stem from inaccurate perceptions about psoriasis and its therapies and your self-image. Cognitive therapy techniques can change these perceptions.
Distortion
"I'm the only one with such a bad case of psoriasis," and "I did this to myself because my life became so stressful." Base your feelings on fact. While emotional stress can exacerbate psoriasis in some people, it does not cause psoriasis. Psoriasis can flare independently of emotional stress.
Disappointment
Psoriasis is incurable at this time, so no single treatment will make it go away forever. Coming to terms with the fact that psoriasis is incurable eliminates false hope and disappointment.
Hopelessness
Psoriasis is, however, treatable by therapeutic approaches. Although one treatment doesn't work, another might. It is your right to work with your doctor to find a treatment that works for you.
Helplessness
Knowledge is the key. Knowing your options, striving for proper perspective, being assertive and pursuing your rights with patience and diligence will banish helplessness.
Cognitive therapy
Cognitive therapy teaches how certain thinking patterns can worsen your ability to cope with your psoriasis and provides tools for challenging negative thoughts. By repeating positive statements, learning to relax and taking action to change inaccurate perceptions, a person can get rid of distorted ideas.
Dr. Koo gives the following example of a cognitive strategy for a man with psoriasis who is considering asking someone for a date:
1. Identify the negative thought and write it down: "No one will ever want to be with me because of my psoriasis."
2. Test the thought: Are you jumping to conclusions? Are you jumping to the worst conclusions possible? Are you making psoriasis the scapegoat for not dating, or do you stay home for fear that someone will turn you down? What proof do you have that no one wants you around?
3. Dispute the thought: Lots of people with psoriasis have good friends and partners. People with other health problems date and make friends. Sometimes you were rejected before you had psoriasis—that happens to everyone. You have a great personality and tickets for a sold-out concert. What's the worst that can happen? Suppose you get turned down and hear that it is because of your psoriasis. Do you really want to spend time with someone that shallow?
4. Review possible rebuttals: If the person you ask says, "I'm busy Thursday," you suggest another day. If she doesn't like concerts, suggest a quiet dinner or a movie. If she says, "No, because you have psoriasis," you answer, "Sorry, I thought you would want to know me before you made a superficial judgment."
5. Carry out the action. Ask someone out.
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