And why treating one helps the other.
Chronic conditions can be difficult to deal with, and it’s perhaps not a surprise that having one can cause stress and increase the risk of mental illnesses like depression. This is also true for psoriatic arthritis (PsA), a chronic autoimmune condition that causes joint pain and flaky skin lesions.
“Although there is an increased risk of depression amongst all autoimmune conditions, psoriatic arthritis does have one of the higher ones, if not the highest,” says Nicola Kim Berman, MD, a rheumatologist based in New York.
In a 2010 study, people with psoriasis had a 39 percent higher risk of being diagnosed with depression than people without psoriasis—and developing PsA increases that risk even further, according to the National Psoriasis Foundation.
In addition to the general stress of dealing with a chronic condition, psoriatic arthritis has the added effect of being a visible disease. Psoriasis and psoriatic arthritis can result in red, flaky, scaly patches of skin that may cause extreme self-consciousness, especially for younger patients.
“Being a young teenager or a young woman or man is hard enough. I think having diffuse skin lesions adds a lot of psychological issues on top of everything else,” says Dr. Berman.
Treating Psoriatic Arthritis + Depression
Tackling both your depression and your psoriatic arthritis has many benefits. Each condition can be grueling on its own, but together, they can worsen each other’s symptoms. “Stress itself can exacerbate flares and can exacerbate an inflammatory state in your body,” says Dr. Berman.
Chronic stress can cause chemical and hormonal changes in the body. Stress hormones (e.g., cortisol) are released, and this can increase inflammation and suppress the immune system. Since psoriatic arthritis is already an inflammatory condition, additional inflammation can be devastating.
Seeing a therapist about your mental health can be extremely effective for many people, as well as attending support groups. “It’s very helpful to talk to other people with the condition. When you have an autoimmune condition, a lot of times you can feel quite alone and like you’re doing this on your own,” says Dr. Berman.
Additionally, sticking to your prescribed treatment plan for PsA may help relieve both your PsA symptoms and your depression. After all, a major goal of treatment is to improve your overall quality of life.
“A lot of people who take their medication correctly and live a healthy lifestyle and see their doctor regularly … are able to return to baseline and have families and enjoy their weekends and go to work every day,” says Dr. Berman. “That should be what everyone strives for.”
Liu Y, Wang Y, Jiang C. Inflammation: the common pathway of stress-related diseases. Front Hum Neurosci. 2017;11:316.
The link between psoriatic disease and mental illness. Portland, OR: National Psoriasis Foundation, 2015. (Accessed on May 14, 2019 at https://www.psoriasis.org/advance/link-between-psoriatic-disease-and-mental-illness.)