Stress and psoriasis

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Studies have shown that stress and psoriasis go together. And while stress is known to make psoriasis worse, psoriasis can make you more stressed out. some particular stress-induced effects on circulating lymphocytes with implications for the cutaneous inflammation in this chronic relapsing skin disease.

Stigma.  People living with psoriasis can become self-conscious and ashamed.  Everyday social interactions can become stressful, from going on a date to merely shaking someone's hand.

Finances.  Lots of psoriasis treatments can be expensive. A year's worth of biologic medicines can cost over $25,000. And the costs of even the cheaper treatments can add up.

Pain. Psoriasis can cause chronic pain, which adds a constant level of stress in your life.  Sometimes, that pain -- especially with psoriatic arthritis of the hands -- can seriously interfere with your ability to do day-to-day activities.

Treatment. Unfortunately, treatment itself can be stressful. Some therapies require a lot of commitment -- phototherapy sessions might be five times a week for up to a year. Trying to fit that into your schedule isn't easy. Coping with the side effects of a drug can be stressful. And of course, there's nothing more frustrating than trying a treatment for months that doesn't end up working.

Life with disease. Psoriasis is a chronic condition. There is no cure. When it's bad, psoriasis can wear you down. Even when you're doing well, you might still find yourself anxious about the future. What if it gets worse again?

Tips for Coping

Use relaxation techniques.  Many practices -- like deep breathing, meditation, tai chi, and yoga -- can make a big difference for people with psoriasis. In some cases, it may actually help with treatment. One study found that people receiving light therapy while listening to meditation tapes did twice as well as people who just got the treatment. Obviously, simpler stuff -- like long walks or long baths -- can help relax you too.

 Benefits of relaxation technique

Get a massage.  Many people suffering with stress and psoriasis find that massage is a good way to ease tension. Massage includes specific techniques like acupressure and reflexology. When looking for a masseuse, you might want to find one who has previously worked with people who have psoriasis. 

Have trust in your doctor. To reduce stress, you need to have confidence in your treatment -- and that means faith in your doctor. You must have a good working partnership. If you don't, or if you have doubts about your treatment plan, don't hesitate to get a second opinion.

Get professional help. If you're finding the stress and psoriasis hard to handle -- or are worried that you're developing clinical anxiety or depression -- schedule an appointment with a therapist.  Therapists can help you cope with some of the intense emotional issues that stem from life with psoriasis. But he or she can also give you more practical tips on ways of reducing stress.

Get better treatment. Yes, treatment can be a cause of stress for people with psoriasis.  But it can also be the best cure for both your stress and psoriasis. If you have good control of your condition and can resolve the symptoms, you're removing the core cause of your stress.

If you're in severe depression or stress you can use antidepressant drugs after taking your doctor advice about these drugs .  It has been published reports of improvement of atopic dermatitis with topical application of the strongly antihistiminergic tricyclic antidepressant doxepin and of psoriasis with oral administration the tricyclic antidepressant imipramine ,with the monoamine oxidase inhibitor moclobemideand with bupropion-SR .

Antidepressants have neuroendocrine and immunologic effects including decreasing natural-killer cell activity and inflammatory response in mice; decreasing macrophage migration and hypersensitivity reactions in rats; and in humans, altering concentrations of opioid peptides and beta-endorphin concentrations in lymphocytes, suppressing natural-killer cell activity altering interferon/interleukin production ratios normalizing the chronic hypothalamic-pituitary adrenocortical (HPA) axis overactivity in patients with depression , and inhibiting the substance -P inflammatory response in skin . the skin and brain are derived from embryologic cell populations adjacent to the neural crest there is enough commonalty between these tissues that bupropion may have specific effects of its own on adrenergic receptors in dermal or epidermal tissue.

It's reported that Pharmacological treatment of depression secondary to cytokine administration has included antidepressants, opiate antagonists, stimulants and corticosteroids. Serotonin selective reuptake inhibitors as well as tricyclic antidepressants have been used to treat and prevent IFN-α induced depression .

Administration of anti-depressant drugs is reported to result in immune system changes (i.e., decreasing expression of inflammatory mediators) suggesting a link between increased inflammatory mediator expression and disease. In support, cytokine antagonists have been administered to patients with chronic inflammatory disorders to alleviate physical illness as well as symptoms of concurrent depression. Administration of anti-cytokines (e.g., TNF-α) is reported to clear up psoriatic lesions and relieve symptoms of fatigue and depression in patients with psoriasis. Although speculative, this suggests an association between increased pro-inflammatory cytokines and pathogenesis of depressive disorder.