Tips to Help You Cope

Staying on top of medications and doctor’s appointments, taking steps to avoid possible triggers, being on the lookout for possible flare-ups — it takes a lot to manage psoriasis. And, that’s not even taking into account the stresses of everyday life, such as work, relationships, and your overall health.

It’s common for people with psoriasis to feel worn out by all they have to do. “Psoriasis can absolutely impact quality of life and contribute to burnout,” says Marisa Garshick, MD, an assistant clinical professor of dermatology at Weill Cornell Medical Center and dermatologist at MDCS Dermatology in New York City. “This may relate to the visible nature of the condition, the chronic nature of it, or that for many individuals, the use of topical creams and other medicines can be very cumbersome and difficult to incorporate into a daily routine.”

But, what exactly is burnout? It’s more than just feeling emotionally fatigued. It’s when the weight of managing your condition leaves you feeling overwhelmed by even the simplest tasks, and the stress makes you sad or angry. Burnout can affect your appetite and make it hard to sleep. It can make you feel apathetic, even for things you used to love to do. It can also take a toll on your health.

Research shows chronic stress and burnout can lower quality of life and contribute to depression in people with psoriasis. What’s more, burnout can lower the odds of psoriasis treatment being successful.

How Does Psoriasis Lead to Burnout?

Psoriasis can bring on various forms of chronic stress that may affect your well-being:

• Dealing with unpredictable flares: Although you may be able to recognize factors that lead to a psoriasis flare-up, flares can also come on unexpectedly. Psoriasis triggers are individualized, varying from person to person, according to the National Psoriasis Foundation (NPF).
• Constantly monitoring for triggers: Trying to stay a step ahead of psoriasis triggers can be exhausting. “Psoriasis may flare up with stress, changes in weather or environment, or with injury to the skin, such as getting a tattoo,” says Dr. Garshick. “It can be difficult to remember to monitor for all of these triggers.”
• Feeling discouraged as you try multiple treatments: There are many treatment options for psoriasis. But, it can be frustrating to change medications or tweak doses, hoping for better results. One study found that switching medications is common in people with psoriasis. After 2 years, 1 in 4 people had changed from one biologic to another.
• Sticking to a long-term treatment plan: “It takes commitment to follow a treatment protocol for psoriasis, as some people may find even just skipping one or two days can cause a flare-up,” says Garshick. “That can be frustrating, as it always has to be on your mind to remember to take your medicine.”
• Dealing with social stigma: No one has to tell you how people react if they see a patchy, scaly rash on your body or skin that’s a different color. It can be embarrassing. The stigma people with psoriasis feel can take a toll on mental health and quality of life — and can even lower the response to treatment, according to one study.
• Worrying about psoriasis-related conditions: Although psoriasis shows up on the skin, it is actually caused by an overreactive immune system. That can raise the chances of developing other inflammatory or autoimmune conditions — psoriatic arthritis, heart disease, inflammatory bowel disease, eye inflammation — and adding more specialists to your healthcare team. “It can be difficult to know that you may need multiple doctors from different specialties to help manage and address the potential risks,” says Garshick.

Tips for Managing and Preventing Psoriasis Burnout

With all the challenges of living with psoriasis, it’s important to take care of yourself both mentally and physically. You don’t have to do it alone. Try these strategies to lessen burnout:

1. Lean on your loved ones. “It is important to lean on your support network, because while they may not fully understand what you’re going through, they can help you navigate and provide comfort,” says Garshick. You might also want to ask a friend or family member to accompany you to a dermatologist appointment, so they can ask the doctor questions and more fully understand how to help you deal with the condition.
2. Join a psoriasis support group. When you’re managing a chronic condition like psoriasis, connecting with others who understand how you feel and can offer tips for coping can be a godsend. Ask your dermatologist about local support groups. The NPF offers free services, such as talking to a patient navigator, as well as events throughout the United States. The Psoriasis and Psoriatic Arthritis Alliance also offers an engagement group and personal journeys from people with these conditions.
3. Make time for yourself. “Self-care can help overall mental and physical well-being,” says Garshick. Meditation can help with stress relief: One study found that people with psoriasis who followed guided meditation for 12 weeks had an improved quality of life and fewer psoriasis symptoms than those who didn’t meditate. You don’t have to spend an hour sitting cross-legged on a cushion, either. Taking a walk and focusing on your footsteps or the birds chirping counts as meditation. So do 5-minute breathing sessions. Also, don’t forget about other ways to practice self-care, including eating healthy foods and staying active.
4. Decide how you want to handle questions and stares. It helps to have a short explanation you can share with coworkers or other people who may not understand your condition. For example, say, “I have a skin condition called psoriasis. It’s related to my immune system and isn’t contagious.”
5. Ask for help when you need it. Whether you need to talk to a friend after a tough day managing a flare or discuss other treatment options with your dermatologist, reach out. “Don’t be afraid to speak to a friend, a loved one, a colleague, or even your healthcare provider,” says Garshick.

Remember to be kind to yourself. Psoriasis isn’t easy to live with, and you deserve to feel your best.