Psoriasis and Depression: The Lesser-Known Impact of the Disease
By Nolan Brown, Marketing Intern, Butler University
Psoriasis is a chronic inflammatory disease of the skin that affects both the personal and social lives of the people it strikes. Psoriasis Awareness Month is an important time to discuss one of the lesser-known impacts of the disease.
“Many people are familiar with the physical appearance of psoriasis, but most are unaware of the severe psychological impact it has on the patient,” says VMS BioMarketing Clinical Nurse Educator Samara Ashley, who provides education and support to people with this condition within the biopharma industry. “The severity of psychological distress from psoriasis is higher than most people realize.”
While psoriasis lesions can be physically uncomfortable, fear of social rejection and stigmatization can cause even worse psychological distress. Due to the visibility of psoriasis, people may suffer from embarrassment accompanied by low self-esteem, anxiety, and depression. Psoriatic lesions can appear anywhere on the body, but they often appear in areas such as the scalp, face, and hands. This challenge often leads patients to socially isolate themselves and may impact all areas of their life.
In a study recently published in the journal Cureus, researchers at the California Institute of Behavioural Neurosciences and Psychology studied the link between psoriasis and depression and how they amplify each other. Researchers found that 9.7% of psoriasis patients “wished they were dead” at the time of the study, and 5.5% had suicidal ideation. The way patients see their psoriasis directly impacts the severity of mental distress; the worse patients view their own symptoms, the worse depression may get.
While people with psoriasis face these emotional challenges year-round, Ashley says the impact of the warm summer weather only works to further these issues. “Often, especially in the summer,” she says, “I hear from so many patients who are uncomfortable due to breakouts, flaking skin, or dry itchy areas. They often want to wear more comfortable clothes – tank tops, sun dresses, shorts – but feel embarrassed or uncomfortable due to questions they get or looks from people out in public.”
Among all dermatological diseases, people with psoriasis have the highest risk of developing depression, researchers said, and this can catch patients in a dangerous cycle. As the visible symptoms develop, they may get more depressed about their self-image. In the study, depressed patients were shown to be more likely to develop worse symptoms. As stress and depression increased, so did psoriasis flare-ups.
If psoriasis patients continue down a depressive path, they may become more detached from their prescribed therapy, researchers noted, and patients who are depressed are most non-compliant. “They might think that they would never get rid of the disease despite the treatment. Managing the psychosocial part of the illness, along with its physical aspect, would give better treatment outcomes,” they said.
“This is why education and support are key ingredients in managing the symptoms of psoriasis,” says Ashley. “Through better education for healthcare providers and more psychological support, patients can be empowered to fight their psoriasis while maintaining their mental health.”
Nolan Brown is a senior strategic communications major at Butler University interning with VMS BioMarketing. Samara Ashley, RN, is Clinical Implementation Specialist at VMS BioMarketing, with 20+ years of experience in the nursing field.
 Sahi FM, Masood A, Danawar NA, Mekaiel A, Malik BH. Association Between Psoriasis and Depression: A Traditional Review. Cureus. 2020;12(8):e9708. Published 2020 Aug 13.