The symptoms of psoriatic arthritis (PsA) are usually quite visible – painful, swollen joints, skin reactions and fatigue. Less apparent, but just as impactful, is the emotional toll the disease can take.
“They tell me that it’s taxing,” Julie Nelligan, PhD, a Portland Oregon-based psychologist, says of her psoriatic arthritis patients. “They may say things like, ‘Nobody understands me, I feel like I’m not contributing. I’m lonely, I’m anxious because I don’t know when I can get things done and I can’t commit to doing things,’” she adds.
Living with a disease that has both subtle and obvious symptoms can be a double-edged sword. When you don’t have any noticeable skin lesions, friends and family might not realize how much pain you’re in, and fail to take your illness seriously.
When you do have obvious plaques, you have to deal with the embarrassment and constant fear of others judging you. “It’s pretty devastating to patients because some of them have had the experience of salons refusing service. Swimming pools and gyms have kicked them out,” Nelligan says. Fear of judgment and low self-esteem can keep you at home; isolated and lonely.
Psoriatic arthritis can affect every aspect of your life: work, exercise, dating, traveling and doing many things you once loved. “You can often feel like you don’t fit in or you can’t do your job, which can be pretty depressing,” says Nelligan.
似乎这种疾病的机制也会直接影响你的情绪。奈利根说:“造成关节温暖、肿胀和疼痛的炎症物质似乎也会导致抑郁。”根据一项研究，这可能就是为什么相当多的银屑病关节炎患者(超过20%)患有抑郁症的原因。
Managing Painful Emotions
When you’re in a good place emotionally, it’s easier to withstand the challenges your disease can cause, whether it’s the stare of a supermarket cashier, or the downplaying of your symptoms by a well-meaning relative.
How can you become more emotionally resilient? Start by talking with someone who understands both psoriasis and the depression it can cause. Find a psychologist who works with people who have chronic conditions. You can get a referral from your doctor, or search online resources, such as Health Grades and Psychology Today.
You can also get emotional support from a peer. The National Psoriasis Foundation offers aOne to Onementoring program that pairs you with another psoriatic arthritis patient – someone who knows what it’s like to deal with this disease every day. You can also find a support group online or locally, which will give you access to people who’ve been through similar experiences. “I think it’s really helpful to talk to somebody who gets it,” Nelligan says.
Try to stay involved, even if you don’t feel up to it. Getting out can distract you from the pain and fatigue. If you don’t feel well enough to venture out, call or text a friend to stay connected. Nelligan also recommends keeping a journal to express your emotions, and to record your symptoms so you can start to understand your limitations and work around them.
Another way to beat the blues is with exercise. Physical activity not only relieves soreness and stiffness, but it also releases brain chemicals that boost mood. You don’t have to take an hour-long spin class to see benefits. A 10-minute daily walk or swim can do wonders for both your physical and mental state. An activity like yoga or tai chi combines exercise and relaxation to simultaneously combat pain, stiffness, fatigue and depression. Choose whichever program best fits your abilities.
Finally, don’t be too hard on yourself when fatigue or pain interrupts your life. “Just be compassionate toward yourself for what’s happening, because it’s not your fault,” Nelligan advises.
Related Resources:
- How to Build Resilience and Bounce Back Into Life
- 8 Ways to Fight Fatigue With Food
- Arthritis & Depression
- Arthritis & Fatigue
谢谢你的分享。我患银屑病关节炎已经将近10年了，现在又加上了多发性硬化症。另一种流行疾病.....事实上，我很难把这些都拼凑起来。我期待着开始我的医学生涯，这已经到来了很长一段时间，将会有一些严重的PT来帮助关节炎，多发性硬化症，骨质疏松症，梅尼尔氏症等。我已经申请了小巴，因为我的视力问题不能再开车了。听起来像是一个可怜的派对.....再次感谢。
我的左肩和左膝疼得厉害。还骑着我的哈雷摩托车，挖金子，钓鱼，露营，捕猎外来害虫。在糟糕的日子之间，我做这些活动，因为我不会让这个可怕的疾病影响我。
I suffered with psoriasis on my palms and elbows and cracks in heels for 50 years. I also had pain in my right hip after sitting for a while and would limp for a while upon standing. I was also bothered with dry eye. I love shrimp and ate it often and decided to stop for a while because I knew it could cause allergies. When I stopped eating shrimp, everything improved a lot!! I went to the dermatologist asking for confirmation of my belief that I was allergic to shrimp. The test came back negative, but he told me to be careful. Whenever I ate shrimp, symptoms would return.
Then my daughter was diagnosed with a nickel allergy and was given a list of foods high in nickel. I had also been diagnosed with a nickel allergy 50 years ago, but was never told it was in food. Shrimp was on the list of foods containing lots of nickel!!! Hope this helps someone.
what happens when you have medicare and as a back up Aetna you can not find a doctor who can help you. The pain clinics are glad to see you, they can turn you into a junkie, who wants that. I have 2 dogs and 2 horses and can’t find a doctor. I don’t know what I am suppose to do. I fall on average of once a month and the last time really did some damage. I don’t want to use emergency rooms. I am 66 years old and have been dealing with this since 1991. Had good insurance then and was on Enbrel but now it would cost me $1,037.30 monthly. Don’t qualify for any of the programs so just stuck. Any advice would help because going down hill fast.
In mu lifetime of 70 years nevet once did i have psoriasis within ladt uear 2 attacks each attack lasting 3 months. Recentky i was diagnosed w psoriatic arthritis after mega xrays blood tests n’ exams. Rheumatologist has me taking weekly injections n daily folic acid
Oains awful sevetal fingers n toes bone on bone, shouldets n neck alwats hurt s lot, fatigues awful!
Help plz Thank You??
This was very helpful as I’m dealing with symptoms of such, and not yet diagnosed. Hopefully I can find out more about this topic with my Dr and ask for a referral to a specialist.
This is very helpful to me! I have PsA and you described what I feel daily. I well was and still have my nursing license, but it’s like my auto immune system kicked my tail over the past yr and a half. And then apparently a digestive problems developed too and it all started really slowing me down at work. Depression , very much has impacted my life because I have cheered for 10 yes and been a very active and independent person. I hate to ask for help. But I really found your article helpful! Thanks so much!! Trina:)
Your blogs are very interesting. I have arthritis in my both knees. Also right big toe.
我正在进行我的第三次生理测试，我认为它不工作，我在床上，外面很美。我在写这篇文章的时候,太多的痛苦,我恶心也发生过很多次,我没有,t Prednizone用于相当长一段时间,因为它把我的血但是我苏格,m为2型胰岛素没有所以也许这将帮助加我需要休息,我的意思是,我在痛苦每一天,我必须使用鸦片但使用不到规定,因为我讨厌被醉酒的,实话告诉你,我吓得要死,我,在严重的疼痛,甚至影响我的睡眠。我有一个多年的导师，我是在钓鱼时认识他的，他的病比我还严重，但我去年就摆脱了他，他是一个廉价的混蛋，一个真正的混蛋，这开始影响我的精神，焦虑发作。正是我需要的。不管怎样，这个夏天我什么都没做，太糟糕了，连开车都开始有大问题了。去年秋天，我60岁了，是一个狂热的猎人和飞渔夫，我，恐怕，一切都结束了，它，只是太多了。I WISH .
I have Hemochromatosis. This causes Arthritis as well. I suspect I might have Psoriatic Arthritis. I have been blaming the hemochromatosis for this. My Doctor already diagnosed psoriasis. My hands and feet keep going through a peeling and dryness period, every few months. My fingers in the last few months have become very stiff, where I cant clench a fist in the morning. It improves through the day. A few of my finger nails have changed where I have ridges on them. My joints on both sides of my body are painful. Thigh, knees and toes.The bottom of my feet are very painful. Toes are starting to be painful as well.
Even my rheumatologist years ago misdiagnosed me as did the next one. My general practitioner suspected I had PsA but didn’t overuse them. Finally a new rheumatologist got it right. Everything makes sense now even the depression. Years of misdiagnosis have left me with some joint damage. At 65 I still work full time but it is hard. My time off is spent resting and taking care of my 2 yr old grandson who lives with me. That’s why I still work to provide for him but he is my joy. I would say to doctors… Listen to your patients. They already feel bad enough not being understood by family and friends.
谢谢你寄来这封信。我认为治疗这种疾病的医生要意识到它对每个人的情感影响，这很重要。作为一个16岁就被诊断出患有银屑病关节炎的人，我已经患有这种疾病超过50年了——我可以诚实地说，这种疾病确实会对情绪产生影响。每隔几年就会出现一种新的治疗方法——几十年来，我尝试了所有的药物或治疗方法，以至于许多处方药或治疗方法给我带来了更多的医疗问题——皮肤癌、黑素瘤手术、皮肤瘀伤、关节变形(注射太多可的松)等等。难怪我对新药持怀疑态度，直到它们被使用好几年。但一些医生就是不理解我为什么会担心这个问题。有趣的是，当我16岁住在克利夫兰的时候，我的医生给我的膝盖、脚踝、脚趾、肩膀、手腕等注射了可的松，直到桥上，我注射了无数次，现在我的脚趾变形了——在过去的10年里，我每周都在接受物理治疗。医生告诉我的父母，我应该去佛罗里达上大学——太阳是最有益的——事实确实如此!我去了迈阿密大学，周末去了海滩——我的牛皮癣消失了，几乎没有任何关节炎的症状。但几年后，在圣地亚哥接受了两年的PUVA治疗后，黑色素瘤开始出现。 More surgeries. And then a bout of Cellulitis – so I was told I could not take biologicals. Now I’m told I should take a new drug which has a TV commercial with a happy dancing girl in it – with the side effects including possible depression, suicidal thoughts, diarrhea, etc. When I told one of my doctors that I don’t think I can take the drug now – his response was that I never want to take anything he prescribes. But perhaps there is a reason.
非常感谢你的这篇文章……百分百正中要害。我希望你能发表更多的文章，让朋友和家人了解这种疾病。
非常感谢银屑病关节炎的信息!我有银屑病关节炎，这是一个令人沮丧的状况!家人不理解我的感受，也不理解我有多累!我住在加拿大，觉得你的文章信息量很大。我喜欢看你的邮件。