Coping with Psoriatic Arthritis

Depression is common, underdiagnosed, and undertreated in patients with psoriatic arthritis.^[1] It's a study finding that doesn't surprise me.When chronic pain comes together with a chronic skin condition, it makes a great deal of sense when depression accompanies it. If you don't feel good and you feel like you don't look good either, it's a tough combination. Studies have found depression to be common among multiple forms of inflammatory arthritis, but in one study focusing on rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis, the psoriatic arthritis patients were found to have greater psychosocial problems - namely with mental health, limitations due to emotional health, and social functioning.^[2] The study authors point toward the combination of inflammatory arthritis with inflammatory skin condition as the reason for the greater effect on our mental health.

I was most depressed shortly after my diagnosis. I commonly describe the experience of receiving my diagnosis as something of a "grieving process", and depression definitely preceded acceptance. This is a chronic, painful disease that causes permanent damage. It currently has no cure. The treatments come with varying degrees of terrifying side effects. It can take months and years to find a treatment that works well, and there's no guarantee that any treatment will work indefinitely. The disease forces you to reassess your dreams and goals, sometimes taking them away from you entirely. There's a lot to be depressed about.

With everything we're up against, it makes a lot of sense to work with a mental health professional. Your rheumatologist (or any of your other doctors) can refer you to one. Just ask.

Here are a few other tips from Arthritis Today on warding off depression:

• Spend time with friends or join a support group.
• Do things you enjoy. If your arthritis prevents something, enjoy a modified version instead.
• Try positive thinking: instead of thinking, "This pain will last forever", think, "This pain will come and go."
• Make yourself feel pretty. Even if you don't feel like leaving the house, don't just mope around in sweats. When you look good, you can feel good.
• Don't berate yourself for your depression. It isn't a matter of discipline or character.^[3]