Psoriasis Advance
Here come the holidays — Don’t let stress send you over the edge

From November/December 2007 Psoriasis Advance

Reprinted from Psoriasis Advance, our Member magazine Join the Foundation today to access more in-depth news on treatments and research

Holidays and stress seem to go together like hot chocolate and marshmallows. Many people report that stress—both good and bad—makes their psoriasis worse. If that sounds like you, winter may be your least-favorite season. Don’t despair. You can increase your comfort this winter, and improve your stress management. Start by learning more about stress. Consider a few “stress-buster” ideas that have worked for others, and then create a few of your own.

We can’t eliminate stress—it’s fundamental to life itself. But experts tell us that we can learn to change our response to it. Because the winter holidays tend to throw more stressors our way than other times of the year, this is a great time to examine the psoriasis-stress connection.

The power of thought

“Stress has a lot to do with the way we think about what’s happening around us,” according to Julie Nelligan, Ph.D., a psychologist at Oregon Health & Science University in Portland. “If the holidays are synonymous with family guilt or not having enough time, money or whatever, you’ll probably feel stressed.”

Feeling overwhelmed is no fun. But if your skin erupts or your joints flare as well, holidays can be pretty grim. To combat holiday pressures, Dr. Nelligan recommends four simple guidelines:

1. Know what stresses you. Is it particular people, travel, obligations or maybe finances? Knowing the triggers for your own stress will help you manage them. Then you can focus on minimizing your exposure to them.
2. Know how you respond to stress. When you feel pressured, do you get overly emotional, overeat, skip meals, focus on sweets, sleep poorly, smoke more or get cranky? Learn to recognize your own personal “stress signals.” Your goal is to catch them early, before you begin to feel too strained.
3. Make small adjustments to regain control. Once your behavior signals that you are stressed, make small changes. Get more sleep or take a nap during the day. Drink more water and less caffeine. Avoid alcohol and smoking.
4. Be good to yourself. Our focus on others is a major component of holiday stress, according to Dr. Nelligan. December is often crammed with activities. All the shopping, bright lights and parties can be fun, but take time to recharge. Give yourself the gift of quiet time, as a break between all the activities.

Winter, stress and psoriasis

Abby Van Voorhees, M.D., of the Department of Dermatology at University of Pennsylvania, lives in an area where winter brings biting cold and snow. She points out that a psoriasis flare during the holidays could be related to factors such as weather.

“We know that the average person tends to see their psoriasis get worse during the winter,” she says. If that’s your pattern, treatment should be your first step toward greater comfort this winter. “A simple adjustment in medication may make all the difference,” she says. “Or, winter may be the only season when a drug or light therapy are necessary for you.”

Colder temperatures and lower humidity can physically damage the skin, which is then more likely to flare, she adds. In the northern hemisphere, shorter days mean reduced exposure to the sun’s ultraviolet rays. “If natural sunlight normally helps your skin, the reduction in daylight may prompt a flare.” Conversely, if you live or vacation closer to the equator, too much sun can be a bad thing. Limit your exposure, and use protective clothing and sunscreen to avoid sunburn, she says.

Also, remember to keep skin moisturized, and consider using a humidifier to restore moisture to the air.

When asked if stress actually causes psoriatic flares, Dr. VanVoorhees says the jury‘s still out. Yet so many people can trace a pattern of stress followed by a psoriasis flare, that it makes sense to manage both emotional and physical stress, according to Dr. Van Voorhees.

She recommends a common sense approach to the holidays. Focus on reliable, proven ways of reducing stress. “Your goal is to stay centered,” counsels Dr. Van Voorhees. The following tips may help:

• Stick to your regular sleep regime.
• Make exercise a relaxed experience. Walk, meditate, do yoga or tai chi.

• Eat nutritious meals.
• Enjoy holiday treats in moderation.

A gift for yourself

Joe Ettari has been a psoriasis support group leader since 1994. Especially around the holidays, he tells those in his support group that taking care of their emotions is a very good way to manage psoriasis.

Just before the holidays, the members of Joe‘s Long Island, N.Y., group begin talking about what they can‘t do.

“I call it the holiday blues,” he says. “They start saying they want to do this or that, but they can‘t. And the reason they can‘t always comes back to their psoriasis.” A few years ago, Joe realized his friends needed to change their thinking.

With rock-solid resolve, Joe told his group that they had to give themselves a holiday gift. Then he asked each member what they wanted. One woman wanted to go the gym, but she didn’t want anyone to see her skin. Joe recommended that she wear tights under her gym shorts.

“What about my scalp?” she asked. The workout benches were black. She worried that a coating of white flakes would give away her condition. “Lay a white towel on the bench,” advised Joe. When she protested that people would see her skin in the shower, he recommended going when the gym was not crowded. Joe had a solution for every concern she raised.

The following February, Joe learned that she had followed his suggestions, with amazing results. Not only did she enjoy going to the gym, she also met her future fiancé there. So take Joe‘s advice and think about what you want this holiday season—and give yourself a gift!

Plan ahead to ease holiday stress

Perhaps the biggest cause of holiday stress comes from the flood of overwhelming demands from family and friends. That’s what Shelly Rahe Gordon of Portland, Ore., believes.

Shelly, who has psoriasis, is a working mom with a kindergartner and husband. Writing her holiday plans down on paper helps her fight the urge to do more than she can manage. It also preserves quiet time for the family, and gives them time to relax. She makes the plan in late November. “I know how much money I’m going to spend, who I’ll be spending time with, where we’ll be for each celebration,” she says.

Time management has been no small matter for Shelly. After a severe guttate psoriasis flare several winters ago, she was spending an average of six hours a week dealing with moisturizers, medications and treatment appointments. New treatments have reduced that demand, but her spare time is still limited.

The biggest benefit of the plan, according to Shelly, is that it defines what a successful holiday looks like for her family. “It means we can’t do everything, that we have to say ‘no’ to some invitations,” she admits. “But it’s better than feeling like the holidays are out of control and risking a flare that would make the season really uncomfortable.”