People with psoriasis and psoriatic arthritis often get hit with a triple whammy in the winter months—cold, dry weather that irritates skin, exposure to viruses that challenge the immune system, and the intensified stress that comes along with holiday preparations and family gatherings. All that can lead to flare-ups.
While it's hard to change the weather or quarantine yourself (though an inactivated flu shot—recommended versus a "live" vaccine if you're taking drugs that suppress the immune system—is highly advisable), you can address issues that ratchet up stress, said Elaine Rodino, a psychologist in private practice in State College, Penn..
"People feel more stress—and more intense stress—at holiday time," she said. "There are overwrought expectations, more commitments, and sometimes, more sadness."
Rodino notes it's particularly important for people with conditions affected by stress to consciously acknowledge their need to take extra care. She recommends these steps to knock down stress levels—and psoriatic flares.
- Speak up. "If there's a particular holiday tradition you know causes you a lot of stress—expensive, elaborate gift giving or making your great aunt's complicated dessert recipe—talk to those involved about skipping it or making a change," she said. "Often the people involved have no idea what they're doing is stressful to others and are glad you've told them."
- Learn to say no. If the family wants to go ahead with stressful plans, don't be afraid to give yourself permission to opt out or take a reduced role, Rodino said. "Sometimes people don't realize how profoundly stress affects psoriatic conditions, and, if that's the case, you need to set some boundaries and give yourself permission to do less."
- Amp up self-care. Counter extra stress with extra time for the relaxation techniques you hopefully already have in your toolbox. "If you exercise, try to get a little more, if massage or mediation are your go-to techniques, schedule extra sessions. And don't forget to keep up with your medication regimen," said Rodino, who also advises being mindful of other holiday pitfalls that contribute to stress: Excess alcohol, rich food along with full days and late nights can lead to fatigue.
- If you're alone, reach out. "Our society tells us we should be in a crowd at holiday time," Rodino said. "But not everyone has a large circle. Holidays can emphasize this and bring feelings of sadness." She suggests saying yes to invites from acquaintances or, if it's in the budget, taking a trip. "Volunteering is another great option. Bringing happiness to other people is one of the surest ways to bring happiness to yourself."