‘We’ll Get Better Together’

People dealing with chronic conditions or diseases – especially the chronic pain that can come with PsA – might dismiss symptoms of depression and anxiety, says Dr. Chandran. He emphasizes, however, that not everyone who has PsA experiences these symptoms.

“It’s not a given that every patient with arthritis has [mental health] issues, especially if you recognize it and treat [PsA] overall. The arthritis also will feel much better, and the quality of life will improve,” says Dr. Chandran. He adds that many people with psoriatic disease are treated with a biologic and an antidepressant or anti-anxiety medication concurrently.

Dr. Chandran notes that those with psoriatic disease also may face a lesser-known challenge when it comes to mental impacts and disease severity. “If you have anxiety or depression, then you are less likely to respond to [psoriatic disease] treatment and reach a state of minimal disease activity,” he says. This makes it especially important to note any changes in your mood, especially if they impact your day-to-day life. Talk to your primary care provider, dermatologist, or rheumatologist if you suspect anxiety or depression or if you experience mood changes.

“If we diagnose early and start treatment early before the disease gets really well-established, you likely prevent many of these comorbidities,” says Dr. Chandran.

And that includes mental health problems. “It’s not the difficulty in treating the psoriatic part with the current medication that we have, but managing the pain and anxiety, depression, metabolic syndrome, obesity – those things are integral to the disease but still not directly under the control of the dermatologist or the rheumatologist,” he adds. “That is where we have the biggest challenge. And so, ideally, we need to really work closely with primary care and necessary specialists.”

You can do things that can help keep mental health challenges and the other comorbidities of psoriatic disease in check. Dr. Chandran says a regular exercise regimen, good sleep, and mindfulness practice can help. At times, though, that is easier said than done, particularly when dealing with mental health problems. “Yes, you might feel a little worse initially, but eventually, with continued small baby steps, you will ultimately do better,” he says.

Mobility and low-impact exercise routines often are suggested for those with PsA. [2] Even for people without PsA, exercise can improve energy and sleep, and reduce anxiety and depression. [3]

Just as with psoriatic disease, depression and anxiety affect everyone differently. While some may experience intense sadness and hopelessness, to others it may seem as though their ability to have any emotions – good or bad – has abandoned them. If the way your depression or anxiety manifests is different than what you see on TV or what you have heard about from others, this does not mean it cannot or should not be treated.

Ultimately, though the cause of depression may be unknown, you have options that can get you back to your old self. For some, that means treatment with antidepressants or anti-anxiety medication, talk therapy, or exercise. It is important to remember that you deserve to feel your best. While sometimes that may feel like an impossibility, you do not have to make all the changes and decisions at once or in a hurry. And you do not have to do it alone.

Dr. Chandran advises those with psoriatic disease to keep watch for symptoms of depression or anxiety. If a family member is impacted by psoriatic disease, keep watch for him or her. “Look out for each other, and we’ll get better together. We are all there to help each other out,” he says.