Depression

Children and teens with psoriasis and/or psoriatic arthritis are at higher risk for developing depression than those who don’t have the disease.

 
A teenage girl looks out the window looking sad.

A growing body of evidence shows inflammation associated with psoriasis and psoriatic arthritis may play a role in the development of depression.

Secondarily, the effect that psoriasis may have on physical appearance may impact your child’s self-esteem causing anxiety and depression. With depression may come a lack of wanting to stick with a treatment plan. Unfortunately, increased severity of psoriasis or psoriatic arthritis can make both diseases worse, creating a cyclic effect. Much research is being conducted to discover the link and why children and adults with psoriatic disease are at higher risk for developing depression.

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Recognizing the signs

It can be hard to know for sure if a child or teen is depressed or has anxiety. Depression and anxiety in youth are often missed or misdiagnosed because signs can be seen as normal emotional responses. Emotions also change as a child grows older. It’s important as a parent to recognize the signs of depression or anxiety and obtain help for your child when needed.

Signs of depression to watch for include:

  • Persistent, day after day feelings of sadness and hopelessness
  • Crankiness, anger or irritability
  • Increased sensitivity to rejection or feeling that they are not good at anything
  • Vocal outbursts or crying
  • Changes in eating or sleeping habits (either increased or decreased)
  • Social withdrawal, loss of friends, lack of interest in family activities
  • Loss of interest in school accompanied by missed school days and declining grades
  • Fatigue, low energy, and trouble concentrating
  • Feeling that everything is their fault       
  • Vague health complaints like a stomachache or headache
  • Other symptoms like heart pounding, feeling dizzy, shaky or sweaty
  • Use of alcohol or drugs
  • Thoughts of harming oneself or of suicide

Some of these signs are similar to those of a child being bullied, which can also lead to depression and anxiety. It’s important to note that not all children show signs of depression or anxiety and different signs show up at different times in their lives.

What You Can Do

While the American Academy of Child and Adolescent Psychiatry (AACAP) recommends healthcare providers routinely screen children and teens for mental health concerns, if you suspect your child is depressed or has anxiety and the symptoms persist for more than a couple weeks, ask for help. Talk with your child’s teacher, friends or classmates to see if they’ve noticed any change in behavior.

Talk with your child. Share your concerns and reassure your child that they can always talk to you and how much you care about how they feel. Avoid telling them what to do to help foster discussion. If the issue is about their psoriasis or psoriatic arthritis, find out exactly what the issue may be. Reinforce that having psoriasis is not their fault. Nor is it contagious.  

Schedule a visit with your child’s health care provider to discuss the symptoms of depression and/or anxiety. Ask for a referral to a mental health care professional or find a mental health care professional who specializes in children and can help diagnose the depression or anxiety and offer treatment options.

Treatment

While depression and/or anxiety is serious it can be treated. Following a mental health screening to aid in diagnosis, treatment options could include:

Psychotherapy or counseling to address how your child is feeling and why. Types of therapy include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), family therapy and group therapy.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) helps your child identify harmful thoughts and behaviors that cause the depression and then teaches them how to reframe such thoughts and behaviors more positively to deal with daily issues.

Interpersonal Therapy

Interpersonal therapy helps your child look at interpersonal relationships and events through talking and role playing to address how both affect their mood and life.

Family Therapy

Family therapy sessions include talking with your child, you as a parent, siblings and potentially other relatives who play a significant role in your child’s life. Sessions assess family function and how to more positively communicate with each other.

Group Therapy

Group therapy occurs when a number of children or teens led by a therapist meet to discuss and understand their experiences as part of their interaction with peers.

Medication such as antidepressants may sometimes be added to psychotherapy treatment to help improve or relieve symptoms. As with all medication, before starting a treatment the health care provider will discuss risks and benefits for your child, as well as how the medication will be monitored. It could take four or more weeks before an improvement in symptoms occur so don’t expect an automatic change. Medication is most effective when used in conjunction with psychotherapy that meets the individualized needs of your child and family.

Other actions that may be helpful to improving the psoriasis and psoriatic arthritis depression cycle include stress reduction techniques (such as meditation, journaling or regular exercise), eating healthy, good sleeping habits such as decreased screen time before bed, and seeking support from other parents through the One to One Program.

Take Action

Over time depression and/or anxiety should improve with appropriate treatment and guidance. But if left untreated, depression in children and teens can lead to serious and lasting consequences such as use of drugs or alcohol, getting into trouble, or even suicide. It’s important to know that once a child or teen has had an episode of depression, they’re more likely to have depression in the future. Recognize symptoms early and take the necessary actions to seek treatment when needed. Depression and anxiety won’t go away on its own.

Resources

Overcoming Hurdles in Living with Mental Health and Psoriasis

Listen to this episode of Psound Bytes from dermatologist and psychiatrist Dr. Evan Rieder.

Listen now

Facing Psoriatic Disease is a Matter of Perspective

In this episode of Psound Bytes, dermatologist Dr. Arianne Shadi Kourosh and psychiatrist Dr. Theodore Stern discuss strategies to change your perspective.

Listen now

One to One Program

Find the support you need through individualized discussion with a One to One Parent Mentor.

Get in touch

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