As someone suffering from psoriasis, you may be highly conscious of how others may perceive you1. Will they think that your condition is contagious? Or are they afraid of being close to you or touching you? Because of that, your self-esteem may suffer. Consequently, you may begin to feel less enthusiastic about work or other social and physical activities, and experience the urge to withdraw.
To make things worse, recurring flare-ups or ineffective management of the disease could prompt feelings of despair – you may feel as though your skin will never clear up. The accompanying pain could also deter you from participating in a lot of activities.
Due to these factors, some studies show that psoriasis patients are at a significantly greater risk of attempting or thinking about suicide2. This effect is more pronounced in patients with severe psoriasis.
Younger Psoriasis Patients Are at Greater Risk
Although depression can happen at any age, it is much more likely to strike in one’s youth3.
A large study with about 850,000 participants indicated that younger psoriasis patients are likely to experience higher suicidal behavior compared to older patients4. According to medical experts, this risk factor may be due to a less-developed coping mechanism and a tendency toward impulsivity5.
This is completely understandable. It is an age where people undergo intense scrutiny while trying to find their place in the world. Psoriasis may turn them into “targets” for being different. This may cause them to encounter bullying, experience performance-related anxieties, or develop a habit of shutting people out.
Measure How Psoriasis is Impacting Your Life
If you’re unsure how psoriasis is affecting your quality of life, take a simple questionnaire called Dermatology Quality of Life Index, DLQI. It is an easy and practical measure routinely used in clinics, applicable to patients of every age and gender6.
This tool may assist you in discussions regarding your emotional health and coping strategies with your dermatologist. It will help him or her understand your struggles, which are useful considerations when deciding on a treatment strategy.
A Dermatologist’s Weighs in on Psoriasis and Depression
Depression is common among psoriasis patients. When you have severe psoriasis, harmful thoughts and negative feelings are not uncommon. Depression is one of the leading comorbidities associated with the disease.
Discuss and share how psoriasis affects you emotionally and psychologically.
Establishing a strong physician-patient relationship is the foundation of effective psoriasis treatment. By confiding in your dermatologist during consultation, you will potentially improve your mental and psychological state, not to mention get the best treatment outcomes.
Common symptoms of depression. Watch out for changes in body weight, sleeping problems, loss of interest in hobbies, friends, and work. Teenagers and young adults are more prone to becoming depressed.
A dermatologist’s treatment plan for psoriasis patients with depression. Reducing the severity of psoriasis and helping you achieve clear/almost clear skin so that you can lead a normal life is the primary strategy. You may be referred to a psychiatrist or a patient support group to improve your physical and mental health.
Medication for depression. A dermatologist does not prescribe such medication. Ideally, you will be referred to a psychiatrist if there is such a need. Discuss treatment options for depression with a psychiatrist.
Do Not Hesitate to Reach Out
If you have psoriasis, do not suffer in silence. Psoriasis symptoms are manageable and there are many treatment plans to fit your needs. If you are struggling to regain control over your skin condition, consider talking to your dermatologist or reaching out to a psychiatrist to maintain your mental wellbeing.
Additionally, have open conversations with people who care about you. Understand that people may not always realise that you need help unless you ask.
Also, be vigilant about your symptoms and inform your dermatologist, psychiatrist, family, or friends if you currently feel overwhelming sadness in your battle with psoriasis. You may not be able to see immediate changes in your life, but you certainly can change how you react to your situation. Improving your psoriasis and quality of life starts with you.
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Dr Ch’ng obtained his specialty training from the Royal College of Physicians in London. Subsequently, he obtained his Advanced Masters in Dermatology from the National University of Malaysia. He was previously the Head of Dermatology of the State of Pahang and Hospital Sungai Buloh.
His call to dermatology started way before he even contemplated doing medicine. His father suffered from severe psoriasis, and was in and out of hospital a lot in the late 1970s. His father’s condition made him see that skin disease is not just an aesthetic problem, as it can cause the patient and the entire family so much grief. His practice today reaffirms his belief, with many patients expressing deep relief and gratitude after their treatment.
Place of Practice
Dr. Ch'ng is a NSR registered consultant dermatologist. She graduated as a gold medalist from Univeristy Malaya in 2006. She obtained Membership of the Royal Colleges of Physician of the United Kingdom in 2010 and joined dermatology team in University Malaya in the same year. She completed Advanced Master in Dermatology (UKM) in 2014 and a visiting fellowship in Cutaneous Laser Surgery in Mahidol University (Thailand) in 2017. Her special interest include acne, psoriasis, urticaria, contact dermatitis/eczema and procedural dermatology.
Dr. Ch'ng started her instagram account @cccskindoc providing free skin care tips and education to public. She believes everyone deserves up-to-date and accurate information on skin care to embrace the skin that he or she is in.
Place of Practice
Dr Khor graduated from National University of Malaysia (UKM), Kuala Lumpur in 2002. He obtained his Internal Medicine specialty training from the Royal College of Physicians of London in 2007 and further subspecialized in Dermatology by obtaining his Advanced Master in Dermatology from UKM in 2013. Dr Khor served as the Head of Dermatology service for Perlis from 2013 to 2015 before transferring back to Penang. Currently, he is the Deputy Head of Department of Dermatology in Hospital Pulau Pinang. He is also a visiting consultant dermatologist at KPJ Penang Specialist Hospital and Northern Skin Specialist Clinic.
Dr Khor is active in academic activities, performing as an honorary lecturer for Allianze University College of Medical Sciences and Penang Medical College. He is active in research as well with the publication of original papers in dermatological journals and serves as a reviewer for Malaysian Journal of Dermatology. His dedication to the profession earned him Excellent Service Award from the Ministry of Health in 2009 and 2017.
Place of Practice