Communication, relationships and psoriasis

The hidden social impact of psoriasis and why communication matters

Photo by Shelby Deeter on Unsplash

As a psychologist who uses Interpersonal Psychotherapy in my practice, I strongly believe that our mental well-being and our interpersonal worlds are closely interlinked.

Take a client I saw for the first time last week: feeling depressed, she had begun withdrawing from her friends and family and was spending a lot of time alone in her bedroom. This isolation was not helping with the persistent negative thoughts which kept popping up and were so hard to dismiss: ‘no-one cares about you’, ‘you’re worthless’, ‘you’ll never be loved’. This meant that as the isolation increased, her mood fell further, which made her withdraw even further. It was clear to see the downward spiral.

I also know that our interpersonal world and the people around us can protect us from depression. If we have people to support us through the hard times, it can help us move out of a depressive episode and even stop us becoming depressed in the first place. But it’s hard for the people around us to give the support we need if we withdraw or keep our challenges to ourselves.

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I was interested to read a recent research paper looking at social interactions in people with psoriasis. The researchers, based at the University of Manchester, interviewed 24 people with psoriasis about their views and experiences. As someone who lives with psoriasis, their findings really struck a chord with me.

The people who took part reported that the social impact and visibility of psoriasis were the most significant challenges of living with the disease. Many participants described social avoidance and isolation, driven by anxiety about how others might judge their skin. Their fear of negative evaluation from others influenced daily behaviours, such as repeatedly checking their appearance, wearing concealing clothing, or making defensive comments.

The fluctuating nature of psoriasis, with flares and remissions, made adjustment difficult. Periods of isolation during flare-ups reduced confidence in social skills, meaning participants sometimes struggled to reconnect socially even when their skin improved.

One of the quotes was especially poignant: ‘I think I am too far gone now… I’d have to learn to be confident with myself again. I’d have to learn then to socialize with people… cause I think I’ve forgotten that.’ We can fall into such deep grooves of interacting that this can continue even if we’re in remission.

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If you’ve lived with psoriasis (or any other chronic health condition) for a long time, ask yourself this: Do I ever tell anyone when I’m struggling? Do I ever ask for support? Do the people around me know how bad my symptoms are?

Chances are, you answered ‘no’. It’s what I used to do too. With that in mind I’ve created a communication workbook to help you begin to communicate and get the support you need. You can download the free workbook here.

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And if you’re a healthcare professional reading this, be sure to ask about your patients’ social relationships and emotional wellbeing and guide them toward support networks.

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Relationships and communication are so important. As Benjamin Disraeli said,

‘We are all born for love. It is the principle of existence, and its only end.’

If you live with psoriasis or another chronic condition, leave a comment below and let me know whether this resonates with your experience.

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Author’s note:
This piece is drawn from my clinical work with people living with chronic illness, but I have used a fictional case study for illustration.