How to Care for Your Mental Health When Psoriatic Arthritis Pain Becomes Too Much

Psoriatic arthritis and mental health are deeply connected. Because the condition is so unpredictable, you may never know exactly how you’re going to feel when you wake up in the morning, which can trigger really complicated feelings of anxiety, depression, and even guilt.

Psoriatic arthritis, a chronic inflammatory condition that affects about 30%1 of people with psoriasis, causes joint pain, stiffness, and swelling, as well as immense fatigue that can make the simplest tasks feel impossible, from brushing your teeth to chopping up vegetables for dinner. Especially in the midst of a flare, you might have to quickly change your plans to accommodate your condition or prioritize rest when your symptoms are hard to deal with.

How does psoriatic arthritis affect mental health? 

Understandably, managing all of this can affect how you feel about your body and your life, and the weight of these emotions can be a lot to navigate on your own on top of already painful symptoms. In fact, about 33% of people with psoriatic arthritis reported being at least mildly anxious and 20% experienced mild depression, according to a 2020 review of studies involving more than 31,000 people with psoriatic arthritis published in the journal Clinical Rheumatology.2

So we asked people who have psoriatic arthritis (PsA) about how they take care of their mental well-being when day-to-day life starts to feel isolating, frustrating, or overwhelming. Here are some psoriatic arthritis strategies that make a true difference for them.

1. Consider talking with a therapist about your psoriatic arthritis if you don’t already.

Jocelyn Hall, 35, who was diagnosed with psoriatic arthritis when she was 28, says her symptoms are well-managed and she is able to remain active thanks to medication. But she still feels anxious knowing there is a risk for unpredictable flare-ups. Plus, she sometimes feels judged by coworkers who don’t understand why she has difficulty moving some days, like when she has trouble carrying heavy plates at her job in a restaurant.

To process her emotions, she finds it helpful to talk with a therapist, who encourages her to think about being kinder to herself during stressful times. “She helps me maintain good expectations for myself, not ones that push me too far,” Hall tells SELF.

For Meaghan Ingram, 28, who was diagnosed with psoriatic arthritis at 26, the symptoms go beyond physical pain. “When I’m in a flare and I can’t move, the depression hits pretty hard and fast,” Ingram tells SELF. She has worked with a therapist who incorporated cognitive behavioral therapy (CBT)—which involves reframing unhelpful thoughts and changing thinking patterns3—in their sessions.

Now Ingram practices acceptance and commitment therapy (ACT) strategies on her own, using The Happiness Trap book (Amazon, $8). This form of psychotherapy teaches her to observe and sit with her thoughts without trying to fix them. “It’s about accepting where I’m at in that moment, and not trying to be anything else,” she says.

Even though it can be helpful, finding a therapist is a tricky process for many people, and it may not be accessible for everyone. If you have insurance, you can contact your provider for mental health professionals in your area. Websites like Open Path, Inclusive Therapists, and Thero.org include directories of therapists who accept reduced-fee payments if you don’t have insurance or don’t want to use your insurance benefits. And finally, you can check the Association for Behavioral and Cognitive Therapies for a therapist that specifically practices CBT. 

2. Connect with other people who have psoriatic arthritis.

Psoriatic arthritis support groups can be invaluable, according to the people we talked to. “The thing that’s gotten me through this change in my life has been the community that I’ve found online,” Ingram says. “There’s just something so special about being able to really connect with people that understand my day-to-day, what I feel, and what I’m going through.”

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