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Digital Stock 76 080 The impact of psoriasis on the skin can be very visible. What is often not so apparent is the toll it can take on sufferers' experiences, feelings, and behaviors. Shelly, who developed psoriasis at the age of eleven, knows the emotional pain all too well. "I was often treated like an outcast," she recalls. "When other kids noticed the psoriasis on my arms, they thought it was contagious and didn't want to come near me. Some parents even told their kids to stay away from me."

Social Stigma

For many years, Shelly struggled with feelings of shame, low self-esteem, isolation, and loss of self-confidence. "For me, the worst was seeing the fear it aroused in some people. After a while, I started to feel like I was a "freak" she says. These feelings carried over into adulthood. Shelly wore long sleeves to cover up her psoriasis, even on hot days. She avoided the beach. Socially, she had become so unsure of herself that she expected rejection. "I dated a few men who were emotionally abusive, and I just put up with it. I thought no one else would want me."

In her late twenties, Shelly decided to become more proactive with regard to her skin disease. "I was working as a preschool teacher and had done a good job hiding my psoriasis. Then one day at a gathering, one of the administrators caught a glimpse of my arm and seemed very alarmed. Shortly thereafter, I was fired for reasons that made no sense to me. I felt that it was because of the psoriasis." Driven by her emotional wounds, Shelly entered therapy and became involved in efforts to educate the public about psoriasis. "Having worked through the shame and humiliation, I was finally able to talk openly and confidently about my skin condition. The most beneficial thing for me has been working to eliminate fear, ignorance, and insensitivity in others" she says.

Emotions

Experiences like Shelly's are not uncommon among sufferers of psoriasis and other chronic skin conditions. Feelings of sadness, helplessness, guilt, anger, and low self-esteem may surface as a person struggles to cope with the disease. Frustration can arise from lack of understanding about the disease or the difficulty finding an effective treatment. Sufferers may not have anyone who can understand the challenges that psoriasis brings to their lives. These are completely normal responses, but sometimes they lead to depression.

Coping Strategies

Not everyone with a chronic skin disease needs help developing emotional coping strategies, but many do, especially if their skin condition is severe. Emotional and social coping varies among individuals and is often related to personality type. Some people are less self-conscious than others, or better able to shrug off inquistive looks, insensitive comments or rejection. Here are some effective coping strategies.

Psychotherapy

A good therapist can help you work through pain, self-consciousness, and psychological immobilization. If possible, it would be beneficial to find a therapist with experience treating individuals with skin conditions. Many people find help and freedom by being able to talk openly about their condition and how it has impacted their lives. A good therapist can help you work through feelings of shame and self-consciousness so that you have a better quality of life. A good therapist can help you feel more comfortable and confident with psoriasis, but cannot necessarily help you erase all the disturbing feelings.

Support Groups and Networks

Many people who suffer from psoriasis find it helpful to talk to others who have the same condition. A good place to start would be contacting the National Psoriasis Foundation. Support networks provide an atmosphere of understanding, acceptance, openness, and information sharing. If no support groups exist in your area, consider starting one. Even a small and informal network with just one or two people can help you feel less alone in your suffering.

Other Supportive Strategies

  • Learn as much as you can about psoriasis and keep yourself abreast of new information. By educating yourself, you will be better able to take care of yourself and discuss your condition with others.
  • Practice answering questions about psoriasis so that you are more comfortable talking about it.
  • Focus on the positive things in your life—family, friends, hobbies, pleasurable activities, developing your talents, etc. Find new activities and groups to join, if necessary. Psoriasis may be painful, but it's just one small part of your life. Don't let it take center stage and hold you back from living fully.
  • Do things that empower you. This may include:
    • Setting and achieving personal and professional goals
    • Developing friendships and support systems
    • Reframing the way you view your condition-seeing it as a medical condition rather than as something weird and embarrassing
    • Taking good care of your health and appearance
  • American Psychological Association

    http://www.apa.org

  • National Psoriasis Foundation

    www.psoriasis.org

  • Canadian Psychological Association

    http://www.cpa.ca/

  • Psoriasis Society of Canada

    http://www.psoriasissociety.org/

  • National Psoriasis Foundation. Available at: www.psoriasis.org .