Then, in the summer of 2018, she started feeling stiffness and pain in her fingers.
I looked at my friends with kids and thought, This isnt normal.
She describes the experience as disempowering, and says it elevated her anxiety even more.
Psoriatic arthritis and mental health are inextricably linked.
I felt like I wasnt being listened to.
I was being brushed off, and that was challenging.
Its frightening being in pain and not knowing whats going on with you.
After seeing a new rheumatologist in April 2019, she was finally diagnosed withpsoriatic arthritis.
It was horrific, looking back, she says.
I was literally bed-bound with my pain and also my anxiety.
Everything felt so dark.
If you read about psoriatic arthritis on the internet, its very doom-and-gloom, she says.
Its a progressive and degenerative disease, and I just found it so frightening.
In the months that followed, Birch was also diagnosed withgeneralized anxiety disorder.
Its also not surprising for this experience and this condition to have a significant effect on your mental health.
Rheumatologists recognize the link betweenpsoriatic arthritis and mental healthbut are still learning about the nature of the connection.
Prior to her diagnosis, Duncan lived withdepressionand anxiety that she was managing well enough to stop taking medication.
When she was diagnosed with psoriatic arthritis, she decided to get back on medication.
I couldnt handle the emotional toll it was taking on me and the embarrassment of it.
It was really tough.
These arent simply isolated anecdotes.
There is a well-established link between psoriatic arthritis and mental healthparticularly anxiety and depression.
This tracks with a recent survey conducted by SELF and the Olson Research Group in April 2021.
There are a lot of potential reasons for this.
Duncan describes being in constant pain as mentally draining.
When she was diagnosed with psoriatic arthritis, everything hurtsitting down, lying down, walking.
No matter what I did, I was in constant pain.
Her life suddenly revolved around this pain.
I couldn’t do anything without thinking about how sore it would make me.
When I was diagnosed, I went home and changed and went to a New Years Eve party.
I said to my boyfriend, Lets go for two hours.
But if I can get a seat, we can maybe do three or four.
It really took the fun out of things, Duncan says.
The mental focus on her pain became all-consuming.
I became really down and anxious.
Looming over thedaily symptomsis also a feeling of uncertainty and the perception that youre not fully in control.
How bad will it get?
What meds will I go on if these stop working?
Will I get new joint involvement?
She worries about the future and how her health might changewhich also makes it really difficult to plan anything.
The lack of being able to plan is something I really struggle with, she adds.
And then therespsoriasisthe chronic skin condition that almost always occurs alongside psoriatic arthritis.
As SELF previously reported, skin conditions can have areal psychological impact.
Meaning that often, when one suffers, so does the other.
This is often referred to as the mind-body connection.
Its an association, and we cant say theres direct causation, he notes.
In fact, experts think it could be a two-way street.
We have also found that depression drives skin and joint disease, Dr. Gupta says.
Social anxiety is a big one that Dr. Guptas patients mention.
Dr. Douglas recommends addingmeditation and mindfulnessto your self-care toolkit.
But getting outside support can also be incredibly helpful.
I found just talking it through with somebody to be helpful.
My counselor really acknowledged my feelings, she says.
Like so many others, Birch notices a cycle in her physical and emotional health.
Being in pain and facing limitations takes a toll on her mental health.
And when her mental health gets worse, her arthritis follows suit.
Breaking this cycle is an ongoing balancing act, but she says shes getting better at it over time.
Shes trying to enjoy feeling good and avoid her instinct to worry about when her next flare will come.
Exercising regularly and eating nutritious foods also seem to helpboth physically and mentally.
Thats really something Ive come to terms with.
Psoriatic arthritis disease management is ongoing, and mental health care should be too.
It is important to pay attention to ones mental health even before physical symptoms manifest, Dr. Douglas says.
