Stress, Depression and Psoriasis – A Vicious Cycle
About the Author:
Dr. Nidhi Luthra Arora
BHMS – Nehru Homeopathic College, Delhi, 1999
Expertise : In Treatment of Conditions
Allergies, Infectious Diseases
Services offered/Procedures performed :
Hair Fall Treatment, Headache, Fever, Homeopathic Medicine
Certifications & Memberships :
Central Council of Homeopathy
Consultant at Dr Nidhi Luthra Arora Clinic
Treating the symptoms and disorders caused by the never ending stress in everyone’s life can be difficult. Psoriasis is one such condition triggered by stress. Homeopathy has much to offer. The correct medicines but when it is selected, it never fails.
Stress is a common trigger for a psoriasis flare. At the same time, a psoriasis flare can cause stress.
Stress is a common trigger for psoriatic disease, and many patients have experienced the one-two punch of stress and psoriatic disease. Living with the disease can result in more stress, which, in turn, can lead to a new flare. Those living with psoriatic disease can find themselves in what feels like a never-ending cycle.
An August 2010 study published in the journal Archives of Dermatology found that those living with psoriasis have a 39 percent increased risk of being diagnosed with depression than those without the disease, while the risk of an anxiety diagnosis is 31 percent higher. Another study, published in the Journal of Rheumatology in April 2014, found that those with psoriatic arthritis and psoriasis suffer higher rates of anxiety and depression than those with psoriasis alone.
And depression may actually increase the risk of developing psoriatic disease. A study published in the Journal of the European Academy of Dermatology and Venereology in Septem
ber 2013 found that in severely depressed women in the United States, the risk of developing psoriasis may be nearly double that of those who are not depressed.
Growing evidence indicates that the same processes that trigger inflammation in psoriatic disease may also create changes in the brain that affect emotional states. Scientists are now learning more about the correlation among stress, depression and psoriatic disease and are testing new therapies that could treat all of those things.
The biology of depression
Stress triggers the release of CRH and substance P — both of which are found in psoriasis plaques and stimulate mast cells to release TNF-alpha — into the brain and skin. CRH has also been found in the joints of people with inflammatory arthritis, such as psoriatic arthritis. Stress signals travel from the central nervous system, housed in the brain and spinal cord, to the peripheral nervous system, which includes nerves in the skin. This sets the immune response in motion, leading to the release of TNF-alpha and other cytokines throughout the body.
Stress is a common trigger for psoriatic disease, and many patients have experienced the one-two punch of stress and psoriatic disease.
Factors of a psychopathological nature tend to play an etiological role in the development of skin disorders, can exacerbate pre-existing skin disorder as well as patients suffering from dermatological disorders may bear the brunt of disfigurement.
Psoriasis is a common, chronic, recurrent inflammatory disease of the skin, characterized by circumscribed, erythematous, dry, scaly plaques of varying sizes. The neurogenic inflammation hypothesis of psoriasis put forth by Farber et al. states that neuropeptides like substance P (SP) and nerve growth factor (NGF) act as a crux in its pathogenesis. Unmyelinated terminals of sensory fibers in skin release SP and other NP’s thereby resulting in generation of local neurogenic inflammation in those who are genetically primed. SP is synthesized in the dorsal root ganglion of nociceptor C fibers and transmitted peripherally in granules. Stressful life events are associated with higher levels of SP in the central and the peripheral nervous system of animal models. SP expressing neurons are in close and functional proximity of mast cells, which when activated release VIP. Autonomic pathways of the descending type via dorsal root ganglia in the spinal cord through SP containing neurons stimulate release of NP’s, the neurons extend onto having connections to opioid interneurons in the dorsal horn. Increased release of adrenocorticotropic hormone, glucocorticoids and adrenalin during stress may be attributed to the stimulation of hypothalamic-pituitary-adrenal axis. Significantly increased expression of NGF in keratinocytes regulates skin innervations and up regulates NP’s, this has found to be an early event in the pathogenesis of Psoriasis.
Homoeopathy, Psoriasis and Depression
Human body and mind are linked together, is the concept homoeopathy works upon. “A healthy body in a healthy mind”. Homoeopathy truly complies to that and a homoeopathic physician will treat the patient as a whole always giving primary importance to the mental symptoms. It is a cumbersome process to treat a patient suffering from psoriasis but results are obtained if the case is taken in a proper manner and treated on the basis of constitutional symptoms. A patient suffering from psoriasis can only be cured completely if his mental state also improves simultaneously. Proper case taking, individualization, miasmatic analysis are necessary for treating any patient suffering from psoriasis.
Though remedy for each patient would be different depending on the symptoms but here I am mentioning a few remedies which have helped in alleviating psoriasis symptoms along with helping their mental state.
Arsenicum album: People likely to respond to this remedy usually are anxious, restless, and compulsively neat and orderly. They are often deeply chilly, experience burning pains with many physical complaints, and become exhausted easily. The skin is dry and scaly and may tend to get infected. Scratching can make the itching worse, and applying heat brings relief.
Graphites: People needing this remedy often have a long-term history of skin disorders. The skin looks tough or leathery skin with cracks and soreness. Itching is often worse from getting warm, and the person may scratch the irritated places till they bleed. Trouble concentrating, especially in the morning, is also often seen when this remedy is needed.
Mercurius solubilis: People who seem introverted and formal—but are very intense internally, with strong emotions and impulses—may benefit from this remedy. They tend to have swollen lymph nodes and moist or greasy-looking skin, and are very sensitive to changes in temperature. The areas affected by psoriasis may become infected easily.
Mezereum: A person who needs this remedy usually is serious, and often feels strong anxiety in the region of the stomach. Scaly plaques may itch intensely, thickening or crusting over if the person scratches them too much. Cold applications relieve the itching (although the person feels generally chilly and improves with warmth). People who need this remedy often have a craving for fat, and feel best in open air.
Petroleum: This remedy is often indicated for people whose physical problems are aggravated by stressful emotional experiences. It is especially suited to individuals with extremely dry skin, and problems that involve the palms and fingertips. The person may feel a cold sensation after scratching, and the skin is easily infected and may look tough and leathery. Itching will be worse at night, and from getting warm in bed. People who need this remedy may also have a tendency toward motion sickness.
Rhus toxicodendron: When this remedy is indicated for a person with psoriasis, the skin eruptions are red and swollen, and often itch intensely. Hot applications or baths will soothe the itching—and also muscle stiffness, toward which these people often have a tendency. The person is restless, and may pace or constantly move around. A craving for cold milk is often seen when a person needs this remedy.
Sepia: This remedy may be helpful to a person who feels dragged out and irritable, often with little enthusiasm for work or family life. The person’s skin may be look dry and stiff. Psoriasis may appear in many places on the body, including the nails and genitals. Signs of hormonal imbalance are often seen (in either sex), and problems with circulation are common. Exercise often helps this person’s energy and mood.
Staphysagria: This remedy may be helpful to individuals whose psoriasis has developed after grief or suppressed emotions. Any part of the body can be involved but the scalp is often affected. People who need this remedy often seem sentimental, meek and quiet, and easily embarrassed — but often have a strong internal anger or deeply-buried hurt.
Sulphur: Intensely burning, itching, inflamed eruptions that are worse from warmth and bathing suggest a need for this remedy. Affected areas often look bright red and irritated, with scaling skin that gets inflamed from scratching. This remedy is sometimes helpful to people who have repeatedly used medications to suppress psoriasis (without success).
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