After more than 20 years of being physically and mentally tortured by psoriasis, Mr. G. did not dare to get married, lost his job, fell into a deadlock, became depressed, and even attempted suicide several times.
Mr. NVG (38 years old, Dong Nai) was diagnosed with plaque psoriasis when he was in 12th grade. Initially, his skin had patchy rashes and white scales on his chest, arms, and calves 2-3 times a year and the disease improved when treated with hospital prescriptions. However, due to being busy making a living and not having the conditions to continue treatment, he used medicine according to instructions online or traditional medicine.
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For about 5 years now, the disease has progressed to its most severe form, erythrodermic psoriasis with psoriatic arthritis. The patient has erythrodermic dermatitis all over the body, thick skin with white scales from the hairline, eyelids, ears down to the chest, back, and legs. The fingers and toes are swollen and permanently deformed, affecting the ability to grip and walk, and are often painful.
With such skin condition and poor health, Mr. G. did not dare to get married, and also lost his old job, currently working as a motorbike taxi driver in Ho Chi Minh City.
When going out, Mr. G. covers himself with clothes, hats, masks, gloves, and socks. However, he only works a maximum of 4-5 hours a day, when the burning pain in his whole body and joints is relieved by painkillers.
This is the only job that helps him sustain his life and reduce his dependence on his elderly parents in the countryside. Earning a few million VND per month, he saves money to pay for rent, food and painkillers.
In contact with the patient, Dr. Ly Thien Phuc, a specialist in Dermatology - Cosmetic Dermatology, Tam Anh General Hospital, Ho Chi Minh City, noticed that Mr. G. had obvious signs of depression such as a sad, gloomy face and a reluctance to communicate.
Mr. G. also shared with the doctor that he was "stuck in a cycle of illness and poverty" so he felt stuck, depressed, and had an inferiority complex. He even tried to end his life many times but was discovered and saved.
Suffering from psoriasis, Mr. VHH (56 years old, Ho Chi Minh City) went from being a healthy, happy, friendly person to becoming irritable and frustrated.
After a stroke that left him paralyzed on one side last year, which caused his health to deteriorate, causing constant insomnia, pain, and loss of the ability to walk, Mr. H. wanted to give up, refusing to take medicine or go to the hospital for treatment.
Another case is a young girl named LKM (17 years old, Ca Mau) who suddenly got sick when she was at her most beautiful age, her skin peeled off from head to toe like snow, making M. shocked and unable to accept the truth. When she learned that this disease could not be cured and that she would have to live with it for the rest of her life, she became even more desperate. "The days when I had to go to school and meet other people were torture for me," said M.
During more than a year of having psoriasis, M. became a different person, refusing to go to school, refusing to eat, losing sleep, engaging in self-harm, and easily getting agitated when the disease was mentioned. Recalling the first time her mother took her to see Dr. Bich, M. always kept her head down, answered hesitantly, and burst into tears when she took off her mask and coat, while psoriasis scales fell off.
Dr. Dang Thi Ngoc Bich, Head of Dermatology - Cosmetic Dermatology, Tam Anh General Hospital, Ho Chi Minh City and Tam Anh General Clinic, District 7, said that this place is treating nearly 200 people with psoriasis, including all ages, genders and disease levels. The alarming common point of all patients when they first come to the clinic is boredom, confusion, and obvious signs of anxiety disorder and depression.
A study published in the Vietnam Medical Journal showed that, out of a total of 122 psoriasis patients monitored, 26.2% had depressive disorders, of which severe depression accounted for nearly 22%; moderate depression was 25%.
The main, common symptoms of depression in people with psoriasis are depressed mood; loss of interest and pleasure; decreased energy, fatigue; decreased concentration; pessimism about the future; sleep disorders. In particular, 100% of patients have decreased self-esteem and self-confidence. More seriously, nearly 22% have suicidal thoughts or behaviors.
The U.S. National Library of Medicine also notes that the rate of depression in psoriasis patients is higher than the general population. The agency estimates that about 30% of people with psoriasis have mental illness, including depression, anxiety, and suicidal ideation. The rate of depression in psoriasis is estimated to be between 10% and 62% according to different studies with different criteria and scale.
In fact, in one report, 9.7% of patients wished to die at the time of the study and 5.5% had suicidal thoughts. In particular, depression is more severe when psoriasis is in areas that cannot be hidden, such as the face, palms, scalp, nails, etc., making the patient afraid to interact with society.
“Depression makes psoriasis symptoms worse, complications occur more often; many people reduce treatment compliance, leading to reduced effectiveness,” said Dr. Bich.
In Mr. G.’s case, the doctor chose traditional oral and topical medications and moisturizers. The patient received psychological therapy in conjunction with a psychiatrist. He was advised to abstain from alcohol, tobacco, limit fat, red meat, and avoid direct exposure to sunlight to help the disease heal quickly.
Mr. H. and M. chose to be treated with biological injections. After two months of treatment, they were able to overcome their illness and depression and gradually return to normal life.
According to Dr. Phuc, any person with psoriasis is at risk of depression. In particular, people with severe psoriasis, large skin lesions, the disease progresses to many complications; young people, people without economic conditions or without relatives close by to care for them are at higher risk of depression.
When suffering from psoriasis, the skin appears lesions such as red skin, thick skin, red skin inflammation, scaly skin that can appear in any location causing loss of aesthetics, accompanied by itching, pain, causing discomfort. Patients tend to self-stigmatize, feel ashamed, confused and often try to hide their skin.
Lesions that are difficult to hide such as the face, head, neck, and hands make them feel more self-conscious and insecure about their appearance. In some cases, psoriasis outbreaks on the genitals and chest make it difficult for patients to have intimate contact and sexual intercourse.
Some people confuse the symptoms of psoriasis with infectious diseases such as syphilis, scabies, etc., so they discriminate against the patient. This also makes the patient afraid to contact and isolate themselves.
Psoriasis is a chronic, systemic inflammatory disease that can be controlled if the patient adheres to treatment. Some medications cause side effects on the liver and kidneys, forcing patients to return for regular check-ups and tests. In addition, patients must take medication for life (in mild cases, only topical medications are needed) and the cost of treatment is also a burden for many patients.
If the disease is not treated promptly and properly, it can easily progress to more severe forms such as erythema all over the body, psoriatic arthritis causing pain, swelling, joint stiffness, permanent joint deformities...
Patients are also susceptible to diabetes, high blood pressure, high blood fat, cardiovascular risks, etc. Information about psoriasis is very popular on the internet. Frequent access to this information, especially inaccurate information, and incorrect treatment causes "waste of money and health", making patients lose confidence in treatment.
“All of the above make people with psoriasis more prone to depression. In fact, young patients are more stressed because they have a long future ahead of them, and are at the best age to build social relationships and careers, but are hindered by disease,” said Dr. Phuc.
Depression and psoriasis have a mechanism of mutual influence and amplification. Stress is a favorable factor for the onset or recurrence of psoriasis. The more severe the disease, the more stressed the patient becomes, losing sleep and reducing the quality of life. Over time, the unsolved illness and psychological stress lead to depression.
Depression and psoriasis both cause the body to release inflammatory cytokines. These two diseases also disrupt the levels of hormones (cortisol and adrenaline) in the body's stress response, leading to a more intense inflammatory response. This can worsen existing symptoms of depression and psoriasis or trigger a new, worse episode, Dr. Bich analyzed.
“When the disease is stable, skin lesions are clean, the number of recurrences is reduced, and the sequelae and complications of psoriasis are reduced, the patient's depression will improve,” said Dr. Bich.
For people with psoriasis and depression, in addition to psoriasis treatment, the patient needs to be psychologically stabilized with the cooperation of the doctor and family.
Doctors guide patients to join psoriasis patient clubs; spend more time talking and visiting with patients; and encourage their relatives to accompany and support them mentally to help them be more positive.
Currently, there are many effective treatment regimens for psoriasis, such as classic topical medications; light therapy; systemic medications such as immunosuppressants and most recently, biological drugs.
In particular, biological drugs are a new step forward in the treatment of psoriasis because they control symptoms well, quickly and have fewer side effects. Depending on the severity of the disease, the affected body area, accompanying diseases, the level of impact on the quality of life, and the economic conditions of each patient, the doctor will advise on the appropriate treatment method.
Source: https://baodautu.vn/tram-cam-vi-mac-benh-d226146.html
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