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Experts believe that the mental and emotional aspects of the disease result from not only the physical toll of the symptoms but also the underlying inflammation responsible. Keep reading to learn more about how PsA can affect mental health and the steps a person can take to reduce this impact. Mental health with psoriatic arthritis Research has repeatedly found associations between PsA and mental health conditions, including anxiety and depression. A 2019 analysis of 24 studies involving more than 31,000 people with PsA found that approximately 33% of these individuals experienced at least mild anxiety, and 21% experienced moderate or more severe levels of anxiety. Additionally, 20% had symptoms of depression, with 1 in 7 people experiencing at least moderate depression. People with PsA may experience other effects on their mental health. A 2020 study estimated that approximately 45% of people with PsA experience regular fatigue, while 38% have sleep disturbances. Additional aspects of a person’s well-being that PsA may negatively affect include:stressmood and behavioral changesbody image Collectively, these factors may affect other areas of a person’s life, such as work or academic productivity. Effects of mental health on psoriatic arthritis treatment Living with a mental health condition can make many aspects of life challenging, including the management of PsA. Following a survey of more than 5,000 people with PsA, experts determined that depression may make it harder for people with PsA to follow their prescribed treatment plans. A lack of treatment adherence can make it harder to treat the underlying disease, contributing to the persistence of PsA symptoms. This is consistent with research suggesting that people with PsA who also have depression, anxiety, or both are 53–70% less likely to reach sustained minimal disease activity than other people. These results highlight the importance of taking a holistic approach to PsA treatment that considers both the underlying disease and the psychosocial impact of the condition. Effects of psoriatic arthritis treatment on mental health In addition to taking specific steps to improve their mental health, people with PsA and depression or anxiety may benefit from managing the symptoms of their psoriatic disease. A systematic review looked at clinical trials involving three different biologic treatments for PsA — adalimumab (Humira) or etanercept (Enbrel) for 12 weeks, or ustekinumab (Stelara) for 24 weeks. The authors reported an association between each medication and improvements in symptoms of depression among people with psoriasis. In a 2020 study involving more than 19,000 people with PsA, starting treatment with a biologic or nonbiologic systemic therapy led to a decrease in the use of antidepressants. The number of prescriptions for benzodiazepine-related hypnotics also decreased among those receiving biologic treatment but not among those in the nonbiologic therapy group. Benzodiazepine-related hypnotics are medications that doctors use to treat a variety of psychiatric symptoms, including severe anxiety and insomnia. The researchers suggest that the mental health benefits that biologics provide may be due to their ability to more specifically target the causes of inflammation in PsA. Research has linked inflammation to a number of mental health conditions, finding it to have a particularly strong association with depression. Treating the underlying inflammation may, therefore, help improve both the physical and mental symptoms of PsA. Coping with psoriatic arthritis symptoms In addition to sticking with their treatment plan, a person with PsA who has concerns about their mental health can take additional steps to help them cope with the physical and emotional aspects of the disease. The American Psychological Association (APA) recommends that people with chronic pain take steps to manage their stress levels, as stress can negatively affect both physical and emotional health. These steps may involve eating a balanced diet, getting plenty of sleep, and engaging in whatever amount of physical activity their pain allows. The APA also recommends:engaging in positive thinking and self-talkstaying active and engaged with hobbies or interestsfinding a local or online support communityconsulting a mental health professional If insufficient control of PsA symptoms is affecting a person’s mental health, they can discuss their concerns with a rheumatologist, who can help them find a treatment plan that works better for them. They can also contact a mental health professional who specializes in working with people living with chronic pain and chronic medical illness. These individuals will likely better understand PsA than someone without this training. It is possible to filter the search results in most online directories by these criteria. Summary The burden of PsA is emotional as well as physical. Many people with PsA also experience symptoms of mental health conditions, including depression and anxiety. These symptoms can affect sleep and daily functioning, making it more difficult to manage the physical symptoms of PsA. A person with PsA can take steps to help manage their mental health. A rheumatologist and a mental health professional can help anyone with concerns about their mental health identify treatments and coping strategies to help. 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