Arthritis Psoriatic Arthritis How to Manage Anxiety When Living With Psoriatic Arthritis By Jaime R. Herndon, MS, MPH Published on June 23, 2022 Medically reviewed by David Ozeri, MD Print Table of Contents View All Table of Contents How Is Anxiety Related to PsA? 12 Tips to Deal With Anxiety Frequently Asked Questions Psoriatic arthritis (PsA) is a progressive, inflammatory condition that affects the joints and entheses (the tissues that connect tendons and ligaments to your bones). PsA is caused by an over-reactive immune system. It is associated with psoriasis and can be similar to rheumatoid arthritis. About 1 in 3 people with PsA also have anxiety. This can be explained, at least in part, by the pain and sleep disruptions caused by PsA. If your anxiety is affecting your quality of life, reach out to your healthcare provider to talk about treatments that can help. Here's a closer look at how anxiety is related to PsA, along with 12 tips to help manage it. Elva Etienne / Getty Images How Is Anxiety Related to PsA? Anxiety is characterized by feelings of worry or fear. It's common for people with chronic illnesses to have anxiety; often, they worry about their symptoms getting worse. Anxiety becomes a vicious cycle for people with PsA because poor mental health can be associated with higher perceptions of pain and more stress, which can trigger painful PsA flares. It is important to make sure mental health is addressed alongside physical health when treating PsA. 12 Tips to Deal With Anxiety These tips and tricks can help people with PsA manage their anxiety and improve their quality of life. #1 Develop a Pain Management Plan Pain is a significant issue for people living with PsA. But knowing you and your healthcare team have a plan in place to deal with it can help keep you from stressing about it. Treating PsA usually involves a combination of medication, physical activity, dietary changes, mental health support, and other therapies. Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first line of treatment for pain, but if they don't work for you, your healthcare provider may recommend other medications, such as prescription-strength NSAIDs or a corticosteroid drug. #2 Practice Mindfulness and Relaxation Techniques Techniques like meditation, deep breathing, and guided imagery can help with both anxiety and pain. Mindfulness-based stress reduction (MSBR) is a noted and effective form of meditation for arthritis. It involves being fully present in the moment and recognizing thoughts and feelings in a nonjudgmental way. #3 Make Sure You Get Quality Sleep Sleep problems are common in those with PsA. And not getting enough sleep can cause anxiety or make it worse. Sleep medications, practicing good sleep habits, and relaxation techniques may help, but it’s also important to address any ongoing pain issues that could be contributing to your insomnia. #4 Consider a Mental Health Specialist A mental health specialist, such as a therapist, can teach you tools and techniques to manage your anxiety while providing emotional support and referring you for a medication evaluation, if necessary. Taking care of your mental health will not only improve your day-to-day life, it can also help ease your pain and other PsA symptoms. #5 Seek Social Interaction The combination of anxiety and physical pain from PsA can make you feel like staying home and not interacting with others. But isolating yourself can make your anxiety worse. Have a lunch date with a friend, schedule a weekly phone call, join a support group—anything to foster a sense of connection with others. #6 Try Aromatherapy and Other Alternative Therapies Alternative and complementary therapies for PsA have not been well-studied, so before you try any, talk with your healthcare provider first. That said, you may get some relief from both anxiety and pain by trying acupuncture, massage, or aromatherapy with essential oils. Scents used to treat anxiety and stress include rose, sweet orange, clary sage, and lavender. #7 Exercise on a Regular Basis Staying active offers many benefits for people living with PsA. For one thing, people with arthritis notice their joints stiffen up and muscles become weaker when they're inactive. And, of course, exercise is proven to help boost mood, and it can provide a social outlet, too. If you’re interested in starting a regular exercise program, talk with your healthcare provider about what activities are safe and most appropriate for you. #8 Keep a Journal Journaling has been found to have benefits for both physical and emotional health. Regularly writing down your thoughts and feelings can help reduce anxiety while also lowering blood pressure and improving immune system function. #9 Avoid Unhealthy Coping Behaviors Living with anxiety and chronic pain can be incredibly hard, but unhealthy coping behaviors will ultimately make things worse. These include isolating yourself, avoiding check-ups or not adhering to your treatment plan, abusing drugs or alcohol, and other risky behaviors. If you’re having a hard time coping, reach out to your healthcare provider or a trusted loved one for help. You don’t have to do this alone. #10 Limit Alcohol and Caffeine Alcohol has the potential to worsen PsA symptoms and inflammation, and heavy drinking is also linked to anxiety. Too much caffeine can also trigger anxiety. As with anything, moderation is important for both caffeine and alcohol. #11 Contemplate Getting a Pet There are many ways a furry friend can help ease PsA-related anxiety. For example, pets help provide a distraction from pain, provide comfort and companionship, and can reduce feelings of isolation. #12 Eat Nutritious Foods While diet cannot cure PsA, certain foods can help improve your mood while reducing inflammation. These foods include fatty fish, nuts, olive oil, lean protein, and colorful vegetables. If you need some guidance, a dietitian can help put together a meal plan that best suits your needs. Summary PsA is a chronic condition that doesn’t just affect you physically, but also emotionally. Anxiety is common, but there are many ways to manage it, including exercise, seeking counseling or a support group, developing a pain management plan, and more. A Word From Verywell It's important not to overlook the mental health effects of a chronic illness like PsA. If you're struggling with anxiety, tell your healthcare provider. They can go over coping tools with you, and if necessary, connect you with a mental health professional. Frequently Asked Questions Does psoriatic arthritis affect you emotionally? Yes. One in 3 people living with PsA were found to have at least mild anxiety, and 1 in 5 reported at least mild depression. Does stress trigger psoriatic arthritis flare-ups? It can. Your body's stress response can cause your muscles to tense, increasing pain, and it can also trigger inflammation, which contributes to joint damage. Do people who live with psoriatic arthritis have a greater risk of having panic attacks? People living with PsA have a significant risk of having anxiety, which can potentially lead to panic attacks. Not everyone with anxiety will develop panic attacks, though. 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