Five States of Grief

The grieving process is that it generally involves five distinct stages

 1. Denial

What it looks like

It may seem a bit cliché, but denial is very real. You may find yourself pretending the diagnosis never happened or thinking it will just go away. Or you might act like psoriasis is no big deal and ignore or play down any problems that surface. Or you may simply refuse to listen and close your mind to information you find threatening.

Where it may lead

Depending on how actively you deny your diagnosis, you may actually delay your treatment, which could lead to a worsening of your symptoms. You may be tempted to cover up your plaques, or even simply stay home—such self denial can lead to isolation and depression.

Tips for coping with strong emotions

Remember that your psoriasis isn’t going anywhere, and that by ignoring it, you will give it a better chance to get worse. Keep in mind that it’s up to you to do something about it now.


2. Anger

What it looks like

We’ve all been angry at some point, but this is a more generalized anger that can be difficult to get a grip on. You may notice that you have a negative attitude and little patience. Or you could wonder why you feel mad all the time, struggling with periodic temper flares and even outbursts at friends and family.

Where it may lead

It takes energy to be angry—energy you can ill afford to waste. And a negative outlook can get in the way of your forward progress, especially if being angry begins to alienate the people in your life who want to support you.

Tips for coping with strong emotions

Why not channel your anger—and get mad at it. Use it as motivation to talk to someone—a friend, a family member, a counsellor, clergy member, doctor or mental health professional. Learn as much as you can about the condition and take charge. 


3. Bargaining

What it looks like

In this stage, you will begin making deals with yourself and your condition. These often look like “If only” thoughts, such as “If only I wasn’t so itchy all the time, I’d promise not to be angry” or “If only I could go swimming, I’d promise not to skip my therapy”.

Where it may lead

Other than the odd coincidence, bargaining rarely works with others or yourself.

Tips for coping with strong emotions

Listen to the deals you are making with yourself, and think less about the unrealistic “if'' part of the bargain and more about the positive changes you know you should be making. Turn your bargains into deals that reward you for healthier behaviours.


4. Depression

What it looks like

Depression is more than feeling a little blue. It often takes the form of uncontrollable sadness or guilt. You may feel tired, listless or sad all the time. Depression can make it hard to focus on anything for more than a short time, and even make you stop caring about anything. You may begin to withdraw from friends and family, and to feel like nothing you do will make a difference. Just getting out of bed or taking care of yourself can be a challenge, and you may lose interest in eating or having sex. You may even wonder if life is worth the effort.

Where it may lead

Depression can wreak havoc with your quality of life and turn your fear that psoriasis will make your life worse into a self-fulfilling prophecy. Depression can rob you of the energy you need to move forward. Depression robs you of you.

Tips for coping with strong emotions

If sadness is disrupting your normal daily activities, remember that you don’t have to suffer in silence—call someone who can help. Don’t wait. Make an appointment with your family doctor or a mental health professional. 


5. Acceptance

What it looks like

This is the stage you’ve been working toward. Hope returns and brings with it a new and positive outlook. Your energy will return, along with your motivation. You’ll develop an interest in taking control of your future and setting new goals. You can begin the process of getting on with life and being more like your old self again.

Where it may lead

It’s not an easy truth to accept, but it will help set you free when you accept psoriasis for what it is—a chronic, incurable condition that can be managed with proper treatments and lifestyle changes. The truth won’t change the fact that your life will be different than it once was, but it will help you to be happier and more in control.

 


 

Extracted from: Living with Psoriasis,  Your Guide to Living Well After a Psoriasis Diagnosis. Canadian Association of Psoriasis Patients, July 2015
Reviewed by: Sabrina Ribau
Medically Reviewed:  by Dr. Yvette Miller Monthrope, April 2021