A diagnosis of psoriasis can represent a kind of loss. It may change the way you see yourself, the way you perceive others and your expectations for the future. Be patient with yourself. Make sure to take the time you need to come to terms with your diagnosis.

With loss usually comes a sense of sadness, or grief, which is just a normal and very human reaction. While not everyone will experience it when diagnosed with psoriasis, grief tends to play itself out in a fairly predictable process, and understanding the stages of grief can help you make sense of your emotions as you move forward with your life and the management of your psoriasis.

Our understanding of the grieving process is that it generally involves five distinct stages. However, we all experience these stages in a unique way. Some people will go through each stage in order, one stage at a time. Others will go through the stages out of order, or even experience the same stage more than once. The time it takes to pass through each stage is also personal, with some people passing through the stages rapidly, and others more slowly. You will go through the process at your own pace and in your own order.

Emerging from the fog

Diagnosis of a chronic condition like psoriasis may take over your life at first and leave you distracted and preoccupied. The information you have to process—from your doctor, your pharmacist, or any other member of your health care team—can be complex and intimidating, not to mention that it may seem to come all at once.

Denial may begin to set in as you spend more and more time searching for any information you can find about psoriasis. You may even feel embarrassed about your skin condition and reluctant to seek out or accept the help of your family or friends. Other feelings you may be struggling to overcome might include:

● Being overwhelmed
● Confusion
● Disjointedness
● Isolation
● Relief that you finally have a name for your condition

In the early days and weeks following your diagnosis, you may find your mix of emotions difficult to untangle and control. Try to remember that knowing what’s wrong and working with your doctor to find ways to ease your symptoms will help inject hope into that emotional knot.

What you can do:

● Do your best to find out as much as you can about psoriasis
● Keep your doctor’s appointments
● Take notes when you are seeing a health care professional and consider taking someone along with you
● Track your symptoms and print records to bring to your appointments
● Learn about the strong emotions associated with psoriasis and how to cope with them if necessary

Living day to day

As your emotions begin to settle and your thoughts clear, you will have more time and ability to focus on getting through each day without being so preoccupied with itchy skin and covering up. You may find some symptom relief, or you may be challenged by searching for treatments that work for you. Should your psoriasis patches begin to shrink, you may still be worried that they will return. This may cause you to feel uncertain about the future, leading to a focus on living day to day.

The idea of a “normal” life might seem like a distant memory. Feeling uncomfortable, or worrying that you will, may begin to colour your emotional outlook, making you feel:

● Displaced
● Challenged by everyday life
● Isolated or misunderstood
● Fearful of worsening symptoms
● Controlled by psoriasis

Even if you’ve worked out a plan with your doctor, you may be more focused on your skin discomfort and appearance, and less on the actual condition of psoriasis. Accepting your condition for what it is may still be a struggle, and you might not really want to learn more about psoriasis than you need to know to get through each day.

Talking with people may provide you with some comfort, though you may wonder how anyone could understand the extreme itchiness and discomfort you’re going through.

Your expectations may be modest, or you may be fighting off the feeling that getting back to normal will be a real challenge. You probably just want to feel “a little better”.

What you can do:

● Try to improve your outlook by enjoying positive experiences and doing the things that mean the most to you when you can.
● Resist the urge to tell your doctor you are “okay” if you’re not.
● Make the most of your health care visits by preparing a detailed description of all your symptoms.

Feeling more positive

Your journey has taken a turn for the better—your treatment, which can sometimes be a trial-and-error process, is bringing you some relief. Life is beginning to return to something approaching normal, and you may be growing more positive with the results. But you may also be afraid that all this is only temporary, and that eventually your symptoms will begin to get worse.

In this more hopeful period, you may experience a new mix of feelings, including:

• A more positive outlook
• A desire and willingness to take charge of your psoriasis
• A new confidence in your ability to adapt to change
• A sense of achievement tempered by a few nagging doubts

Where you may once have felt helpless, you might now feel more up to the challenge of psoriasis. Your focus may have expanded beyond the day-to-day, but you may not yet be willing or able to set your sights too far down the road to your future. Your goals may be growing more ambitious, but your expectations of treatment might remain low to avoid suffering too much disappointment.

What you can do:

• Remember that psoriasis is more than just itchy, cracked skin—it’s a chronic condition that affects your skin and possibly your joints.
• Take good care of your skin to help delay or prevent more patches from developing.
• If your symptoms return or worsen, talk to your doctor—your psoriasis may be progressing.
• Communicate openly and honestly with your healthcare team.
• Make plans for your future with psoriasis.

Getting into a groove

When you reach this part of your journey, be sure to keep it in perspective—it’s not so much a destination as a new way to help you keep moving forward. If your psoriasis has improved greatly or even gone into remission, you will be feeling great. Or you may be feeling more positive because you have come to terms with psoriasis, which can also be a great accomplishment.

Of course, the concern that your skin symptoms will return may never leave you, but that’s just part of dealing with a chronic condition. More importantly, you will be experiencing a welcome new range of emotions at this point, including:

• Relief
• A sense of normalcy
• Gratitude for the support you received
• A sense of being fortunate
• Hope and positivity
• Success

You probably have learned to take nothing for granted at this point. However, you may also have learned to ask questions, gather information, and make decisions that help you move your care forward. And if you have accepted that psoriasis is just another part of your life, you are surely doing what you can to manage its symptoms and slow its potential progress—which includes accepting and appreciating the support of your family and friends, and asking for help when you need it.

Care is no longer something that is done to you—it’s something you seek out, negotiate, and manage. Your expectations of treatment are probably pretty high now, and so are your goals for life.

What you can do:

• Keep using your online treatment plan to help you better manage your care program and to keep a record of your symptoms
• Stay on your medication unless advised to stop by your doctor
• Don’t get complacent with your improved state of health—keep up the good work, and work hard to manage your psoriasis symptoms

Practical Tips

Here are a few more practical tips to help you take a more active role in your psoriasis management:

• Develop some new hobbies and friendships.
• Keep and use your sense of humour.
• Accept help—and help others.
• List important daily activities and try to do one or two each day.
• Try to stop rushing around—make time for yourself, and relax.
• Do things that make you laugh or smile.
• Consider joining our Facebook page or following us on Instagram or Twitter.