By Nyaka Mwanza
Usually, chronic illness goes hand in hand with chronic pain. But there are often many more symptoms that are also invisible to the outside observer, ranging from embarrassing to debilitating. Because these symptoms and their consequences often go unseen, too often, they are dismissed, invalidated, or ignored, which can impact the quality of life of a person with a chronic illness. Below are just two examples — psoriasis and multiple sclerosis — but much of the invisible toll of chronic disease can be a shared experience across diagnoses.
Psoriasis and Stigma
Psoriasis is a complicated autoimmune condition that causes inflammation and the accelerated production of skin cells, leading to thick, scaly patches called plaques. These itchy, flaky plaques develop on the skin’s surface in 80 to 90 percent of people diagnosed with psoriasis. However, psoriasis is more than a painful skin disease, and people living with psoriasis face many unseen challenges, including stigma and mental health issues.
For example, people living with psoriasis may have to deal with the common misconception that psoriasis is contagious. Discomfort, low confidence, self-esteem issues that may result can disrupt social interactions and productivity. What’s more, emotional distress related to psoriasis can cause and exacerbate mental health issues, like anxiety and depression, which are found to be common in psoriatic disease.
There is also the issue of embarrassment and shame interfering with medical care and other important areas of life. Take genital psoriasis, for example, which is among the most uncomfortable and embarrassing symptoms of psoriasis and which affects nearly two-thirds of people with psoriasis. Having raw, irritated skin in the genital area can take a toll on intimacy, sexual activity, and quality of life. And while genital psoriasis is very treatable, more than 40 percent of people don’t discuss it with their healthcare provider due to embarrassment, shame, and fear of judgement.
Multiple Sclerosis (MS) and Sleep Trouble
People with MS can experience pain of many descriptions — sharp, stabbing, dull, achey, chronic or intermittent — in various parts of the body. Musculoskeletal pain in MS is usually the result of symptoms like muscle weakness and mobility issues, which cause injury and strain. Neuropathic pain is caused by “short circuiting” of the neurons due to nerve damage from MS. As with psoriasis, though, this invisible pain can lead to other consequences that lie beneath the surface, including disrupted sleep.
Almost 50 percent of all people with MS experience some type of sleep disturbance. Sleep trouble may be due to pain, spasms, and anxiety that go well into the night, or as a side effect of medication. Inadequate sleep has an effect on physical MS symptoms, however; sleep deprivation can leave a person with lowered capacity to cope with MS symptoms, which can lead to lower energy levels, an intensified perception of pain, and fatigue. Sleep deprivation can also affect mental health and exacerbate depression and anxiety, in particular. Daytime sleepiness can also interfere with normal functioning during waking hours.
References
- Psoriasis: Overview
- What Are the Related Medical Conditions of Psoriasis?
- The impact of genital psoriasis on quality of life: a systematic review
- Sleep
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