The stress factor: is anxiety making your PsA worse?

Ever wake up after a crazy busy few days and find you’re suffering a skin flare up, painful joints or swelling? Chances are that this isn’t just a random coincidence. psoriatic arthritis (PsA) symptoms can often be directly triggered by stress. 1

But before we make you stressed out just by reading this, take a deep breath. Sometimes when you can understand why something is happening to your body, it can help you be more conscious of how you can prevent it. So dust off your old proverbial science books and let’s take a look at what’s actually happening inside your body when you get stressed out.

Why it’s not just emotional

Believe it or not, stress and anxiety aren’t just emotions. In order for our bodies to deal with these feelings, actual physical reactions are triggered.2 Ever been so stressed out that your hands shake? Gotten those dreaded butterflies in your stomach? What about a racing heartbeat? Those are all physical manifestations of your stress.

But for people with PsA, the reaction in the body goes far beyond the standard jelly legs,1 and could actually cause a real flare-up.

Ok, let’s take a break for a second. We know what you’re thinking. I have psoriasis. And I have arthritis. And now you’re telling me that a typical bout of stress also causes more of a physical reaction for me than everyone else? I’m stressed out just reading that!
We certainly don’t blame you, but stay with us. The science behind what’s happening here is actually pretty interesting.

When stress gets physical

Alright, so here’s how it works. Four simple steps to a stress-induced flare-up:

  1. When we’re stressed, a molecule called corticotropin-releasing hormone (CRH) is released. CRH is designed to help boost our adrenaline and deal with the situation we’re facing. It’s what causes us to do incredible things under pressure.2
  2. Unfortunately, CRH (which is released from sensory nerve endings in our skin) isn’t just limited to the brain. It also kick-starts a chain reaction in the rest of the body and activates mast cells (white blood cells containing histamines; the regulators of the immune system).2
  3. These mast cells release a large amount of protein called TNF-alpha, which is meant to help combat inflammation (think of it as the firefighter of your body).2
  4. But for people with PsA this excessive production of TNF-alpha triggers the body to go into overdrive, causing the rapid growth of skin cells which produce itchy patches of psoriasis, or the damage to joint tissue that causes painful and swollen joints.2

You are now in the midst of a stress-induced flare-up.

It might sound complicated to us, but for our bodies, it’s actually pretty straightforward. And we all know when our bodies take control, we have no choice but to listen. So while we may not like it, the takeaway is simple: stress could cause your PsA to get worse. And no one wants that.

How best to deal with stress?

Life can be hectic, and sometimes stress is unavoidable. But now that you know the impact it can have on your PsA, maybe it’s time to find your inner namaste and make the best effort to de-stress your life. Easier said than done, we know. So we’ve done the hard work for you: check out our list of some of the best podcasts and apps to help you de-stress and relax.

1 Stress as an influencing factor in psoriasis. Heller MM, Lee ES, Koo JY. Skin Therapy Lett. 2011 May;16(5):1-4.

2 National Institute of Mental Health: Fact sheet on stress. Available from: [last accessed: April 2016]

3 Acute mobilization stress triggers skin mast cell degranulation via corticotropin releasing hormone, neurotensin, and substance P: A link to neurogenic skin disorders. Theoharides, T C et al. Brain, Behavior and Immunity, vol. 13 September 1999.

Me, my mom and PsA

PsA friendly orange drizzle cake

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