You may not realize it at first, but a diagnosis of psoriasis, especially at a severe level, can represent a kind of loss. It may change the way you see yourself and change your expectations of what you saw as a future free from the challenges of a chronic condition like psoriasis. 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.
Explore the stages of grief, listed below, to get an idea of what may be in store for you in the coming months or years, and refer back to them to help you better cope with each stage and take a more active role in working through your emotions.
The five stages of grief
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.
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.
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, like “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.
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.
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.
Tips for coping with strong emotions
- Denial: 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.
- Anger: 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.
- Bargaining: 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.
- Depression: If your 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.
