Mental health problems

Mental health problems of patients with atopic dermatitis are often strongly underrated. Atopic dermatitis and other atopic conditions (asthma, allergies, hay fever) are associated with depression, anxiety and bipolar disorder as well as with autistic spectrum disorders, insomnia, suicidal thoughts, hyperactivity, troubles with concentration, low self-esteem, shame, etc.3,5,32

The likelihood of suffering from a mental health problem increases with the severity of atopic dermatitis and the number of atopic conditions. It’s not yet clear what causes these problems, but the grossly reduced quality of life for an atopic dermatitis patient, comparable to that of cancer and diabetes-type-1 patients, may contribute to the deteriorating mental health3,24,27

Clinical trials have shown that mental health disorders and other psychological problems in people with atopic dermatitis are linked to:

  1. raised levels of inflammatory cytokines (such as interleukin (IL)-1, IL-6, TNF-a) that can, in theory, cross the blood-brain barrier and thus influence how the patients feel and act. 30,31,33
  2. insomnia that frequently leads to depression,
  3. itchy skin, the main cause of insomnia, hyperactivity and suicidal thoughts,
  4. grossly reduced quality of life.

Aside from damaged skin and insomnia, severe forms of atopic dermatitis are accompanied by other atopic conditions and other illnesses such as rheumatoid arthritis, inflammatory bowel diseases, cardio-vascular diseases, and so on. The pilling up of such conditions only worsens one’s outlook on life.24,28,29

It is also worth noticing that depression, anxiety and insomnia are listed as possible side effects of corticosteroids.5

Patients with atopic dermatitis too often struggle with discrimination, stigmatisation and social isolation. To this day, many people still maintain that “skin” conditions can be contracted and thus tend to avoid and shun the afflicted. The most vulnerable groups are the children and the young adults. Their inflamed, red and scally skin, hyperactivity and incessant scratching make them the targets of offensive commentaries, bullying and public shaming in kindergartens and schools. The resulting stigmatisation pushes these young people into social isolation and depression.

It is extremely important that atopic dermatitis patients are treated with support and understanding by their GP, dermatologist, family, partner and friends. Seeking professional psychological help and attending support groups and relaxation workshops also plays an important role in maintaining the patients’ mental wellbeing in the face of their illness.