People diagnosed with psoriasis or psoriatic arthritis (PsA) often experience fatigue — mental or physical exhaustion that occurs regardless of how much rest a person gets. Fatigue is more common in psoriatic arthritis, affecting at least 3 out of every 10 people with the condition.
Feeling tired after physical exertion, a busy day, or a night of insufficient sleep is normal. Having fatigue, however, is different from simply being tired. Understanding this fatigue, how it affects one’s physical and emotional state, and how to manage it can help minimize its effects.
Fatigue can affect many aspects of daily life, both emotionally and physically.
The fatigue associated with psoriasis and PsA often manifests as extreme tiredness. As one MyPsoriasisTeam member explained, her husband “gets so sleepy driving to work (an 8-minute drive) that he will doze off at his daily office meeting.” Another member shared, “After a week off, basically sleeping, I'm up and moving again.”
Another member wrote, “The fatigue is the worst when it hits hard. I have fallen asleep at the table before. It’s like my body just says, ‘Stop now!’”
Fatigue can have physical effects, such as making one feel as though their body has simply given out. As one MyPsoriasisTeam member described, “I call it my ‘Shut Down.’ My body goes into shutdown. I feel so tired and heavy. … I have trouble lifting my arms and making my legs work.”
Many MyPsoriasisTeam members experience emotional symptoms from daily fatigue, including frustration from being unable to do as much as they used to. One member put it simply: “It really bugs me that the fatigue hits me so hard.”
Another shared the impacts of fatigue on their life and how they have adapted their mindset accordingly: “Yesterday, I was totally floored by fatigue. Today, I've spent a whole day in the garden. I’m making hay while the sun shines. I have stopped trying to work out the why. I just go with the day, and that leaves me less frustrated.”
Severe fatigue, especially when long-lasting, can take a toll on a person’s overall quality of life. For example, it can hinder one’s ability to get through daily tasks they previously had no trouble completing.
One MyPsoriasisTeam member shared how they navigate life when fatigue hits: “When I’m fatigued, I try to keep my daily routine but just go through the motions and get the basics done. I still go to Pilates but put very little effort in.”
Another member wrote about taking time off from daily activities so she can come back stronger. She said, “I get to the shutdown point, and I tell my family I have got to go. I have to rest!”
Psoriasis and psoriatic arthritis are both inflammatory diseases involving molecules called cytokines. The immune system uses cytokines as signals to tell other immune-system cells what to do. Cytokines do not function properly for individuals with inflammatory conditions like psoriasis and PsA. This causes the immune system to attack when it doesn’t need to, increasing inflammation throughout the body.
The inflammation characteristic of psoriasis and psoriatic arthritis is directly related to fatigue. In fact, the more inflammation a person experiences, the more likely they are to experience significant fatigue.
In one European study, researchers identified 1,062 people diagnosed with psoriatic arthritis. Those experiencing fatigue had a higher incidence of tender or swollen joints and higher C-reactive protein levels, which indicate increased inflammation throughout the body.
Studies have also found correlations between increased fatigue and how long a person’s inflammation lasts. Long-term inflammation seems more likely to cause fatigue than short-term inflammation or inflammation that can be brought under control quickly.
Although researchers are unsure exactly how inflammation causes fatigue, they believe one cause may be some of the complex chemical changes that occur in the body and immune system when inflammation is triggered.
Psoriasis and psoriatic arthritis may also trigger chronic fatigue syndrome (CFS) in some people. The percentage of people with psoriasis or psoriatic arthritis who later develop CFS is higher than that of the general population, but researchers are not yet sure why.
Skin conditions like psoriasis can make sleeping difficult. Psoriatic diseases have been linked to daytime sleepiness and fatigue.
Dermatologists or rheumatologists are the best resources for treatments for managing psoriasis-related fatigue. Possible treatments and at-home management tips for fatigue include medications, healthy eating, plenty of rest, and exercise.
Successfully treating psoriasis or psoriatic arthritis — and the associated inflammation — may alleviate fatigue. Additionally, several studies found biologic medications to be effective in treating fatigue associated with PsA. A dermatologist or rheumatologist can provide guidance in weighing the costs and benefits of using any particular medication.
Some people diagnosed with psoriasis and psoriatic arthritis find that eating a healthy, balanced diet helps combat their fatigue. For example, avoiding processed foods that cause blood sugar to quickly increase, then drop, may help even out one’s energy. Increasing B vitamins and lowering fat intake may also provide relief.
Many individuals diagnosed with psoriasis or PsA find that they simply need to rest when their bodies tell them to. One MyPsoriasisTeam member said, “Some days, I can push myself, and some days, I just have to rest.” Another wrote, “I don’t think there is a way to fight it other than to allow yourself to rest.”
Giving one’s body the time to rest and recover often helps alleviate fatigue.
The right kind of exercise can help alleviate some of the chronic pain often associated with psoriasis or psoriatic arthritis. In some cases, lowering pain levels also helps increase energy levels and reduce fatigue. As one MyPsoriasisTeam member shared, “I’m on the mend now. I try to keep moving with lots of rests and heat packs, as well as little gentle exercises.”
Always consult a doctor before starting a new exercise or diet plan.
MyPsoriasisTeam is the social network for people with psoriasis and PsA and their loved ones. On MyPsoriasisTeam, more than 87,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and PsA.
Are you living with psoriatic arthritis that causes fatigue? Have you found ways to conserve your energy and manage daily activities? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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