Mood Swings, Diabetes & Psoriasis
Ed's Prefatory Postscript: A few days after mounting the following Communique of the Month here, I received a deservedly critical email from a reader who wishes to remain anonymous. His criticism was about my response to this month's correspondent's observation about her husband's "mood swings." "By simply suggesting that all psoriatics have mood swings," this correspondent wrote, "you appear to dismiss the possibility of real clinical depression.... Psoriasis need not be an exclusive disease. The possibility exists that any psoriatic may also suffer from clinical depression. It would have been appropriate for you to suggest to D-in-O that they seek a medical opinion about this possibility." I agree entirely, accept responsibility for the omission, and apologize for it. I would be interested in hearing from psoriatics who may have pursued -- satisfactorily or unsatisfactorily -- psychiatric or psychological help in conjunction, or in tandem with, their psoriasis. I would be particularly interested to learn if the use of antidepressants has had any affect on psoriasis. Send email. (Ed D. 3/24/97)
Dear Ed: As a wife of a psoriatic, I found your pages to be most helpful.... Married twenty years and husband has psoriasis. It is obvious to me that his mood swings are mostly as a result of his disease. I can't imagine how frustrating it is for him. I know our sixteen year-old diabetic son and I are trying to understand his mood swings. Of course when you have a psoriatic husband and diabetic son, a person could write a book on mood swings. I don't even want to elaborate on that subject. The thing I don't understand is why a person won't even try to control it with the treatments that are currently available. It seems it would have to be better than not doing anything at all. This disease has a major affect on the family as well as the psoriasis sufferer. My husband like yourself, is in the telecommunications industry. High Stress.... I've bookmarked your page and I hope and pray that some day soon there will be a cure for this awful disease along with diabetes.
Dear Oregon: You've brought up so many issues, Oregon! Let me respond to the one's about which I have experience or opinions.
(1) Mood swings. We psoriatics do have them--undeniably. And your tolerance of them, as a spouse, is one of the "anchors" we psoriatics count on. When I'm in a pissy mood my wife goes to bed early and alone. I creep in later and then am filled with guilt when, upon awakening the next morning, I feel her arms around me and her gentle sleep-breath in the hair on the back of my head. Here's a confession: Why I Will Keep This Woman Forever. I was flaming mightily and behaving downright nastily. She went to bed early and was asleep by the time I joined her. I got up before her and was already at the computer when she took her shower. I was disinclined to apologize about my misbehavior the day before, or to have any communication with her at all, for that matter. Then, she came out of the bathroom, towel wrapped around her, and said, "There were flakes all over me this morning. Then I realized they were parts of you, and I almost didn't want to wash them off." My resolve to be spiteful dissolved in an instant.
(2) Seeking treatment. I don't know how long your husband has had psoriasis, or how severe his case is, but I suspect he's assumed that hard-jaw attitude about treatments that I possess. The first question I ask when a new treatment, lifestyle, whatever is prescribed to me is, "Is this directed at palliating the symptoms or curing the disease?" I've been told by several people that if I'd just take off six weeks, fly to Israel, check into a spa there and soak in the Dead Sea, I'd be able to forget about my psoriasis for the rest of the year. But I can't afford that and, given the statistics I've read, neither can about 99% of the psoriatics out there. The Skin Cap® people have been after me hardcore, and I've gone through two rounds of trials with their product, now. (Forget the results: it would cost me way-more than I can afford to follow their regimen because insurance pays for my "prescription" solutions and won't pay for their OTC product.) To be honest with you, even if I could afford these things I'd probably not undertake them. I'd rather give the money to the NPF, as a contribution towards a REAL cure for the disease. Many of the closer-to-home treatments I've been prescribed require twice or thrice weekly visits to the derm (PUVA, especially) and either I've been burned to a crisp or business trips interrupted the regimen. Systemic remedies I've elected to categorically deny because I'm ripe for all the potential bad side-effects. So, I broach my disease with study and vigilant application of assorted prescribed ointments. Totally unsatisfactory, I agree; only tolerable because I'm surrounded by people who love me in spite of it all.
(3) Effect on family. I have a wife, two step-daughters, two sons-in-law, and three grandchildren (almost four ... probably four by the time this gets posted) who all live within a few feet of me. We had, until recently, all shared a huge house on a horse farm in central Kentucky. My psoriasis was more than conspicuous, it was ever-present. While we lived on the farm, one of my three year-old granddaughters liked to sneak into Nana's and my quarters without invitation and, on more than one occasion, caught Papa (me) in some state of undress. One evening she pointed at my lesions and asked what they were. "They're my spots, Peanut," I said (my nick-name for this granddaughter is "Peanut"). That seemed to satisfy her. Weeks later she snuck up on me again, but this time, instead of asking about my lesions, she just observed: "When I'm grown up, I'm going to have spots, too!" I gave her the most grandfatherly hug I could and told her that I sure hoped not. What more can I say about family?
(4) High stress occupation. I'm on record as being cynical about the correlation of stress and psoriasis (Flake: Confessions of a Psoriatic). Of course stress is probably a trigger, but trying to avoid stress and live in this world is like trying to get along without oxygen. I just don't cotton to it, if you know what I mean. If I wanted to palliate my psoriasis by stress reduction I'd take up cocaine. There's a lot of ways to reduce stress and most of them are harmful. What your husband and I both realize is the industry we're in--telecommunications--is the most exciting industry in the world right now. Telecommunications is to the twenty-first century what steam locomotion and internal combustion were to the dawn of the twentieth century. No one may remember us when we're gone, but that's okay. We're enjoying the privilege of being involved in the fundament of our childrens' futures. There's more uncomfortable places than being one unsung rung on the ladder of progress.
Dear Oregon, I empathize with your situation--a psoriatic husband and a diabetic son. You must have to spend a lot of your waking hours "soothing" the health misfortunes of those surrounding you. I've no remedy. May I suggest you have hubby log-on here and have son check-out Lou's Bunker? (Being a D-Kid versus a P-Kid is not that much different at the emotional level. Besides, your son is a little older than Lou and he might have some insights of value to pre- or only-now pubescent flakers.) The old addage that "misery loves company" remains true. Besides, I'd love to have a correspondent who shares my malady and is within my industry. -Ed