Arthritis diary A confidence trick Can your emotions affect your psoriasis, asks Julian Worricker I just read a very affecting story, about a 24-year-old man called Adam. His biography went like this: Adam has guttate psoriasis, which initially developed on his scalp in primary school. He has tried different treatments, but worries about exhausting options. Adams confidence has been affected by having psoriasis, impacting on his social life and sexual-romantic relationships. It resonated with me as I looked back to my 24-year-old self. My psoriasis developed when I was in my teens. Like Adams, it began on my scalp, then there were patches on my elbows, knees and my backside. Even though I didnt pinpoint it at the time, I think it did affect my confidence. My arthritis is directly linked to my psoriasis. I am among the 20 per cent of people with the skin condition who develop the joint problems connected with it never so seriously that it became debilitating, but its been a part of my life for more than 20 years. Emotional impact Adams biography added one other detail that he is gay, and that he had struggled with the emotional impact of the condition. He said he had often tried to avoid situations where he would have to expose his skin to others. Not great for his sex life. Again, I found myself looking back to my 24-year-old self. The moment I began to feel better about myself was the moment my skin seemed to respond I came out of the closet pretty late; I was 28 when I took the plunge. Having feared the worst partly because of a political climate that defended an unequal age of consent and the advent of Section 28 (a series of laws across Britain that prohibited the promotion of homosexuality by local authorities) I was proved wrong, and issues of confidence and stress began to slip away. So over time did my psoriasis. It was quite uncanny, but, in the space of a year, nearly all of it had cleared up. I was left with tiny patches on my scalp and one on each elbow, but everything else had gone and its never come back. In recent years, the treatment I have had for my psoriatic arthritis has contributed to getting rid of the rest of it, so my skin is completely clear. Adam also spoke a great deal about his mental health. He said it was frustrating that, too often, psoriasis is seen as something to be treated with yet more ointment, rather than with a concerted effort to deal with stress and mental wellbeing. Im sure hes right. I dont pretend to offer any medical expertise on this subject, but I do have my own experience to look back on. The moment I began to feel better about myself was the moment my skin seemed to respond. Adam made no mention of arthritis, so, hopefully, that will never be an issue for him. But I was struck by his decision to share his story in the hope that others would read it and feel better for doing so. He prompted me to share mine, so thanks Adam and good luck. Julian Worricker is a BBC TV and radio presenter and journalist, and has psoriatic arthritis. 21 Inspire Autumn 22 pp21 Julian.indd 21 16/08/2022 17:05