I’ve been fighting a battle with psoriasis for 20 years. When I was 7 years old, I had chickenpox. This was a trigger for my psoriasis, which covered 90 percent of my body at the time. I’ve experienced more of my life with psoriasis than I have without it.

Having psoriasis is like having an annoying family member who you can’t avoid. Eventually, you become accustomed to them being around. With psoriasis, you simply learn how to adjust to your condition and attempt to see the good in it. I’ve spent most of my life adjusting to my psoriasis.

On the other hand, sometimes it felt like I was in an emotionally abusive relationship with psoriasis. It led me to believe I was cursed and unlovable, and it controlled everything I did and how I did it. I was plagued by thoughts that I couldn’t wear certain things because people would stare or I should avoid going places because people would think I was contagious.

Let’s not forget how it felt like I was “coming out the closet” every time I sat down a friend or potential romantic partner to explain why I was so apprehensive about attending a certain event or being intimate.

There were also moments where psoriasis was my internal bully. It would cause me to isolate myself to avoid having my feelings hurt. That brought about fear of what others around me would think. Psoriasis scared me and prevented me from doing a lot of things I desired to do.

In hindsight, I realize I was solely responsible for these thoughts, and I allowed psoriasis to control me.

Finally, 18 years later, after seeing 10-plus doctors and trying 10-plus treatments, I found a treatment that works for me. My psoriasis has disappeared. Unfortunately, the medicine didn’t do anything for the insecurities that I’ve always dealt with. You might be asking, “After all those years of being covered with psoriasis, what do you have to be scared about now that you’ve achieved 100-percent clearance?” It’s a valid question, but these thoughts still linger in my mind.

I’m not one of those people who can pinpoint a trigger. My psoriasis doesn’t come or go depending on my stress levels, what I eat, or the weather. Without treatment, my psoriasis is around 24/7 without any cause. It doesn’t matter what I’m eating, what day it is, my mood, or who is getting on my nerves — it’s always there.

Because of this, I fear the day my body becomes used to the treatment and it stops working, which has happened to me once before. I was on one biologic that stopped working after two years, forcing me to make a switch. Now I have a new concern: How long will this current medicine work until my body becomes used to it?

For the majority of my life, I’ve only known what it was like to live with psoriasis. I didn’t know what having clear skin meant. I wasn’t one of those people who didn’t encounter psoriasis until adulthood. Psoriasis has been a part of my everyday life since early childhood.

Now that my skin is clear, I know what life is like without psoriasis. I know what it means to put on shorts and a sleeveless shirt without being stared at or ridiculed. I now know what it means to simply grab clothes out the closet instead of having to overthink how to look cute while covering up my disease. If my skin returned to its previous state, I think my depression would be worse off now than before the medicine. Why? Because now I know what life is like without psoriasis.

When I first met my now ex-husband, I was 90-percent covered with the disease. He only knew me with psoriasis, and he knew exactly what he was committing to when he decided to be with me. He understood my depression, anxiety, flaking, why I wore long sleeves in the summer, and why I avoided certain activities. He saw me at my lowest points.

Now, if I meet a man, he will see the psoriasis-free Alisha. He’ll be unaware of how bad my skin can really get (unless I show him pictures). He’ll see me at my highest, and it’s scary to think of meeting someone while my skin is 100-percent clear when it can potentially go back to being covered in spots.

I used to be against biologics because they haven’t been around long and we have no idea how they will affect people 20 years from now. But then I had a conversation with a woman who had psoriatic disease and was on a biologic. She said the following words to me, which stuck out: “It’s the quality of life, not the quantity. When I had psoriatic disease, there were days I could hardly get out of bed, and with that, I wasn’t truly living.”

To me, she made a great point. I started to think about it more. People get into car accidents every day, but that doesn’t stop me from getting into a car and driving. So, although the side effects of these medications can be scary, I’m living in the moment. And I can say I’m truly living without the restraints that psoriasis once placed on me.