Mental Health Spotlight: Seeing a Therapist for PsA

PsA symptoms can be uncomfortable and possibly debilitating. They may limit your ability to do certain activities. They may also negatively affect your:

• sleep
• energy levels
• sense of self
• mood

You might find it challenging to follow your treatment plan. Managing PsA sometimes requires significant lifestyle changes. If you don’t have comprehensive health insurance, affording treatment may be challenging.

These factors may negatively affect your mental health and raise your risk of anxiety and depression. When the authors of a 2019 review pooled the results of past studies on mental health in people with PsA, they found that an estimated:

• 33 percent of people with PsA have at least mild anxiety
• 21 percent of people with PsA have at least moderate anxiety
• 20 percent of people with PsA have at least mild depression
• 14 percent of people with PsA have at least moderate depression

Living with anxiety or depression can make it harder to cope with PsA. You may have a lower pain threshold. You may also find it harder to practice healthy habits or to follow your treatment plan while coping with mental health challenges. This, in turn, may worsen your symptoms.

Let a healthcare professional know if you often feel irritable, anxious, worried, sad, or disinterested in things that usually bring you happiness.

They may refer you to a psychologist, social worker, or other mental health specialist for psychotherapy. This is also known as talk therapy or counseling.

Cognitive behavioral therapy (CBT) is one common type of psychotherapy. It’s often used for people with chronic health conditions, including PsA.

Therapists use CBT to help you identify and change unhelpful patterns of thinking and behavior. They’ll then help you develop coping strategies for challenges you face in day-to-day life.

Research from 2020 suggests that CBT has long-term benefits for treating anxiety and depression. In people with chronic health conditions, it may help reduce pain and limit disability. It’s also been shown to improve sleep and mood.

Psychotherapy has even been linked to improved immune system function.

A 2020 analysis found that people who received psychotherapy — especially CBT — had decreased levels of inflammation markers. This may have implications for people with inflammatory diseases such as PsA.

A 2019 review of research suggests CBT may even help reduce psoriasis symptoms.

Other forms of psychotherapy might also provide benefits.

For example, a small 2011 study in people with arthritis found that a mindfulness-based approach helped to improve fatigue, psychological distress, and participants’ confidence in managing their condition.

Telehealth has also been shown to be effective.

A 2018 review of studies looked at internet-delivered CBT (ICBT) for people with a variety of chronic health conditions, including rheumatoid arthritis. It concluded that ICBT had small but significant effects in improving anxiety and depression.

Your doctor may also prescribe anti-anxiety medication, an antidepressant, or other medication along with therapy.

A variety of mental health professionals offer therapy. Common types of therapists include:

• psychologist
• social worker
• licensed professional counselor (LPC)
• licensed clinical social worker (LCSW)
• psychiatric or mental health nurse practitioner

Mental health professionals may use CBT, mindfulness-based interventions, or other therapeutic approaches. You might find one approach more helpful or appealing than others.

Your therapist may also refer you to a psychiatrist, who can prescribe medications if necessary.

Finding a therapist who has experience treating people with PsA or other chronic conditions may help you get the support you need.

Before you visit a therapist, ask them about their training, their qualifications, and whether they have any experience working with people with PsA.

It’s important to find a therapist who’s licensed to practice in your state. You can use an online registry, such as the Association of State and Provincial Psychology Boards, to check their license.

Developing a good relationship with your therapist is essential. Look for someone who communicates well and provides the supports you need.

Your doctor may be able to refer you to a therapist.

You can also look for therapists online. You can start with a directory such as the American Psychological Association’s psychologist locator tool or the National Register of Health Service Psychologists find a psychologist tool.

Several companies offer online therapy or help connect people to individual therapists who offer online services. This is known as:

• telehealth
• telecounseling
• telepsychology

If you have health insurance, contact your insurance provider to learn which mental health services and providers are covered. Ask a therapist whether they accept your insurance plan before you visit them.

If you have low income, you may be able to find a therapist that offers sliding-scale fees. This means they charge less to low income clients. If a therapist doesn’t offer sliding-scale fees, they may be able to refer you to one that does.

Some community health clinics, university health clinics, and teaching hospitals also offer low cost or free counseling.

If you’re experiencing a mental health crisis or thoughts of suicide, you can contact the National Suicide Prevention Lifeline’s toll-free hotline anytime at 800-273-TALK (800-273-8255).

Therapy sessions typically last 30 to 60 minutes. The number of sessions that your therapist recommends will depend on your:

• symptoms
• treatment needs
• budget

You may attend one-on-one therapy sessions or group sessions. Some therapists only meet with clients in person. Others offer telehealth appointments by phone or online.

During visits, your therapists may:

• ask you about your mood, your thoughts, and challenges you’ve had while managing PsA or other aspects of life
• teach you strategies for identifying and interrupting problematic thoughts and behaviors
• teach you how to use other coping techniques, such as guided imagery and relaxation strategies

Some therapists use biofeedback to help clients develop coping skills. Biofeedback uses sensors to measure your body’s response to different activities or stimuli.

Your therapist may give you activities or assignments to do at home. They might ask you to use a workbook or complete online activities. This may reinforce the coping skills you learn during therapy sessions.

Symptoms of PsA can affect not only your physical health but also your mental well-being. Mental health challenges can make it harder to manage the condition, which can worsen symptoms of PsA.

Connecting with a mental health specialist may help you manage anxiety, depression, or other mental health challenges. CBT or other types of therapy may help you develop more effective coping strategies and may even reduce some symptoms of PsA.

Let a healthcare professional know if you’re finding it hard to cope with the emotional effects of PsA. They may refer you to a therapist or other support resources.

Your doctor may also prescribe medication to treat anxiety or depression.