Acne can cause Anxiety and can lead to Anxiety Disorders and depression.
Up to 60 percent of acne sufferers show significant levels of Anxiety. Some researchers even think that acne can cause these mental disorders. It is certain that stress can cause acne and exacerbate existing Anxiety Disorders and depression.
What is not apparent is how many suicides are attributable to acne. Thirty-five percent of teenagers with bad acne have suicidal thoughts, and more than 10 percent have tried to kill themselves. The numbers are not available for adult suicide ideation and attempts, but there is reason to believe that they are similar.
The first post in this series described how acne affects the lives of both adolescents and adults. This post discusses the interrelation of acne and the Anxiety Disorders and stress, as well as getting help. The headings are:
- Acne and Anxiety
- Acne and stress
- Warning signs that your mental condition is getting out of control
- Get help
The first part of this series details how acne can affect people psychologically and emotionally under the following headings:
- How many people have acne?
- How acne affects your life
- Acne and quality of life
- Adult acne
Acne and Anxiety
Acne often leads to the Anxiety Disorders
Acne often leads to mental disorders, especially the Anxiety Disorders.{{1}} Acne is associated with a greater psychological burden than a variety of other disparate chronic disorders.{{2}} Some researchers believe that acne can actually cause psychological problems, rather than just exacerbating them among those with susceptibility.{{3}} Shannon Hanna, of Dalhousie University Medical School Halifax, Nova Scotia, Canada, says:{{4}}
Acne vulgaris has the potential to cause significant psychiatric and psychological complications, while negatively affect[ing] quality of life. Many factors influence the nondermatological aspects of acne including personality, perceptions, age, and social and cultural factors, as well as disease characteristics (duration, severity, scarring).
The Anxiety Disorders, especially Social Phobia, are the most prominent among acne patients. Up to 60 percent of acne sufferers show significant levels of Anxiety. As might be expected, people with a more severe degree of acne show higher Anxiety values in studies.{{5}} Women with acne have a higher level of Anxiety, and are more vulnerable than males to the negative psychological effects of acne.{{6}} The rates of Anxiety increase among those with a higher education.{{7}}
Acne and stress
Stress causes acne to get worse
Stress is a constant in our lives, but for the acne sufferer it can be especially troubling. It has been found that stress can actually cause acne to get worse and can make any psychological conditions worse, as well. Dr. Jerry K. L. Tan, Director of the Acne Research and Treatment Centre, Windsor, Canada, says:{{8}}
The mental stress of sufferers with acne can be greater than that associated with other chronic diseases such as asthma, epilepsy, diabetes, back pain, arthritis, and heart disease.
There seems to be a two-way street with acne and stress; Acne can cause stress and negative emotions, and stress and negatives can cause and worsen acne. Any effective acne treatment should address both the acne and the emotional state of the person with acne.{{9}} (See “Get Help,” below.)
For those who have mental disorders, the stress caused by acne can exacerbate the condition. And for those who are predisposed to psychological factors, acne’s stress can cause mental disorders to become active.{{10}}
Dr. John Koo, of the University of California, San Francisco’s Psoriasis Treatment Center and Phototherapy Unit, states that psychological factors may play a significant role in acne in at least three ways:{{11}}
- Emotional stress can exacerbate acne.
- It is common for patients to develop psychiatric problems as a consequence of acne, such as those related to low self-esteem, Social Phobias, or depression.
- Primary psychiatric illnesses such as Obsessive-Compulsive Disorder and psychosis may be based on a complaint that is focused on acne.
It is obvious that to properly control acne, a sufferer’s stress must be addressed as well, especially if the stress is making their Anxiety Disorders or depression worse. A professional mental health practitioner is the best source of help, and should be considered as essential as a good dermatologist.
Warning signs that your mental condition is getting out of control
Warning: Avoidance and social withdrawal
In a society that places great emphasis on appearance, acne sufferers often feel uncomfortable or embarrassed. The prevalence of myths regarding acne development may even lead some to feel a sense of guilt or shame, as if they are somehow responsible for their acne.{{12}}
These feelings lead to social withdrawal and to avoiding social situations. This avoidance is a primary reason that Anxiety Disorders get a toe-hold in your life, and avoidance is the main way that Anxiety Disorders grow and flourish. Avoiding going out with friends, finding excuses to not attend family functions or generally having little interest in socializing with others may be warning signs that acne is seriously affecting your life.{{13}}
But the danger of acne goes beyond just Anxiety Disorders and depression. Many people, especially adolescents, contemplate or actually attempt suicide due to their acne.
Thirty-five percent of teenagers with bad acne have suicidal thoughts, and more than 10 percent have tried to kill themselves.{{14}} I have not seen any studies about suicide among adult acne sufferers, but it is logical that there is some degree of these numbers holding true in adults.
Get help
Anxiety Disorders and depression often mixed with acne
The treatment of acne should involve more than addressing skin problems. Disturbance of the psychological state with signs of Anxiety Disorders or depression, as well as mixed depression and Anxiety Disorders, is frequently associated with acne.{{15}}
It stands to reason that any treatment plan should include both physical and psychological care. Shannon Hanna, of the Dalhousie University Medical School in Nova Scotia, says that the treating physician should consider all factors when treating acne. She continues:{{16}}
Addressing nondermatological effects of acne allows the physician to treat the whole patient and not solely the skin condition. Acne vulgaris is a common skin disease with potential complications that are more than skin deep.
And Dr. Peter Watson of the University of Auckland states that:{{17}}
Our data suggest that doctors who see … people with problematic acne have a particularly important role to play in screening these … people for depression, anxiety and suicidal thoughts and behaviour.
Patient education is very important, as well. Too many people have misguided notions of why acne occurs, which can further exacerbate emotional and mental problems. In a study of acne patients in a dermatologists care, almost 30 percent believed that poor skin hygiene was a causative factor of acne. If this belief exists among a patient population who has had some degree of education by their physicians, similar beliefs must also exist in the general population.{{18}}
Here are some suggestions for getting help with your acne:{{19}}
- At a minimum, find a dermatologist who is sympathetic and willing to address the emotional issues that go along with acne. Be honest with your doctor. Let her know if acne is considerably affecting your self-esteem, interfering with social interactions, or causing depression or anxiety.
- Ideally, acne should be treated early, before damage to the self-esteem has begun. People who have chronic, long-lasting acne are more likely to have psychological ramifications. If you believe you may be anxious or depressed, you may benefit from psychological counseling.
- Seek out a support system. Having a compassionate person, or group of people, who understand what you are going through can help dispel feelings of isolation and hopelessness that are common to acne sufferers
What do you think?
Too often, acne is brushed off as just something that teenagers have, and that goes away quietly. The psychological, emotional, and social effects of acne never enter the mind. However, as these posts show, acne often leads to deeper problems that can linger a person’s whole life.
I had the usual adolescent acne, but never very badly. I did have friends who had severe acne, and I remember the suffering and social isolation they experienced. And I have known many adults who had acne whose lives and psyche were impaired by it. How about you?
- If you had or have acne, how does it affect your life?
- Do you know someone with acne who may be experiencing Anxiety Disorders or depression?
As always, your comments are welcome!
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[[1]]Srivastava, S.; Bhatia, M.S.; Das, P.; Bhattacharya, S.N. (2008). A Cross-sectional study of quality of life and psychiatric morbidity in patients with Acne Vulgaris. Retrieved March 21, 2009 from http://www.jpps.com.pk/display_articles.asp?d=199&p=art [[1]]
[[2]]Tan, J.K.L. (2004). Psychosocial Impact of Acne Vulgaris: Evaluating the Evidence. Retrieved March 21, 2009 from http://www.skintherapyletter.com/2004/9.7/1.html#_jmp0_ [[2]]
[[3]]Fried, Richard; Wechsler, Amy. (2006, September 27). Psychological problems in the acne patient. Retrieved March 25, 2009 from http://www3.interscience.wiley.com/journal/118599090/abstract [[3]]
[[4]] Hanna, Shannon; Sharma, Jasdeep; Klotz, Jennifer. (2003). Acne vulgaris: More than skin deep. Retrieved March 21, 2009 from http://dermatology.cdlib.org/93/commentary/acne/hanna.html, Conclusions.[[4]]
[[5]] Asad, Faria; Qadir, Altaf; Ahmed, Lugman. (2002). Anxiety and Depression in patients with Acne Vulgaris. Retrieved March 21, 2009 from http://www.pakmedinet.com/3517 [[5]]
[[6]]Aktan, S.; Ozmen E.; Sanli, B. (2000). Anxiety, depression, and nature of acne vulgaris in adolescents. Retrieved March 21, 2009 from http://www.ncbi.nlm.nih.gov/pubmed/10849125#_jmp0_ [[6]]
[[7]]Datuashvili, M.G.; Chitashvili, M.D.; Katsitadze, A.G. (2002). Psychological Particularity in Acne Vulgaris. Retrieved March 21, 2009 from http://content.karger.com/ProdukteDB/produkte.asp?Doi=64500 [[7]]
[[8]]Tan, Jerry K.L. (2008). The Unseen Impact of Acne: There is help for those suffering. Retrieved March 21, 2009 from http://www.acneguide.ca/articles/unseen_impact_of_acne.html [[8]]
[[9]]Fried, Richard. Healing Adult Acne. Oakland, CA: 2005 [[9]]
[[10]]Kenyon, F.E. (1966). Psychosomatic Aspects of Acne. Retrieved March 25, 2009 from the British Journal of Dermatology, http://www3.interscience.wiley.com/journal/119756413/abstract?SRETRY=0 [[10]]
[[11]]Koo, John; Smith, Laura. (2008, March 20). Psychologic Aspects of Acne. Retrieved March 25, 2009 from http://www3.interscience.wiley.com/journal/119356624/abstract?CRETRY=1&SRETRY=0 [[11]]
[[12]]Palmer, Angela. (2008, December 5). Acne and Your Self Esteem. Retrieved March 21, 2009 from http://acne.about.com/od/livingwithacne/a/effectsofacne.htm [[12]]
[[13]] Palmer, Angela. (2009, January 2). Is Acne Negatively Impacting Your Life?. Retrieved March 21, 2009 from http://acne.about.com/od/livingwithacne/tp/3WarningSigns.htm [[13]]
[[14]]Purvis, D,; Robinson, E.; Merry, S.; Watson, P. (2006). Acne, anxiety, depression and suicide in teenagers. Retrieved March 21, 2009 from http://www.ncbi.nlm.nih.gov/pubmed/17096715 [[14]]
[[15]]Datuashvili. (2002).[[15]]
[[16]] Hanna. (2003), Conclusions[[16]]
[[17]]Purvis. (2006).[[17]]
[[18]] Hanna. (2003), Introduction[[18]]
[[19]]Staff of the New Zealand Dermatology Society. (2008, December 30). Psychological effects of acne. Retrieved March 21, 2009 from http://dermnetnz.org/acne/acne-psychological-effects.html [[19]]