It seems that stress has never been higher for many of us. Stress can harm both our mental and physical health. For those with existing health issues, especially skin health conditions, reducing stress is crucial for recovery.
The Truth About Stress
Stress is not always bad. Some form of stress is necessary for us to stay active and keep motivated. Stress is a natural and physiological response coordinated by our mind and body in response to challenges, demands, or danger.
Stress is a little like a light switch. The stress “switch” flips us from relying on our calming, restorative parasympathetic nervous system to relying on our more reactive sympathetic nervous system. It’s the sympathetic nervous system that cues up our “fight or flight” response so we’re ready to meet the danger or demand ahead.
This stress response sends signals that cause our muscles to tense up so that they’re ready to spring into action, our breathing and heart rates increase so we can run away or battle to survive. However, in order to send more energy to fuel our fight or flight, the stress response reduces energy sent to our digestive and immune function. Stress also decreases the amount and quality of our sleep
Even our brain changes under stress: energy shifts away from the reasoning and decision-making parts of the brain, reducing our executive function capacity and organizing skills. Instead, our brain diverts more energy to primal parts of the brain that are responsible for survival. Our skin is also affected by stress because its health is tied to healthy cardiovascular, digestive, and immune function. When stress negatively off-balances our internal system, it’s harder for our skin to maintain its own natural balance
How Stress Affects Skin Health
Stress can cause or exacerbate a flare-up and make it harder to heal from eczema, TSW, acne, or psoriasis. But at the same time, simply having a skin condition can increase stress above and beyond all the normal day-to-day stressors. That’s why having a skin condition puts people in a double bind when it comes to stress.
Skin patients not only struggle with the stress that comes from the pain and itching due to their symptoms. There are more doctor visits, costly treatments, and time off of work or school.. They can often experience real isolation due to their condition during a flare-up, which compounds their stress even more.
A lot of the stress associated with skin patients is psychological. They can be anxious about their appearance and more self-conscious around others. They may self-isolate and start closing themselves off from social events, fun, and people. The anxiety about their skin condition often takes over their lives and they start living a small version of the life they are capable of living.
Unfortunately, these anxious thoughts trigger a very real and physical stress response.
Enter Cognitive Behavioral Stress Management
One effective way to reduce stress is learning how to stop thinking about your skin condition, or your life situation, in ways that trigger a stress response.
Cognitive behavioral stress management (CBSM) is short-term therapy that focuses on how your thoughts affect your emotions and behaviors. It can help you identify irrational stress-provoking thoughts, and change the behavior and thought patterns that lead to stress.
One of the benefits of CBSM therapy is that it is goal-oriented, meaning your therapist can help you see real results in just a few weeks. Patients with skin conditions can share their situation with their therapist and build goals around reducing social anxiety, or practice better responses for strangers who ask probing questions about their scars or red patches.
The great news is that CBSM works! Research shows that brief group-based cognitive behavioral stress management can reduce the neuroendocrine and cardiovascular stress response. CBSM therapy is also shown to decrease isolation and depressive symptoms while improving immune function.
Another benefit of CBSM is that once you learn how to manage your thoughts and reactions to eliminate imaginary sources of stress, you can also learn how to think more positively when real stressful events occur. You learn to look at challenges and setbacks more positively, with more confidence and optimism: “Sure, I lost my job, but I’ll figure this out. This might be a chance to get a better one in the end!” or “Yes, there are a lot of demands on me this week, and I want to prevent a flare-up. I’ll ask my spouse or boss for the extra help that I know I’ll need.”
What Tools Does CBSM Use?
A CBSM therapist might ask you to jot down your thought processes or journal during the day, so that together you can discover when and where your thinking is negatively affecting your life. Together, you might engage in role-playing to learn more positive ways to deal with stressful interactions with others. Or, your therapist might suggest ways to gradually expose yourself to situations that scare you – like being in a crowd, coming under scrutiny in a job interview, or asking for what you need from your partner — so that you can practice new ways of managing your fears. The bottom line is that CBSM therapy allows you to change your thinking in ways that reduce stress instead of magnifying it.
Conclusion
Our mind and body are intimately connected and always communicating with each other. The health and condition of our skin is part of that connection.
The more you can balance your psychological and emotional health – including your ability to manage stress through therapies like CBSM — the more your physical health, especially your skin health, has a chance to come back into balance as well.
To that end, if you find that you are constantly anxious, overwhelmed, or stressed out — especially about your skin — seek out a professional trained in cognitive behavioral stress management. The good news is that you can also find CBSM therapy online as well as in traditional office or group therapy settings.
We know that with a little help, you can enjoy the calm, confident, and healthy life you deserve!
In the meantime, Dr. Olivia Hsu Friedman is an expert on how emotional and psychological factors affect skin health, and will be speaking on this topic at a virtual event on November 16, 2024. Click here for more information or to attend this online talk.
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About the Author
Olivia Hsu Friedman, LAc, Dipl.OM, DACM, Cert. TCMDerm, is the owner of Amethyst Holistic Skin Solutions and treats Acne, Eczema, Psoriasis, and TSW. Olivia treats patients via video conferencing using only herbal medicine. Olivia is Chair of the Board of Directors of the American Society of Acupuncturists, serves on the Advisory Board of LearnSkin, and is a faculty member of the Chicago Integrative Eczema Group sponsored by the National Eczema Association.