Navigating and Coping with the Unpredictable Nature of Atopic Dermatitis

Significant research has documented the impact of atopic dermatitis on mental health. Not only does stress trigger eczema flares, but atopic dermatitis increases the risk for mental health issues due to the stress of living with the condition. In fact, in some cases, those with atopic dermatitis are at increased risk for suicidal ideation and behavior compared to those without a medical illness and compared to those without medical issues.

Atopic dermatitis can be a vicious cycle of stress triggering flares and flares causing increased stress. While external factors like weather, stress, and other illnesses can contribute to flares, they can also occur seemingly out of nowhere.

Those living with atopic dermatitis can struggle psychologically as a result of the pain and discomfort caused by the condition, as well as the unpredictability of flares. Learn more about the fleeting nature of AD that makes triggers so difficult to manage.

Navigating the Cycle

Atopic dermatitis is unpredictable by nature. Flares can occur in response to stress or environmental factors, but they can also occur seemingly at random. Each individual will have differences that make their experience unique. Even when someone appears to be doing everything right, following their treatment plan, and taking steps to control their symptoms, they can still experience a flare without warning. The frequency, intensity, and length of flares are highly variable and difficult to predict or control.

A middle-aged male who asked to remain anonymous shared his experience: “I’ve suffered from the effects of eczema since childhood, and it’s been very difficult. Every winter my hands get very dry and get cracked, itchy, and bleed. I also have eczema scars over my entire body. This impacts my confidence a lot, and also, my ADHD and eczema seem to have some interplay where an itch gets me distracted, and further exacerbates my short-term memory issues and executive functions. These in turn cause a lot of frustration for me.  And this is every day.”

Kay, who also asked to remain anonymous, shared that she has experienced shame and ridicule for her condition because many assume atopic dermatitis is caused by poor choices and self-neglect: “People assume [atopic dermatitis] is caused by lack of hygiene or bad diet … but it has been an issue since infancy.”

Strategies for Coping

Atopic dermatitis is a painful, uncomfortable, and unpredictable condition. Self-care and coping strategies can both help you manage mental health distress that arises as a result of your symptoms and help you manage stress to decrease your chances of having a flare.

Everyone’s ideal coping strategies vary, so you might have to try different things to see what works best for you. It is okay if something that helped someone else is not the right fit. With that in mind, some coping strategies that you might consider trying are:

• Having a relaxation routine. Since stress can exacerbate eczema, a relaxation routine can soothe flares. It can also help you cope with the stress of a flare.
• Reducing stress where you can. Not everything is in your control, but if you are able to say “no” to projects or events that cause overwhelm, this might help you manage stress levels that can trigger a flare. 
• Have a sleep routine. Kay shared that her atopic dermatitis interferes with her sleep, which further exacerbates mental health issues. Having a routine around sleep can make it easier to get sufficient rest even during a flair.
• Focusing on what you can control. During a flare, it can feel impossible to cope with the discomfort. It can also be frustrating when you experience a flare when you worked hard to reduce triggers. Look at what is in your control, like your skincare or relaxation routines.
• Radical acceptance. Radical acceptance is a mindfulness practice that aims to reduce distress by fully accepting the present moment.
• Meet with a therapist. A therapist can help you manage mental health symptoms caused by the stress of living with atopic dermatitis. You can look for a provider who understands the stress that can come with this diagnosis.
• Educating yourself. David, who agreed to share his experience for this article, found that learning about cognitive-behavioral techniques for treating depression helped him address his mental health issues caused by his atopic dermatitis: “This allowed me to emerge from the depression and provided me with resilience tools for the rest of my life.” It’s helped him reframe his condition: “I am pretty sure that those tools have allowed me to dismiss the eczema as just another annoyance to be dealt with, rather than something that causes me pain and embarrassment.”

Getting Support

Having a solid support system is crucial for mental health. When the people around you support you, it is so much easier to manage stress and the symptoms of atopic dermatitis. Ways to build a support network include:

• Finding support groups for atopic dermatitis. A support group can be a great way to find others who are going through the same things as you. Groups specific to atopic dermatitis can help you meet others who experience the same symptoms. This means finding people who truly understand what you are going through, and possibly getting tips on coping from those who have been where you are.
• Connecting with others online. The anonymous man who agreed to share his experience for this article said that online communities have been key in his support: “I cannot imagine my life without [my online community].” The internet allows you to connect with people who are not in your immediate geographic area.
• Educating your loved ones about atopic dermatitis. It is not your job to teach people about your own experience. At the same time, you might choose to share your experience so that they can better understand how to support you.

Bottom Line

Finding ways to minimize stress and other flare triggers can help reduce symptoms and make existing symptoms easier to cope with. A professional therapist can also help treat mental health symptoms caused by atopic dermatitis, as well as mindfulness skills like radical acceptance. Having a support system can also be key to living with a skin condition.

Mental health and physical health are intertwined, and you deserve full support for both. Atopic dermatitis is affected by and contributes to mental health challenges, making it particularly important for those with the condition to receive support for their mental health and not just their physical symptoms. Fortunately, support and coping tools are available for those who struggle with these symptoms.