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Managing Anxiety and Depression with Hidradenitis Suppurativa

The mental impact of hidradenitis suppurativa (HS) is negative and distressing to many with the disease. Because of the nature of HS, the cause of anxiety and depression is complicated. The physical symptoms of HS, as well as friends and family not fully understanding HS, may add to your mental distress.

Defining comorbidity and the link to HS

Doctors are still trying to figure out the exact causes of HS. Long-term irritation or inflammation within the body are thought to be major reasons why HS happens. In HS, this irritation inside the body is never turned off. This causes the body to show its irritation by the symptoms on the skin.

Since the body has constant irritation, it makes sense that other conditions caused by irritation might occur at the same time.

The term comorbidity is used to describe a condition or illness that happens at the same time of another condition or illness. Morbidity should not be confused with the term mortality. Morbidity means disease or illness and mortality means death.1

There are several comorbid conditions in HS. Anxiety, depression, and increased suicide risk are among these comorbid conditions. These serious conditions are a result of many factors that may occur in HS.

What exactly is anxiety and depression?

There are different types of depression. According to the Anxiety and Depression Association of America, depression is the leading cause of disability among people aged 15-44.2

Depression impacts 322 million people worldwide. General symptoms of depression usually include:2,3

  • An ongoing, sad, anxious, or “empty” mood
  • Feeling hopeless, guilty, or helpless
  • Lost interest in pleasurable things and activity, including sex
  • Decreased energy and increased fatigue
  • Difficulty concentrating and remembering things
  • Changes in weight from not eating enough or eating too much
  • Thoughts of death or suicide

Linking anxiety, depression, suicide, and HS

HS is a painful, long-term condition. Depression and anxiety are common comorbidities in HS. The physical appearance of the skin lesions in HS can lead to a negative self-image. Additionally, the lesions in HS may have a bad odor, adding to the emotional impact of the disease.4

Those with HS may be greatly impacted by mental distress. In fact, studies have shown that suicide risk is greater for those with HS. This risk increases in women.5

You are not alone. If you have thoughts that your life is not worth living, it is important to call your doctor. There is help available to you.

Ways to manage anxiety and depression in HS

Managing your anxiety and depression with HS may help with your daily living and overall quality of life. Talk to your doctor about medication and therapy options.

Your mental health team may include several people or groups:

  • General doctor
  • Dermatologist
  • Mental health therapist or doctor
  • Support groups
  • Online communities

Your mental health is priority. Discuss your symptoms with your doctor. Your doctor and healthcare team will work to manage your symptoms and improve your overall quality of life.

Written by: Katie Murphy | Last reviewed: December 2020
  1. Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M. Defining comorbidity: implications for understanding health and health services. Ann Fam Med. 2009;7(4):357-363. doi:10.1370/afm.983.
  2. Understand the Facts: Depression. Anxiety and Depression Association of America. Available at https://adaa.org/understanding-anxiety/depression. Accessed 8/26/2020.
  3. Understand the Facts: Depression Symptoms. Anxiety and Depression Association of America. Available at https://adaa.org/understanding-anxiety/depression/symptoms. Accessed 8/26/2020.
  4. Vekic D, Gains G. The Royal Australian College of General Practitioners. 2017; 46(8): 584-588. Available at https://www.racgp.org.au/download/Documents/AFP/2017/August/AFP-2017-8-Clinical-Hidradenitis.pdf. Accessed 8/18/2020.
  5. Hannu Tiri, Laura Huilaja, Jari Jokelainen, Markku Timonen, Kaisa Tasanen. Women with Hidradenitis Suppurativa Have an Elevated Risk of Suicide. Journal of Investigative Dermatology, Volume 138, Issue 12, 2018, Pages 2672-2674. doi.org/10.1016/j.jid.2018.06.171.