Finding Purpose Amid Health Challenges
- Fashion model CariDee English, a former winner of the TV competition America’s Next Top Model who has been living with a chronic skin condition called psoriasis since she was five years old, is celebrating her addiction recovery following a relapse three years ago.
- There are seven types of psoriasis, with plaque psoriasis being the most common. People with a family history of psoriasis have an increased risk of developing the chronic disease.
- Symptoms for psoriasis can often be managed with different treatments and some lifestyle adjustments.
- Although psoriasis is incurable, treatment options to manage symptoms include topical ointments and creams. To further help manage symptoms, people diagnosed should discuss with their doctor to learn what could trigger flare-ups, such as foods or environmental factors.
English—who has also struggled with psoriasis since the age of five, but has been embracing the condition since embarking on her modeling journey—has marked three years since she suffered a major head injury during an accident while relapsing, an event which led her to an outpatient rehabilitation center and steered her back on the right path.
Read More“To my sisters & brothers still suffering: It’s much harder for our men to come out of the darkness & ask for help. Conditioned to “man up” & handle it. I’m sorry bb, don’t stay quiet.🎺 Women who suffer addiction are scarlet shamed. Even in a successful recovery. Not allowing our sisters to be messy & rise from the ashes, sentences her to the stake the moment she’s unhinged. Protect her fire.”
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After saying that “everyone has an addiction” of all different sorts, she explained further, “Everyone has an addiction. Greed is our destiny. Voids are unavoidable. It is where dreams are made from, and what destruction is made for.
“All temporary solutions to the problem. The problem is: being human is a f***ing beautiful, brutal buzz. No one gets out alive w/o numbing the pain of existing….The loophole is mastering your villain.
English concluded, “Surviving myself is heroic. Showing my scars to the shameful is OUR victory. I’m braver bc of this community. I love you. I choose MORE life, 1 day at a time. To live gently in my raw skin and face the ghosts in my trauma cameos.
“Suit up show up, and take on less sabotage and more sonatas.”
Expert Mental Health Resources
CariDee English’s Psoriasis Battle
In an earlier conversation with the International Federation of Psoriasis Associations (IFPA), English explained how her psoriasis journey began at age five when she noticed she had spots on her leg.
“The thing I remember most is looking at my mom when I showed her, and her face just kind of fell,” said English, whose mom also coped with the skin condition.
“When I was so young, it didn’t really affect me. I didn’t really comprehend. But then as I grew, my psoriasis grew with me.”
English experienced her symptoms worsen when she went through puberty. She recounted growing three inches and also having her plaque psoriasis go from covering just 20% of her body to 70%.
Looking back as to how she was negatively viewed in school because of her condition, she said, “The other parents are the worst because they are like ‘What do you have? Is my kid going to catch it?’ I remember going to a pool. I would wear two or three pairs of nylons when I went to the pool. I’m sure they looked really funny on my feet, but then I could just run into the pool and people wouldn’t notice. And I remember, I got asked to leave the pool for a summer because the parents were scared that I had a communicable disease.”
After feeling like psoriasis was the cause for her being rejected, English powered through adversity and was determined to embrace her beauty and become a model.
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By the time she was 17, she started taking a new psoriasis medication, thanks to insurance she obtained from a janitor job. Three years later, she had clear skin and soon went on to her next challenge— competing in America’s Next Top Model.
She told IFPA, “I decided that I would do top model as a way to get large exposure to make up for those years between when I got sent home from Miami and when I was 21. Three years had lapsed that I couldn’t model because my psoriasis was so bad.”
Another factor that led her to want to join the show, English explained, “I’m going to be on television. If I tell someone that I have psoriasis, I don’t think they’re going to kick me off. They might be able to embrace me.
“And I’ll be able to reach other people that are sitting there with psoriasis.”
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Now her attitude is something all psoriasis warriors can look up to, as she insists, “I frickin’ love my psoriasis today!”
She told IFPA, “I’m so happy I have the disease because I can speak on behalf of millions of people with this and live in the skin they live in. I’m so proud of it.
“Once you’ve decided you’re confident in [psoriasis], it doesn’t always stay. It’s work. Sometimes I’m walking down the street and I can feel a person coming up behind me. I have psoriasis on my elbows really thick and I find myself wanting to do the inverted arm thing, like one of my weird positions so people don’t see. And then I think, ‘No. You don’t have to hide anymore.'”
She concluded, “Things aren’t going to change on their own unless we as women or men just really own ourselves. [We can do it] by standing up and saying, ‘This is who I am. It’s different. It’s beautiful. I feel vulnerable, but I feel brave today that I have psoriasis.’”
What is Psoriasis?
Psoriasis is a skin condition that causes red, itchy patches to develop on the skin. It is a chronic disease, which means that it does not have a cure.
Fortunately, symptoms can often be managed with different treatment options as well as lifestyle adjustments. This condition is rare. Only about 3.2% of the U.S. population suffers from it, according to the American Academy of Dermatology. Still, there have been major developments in recent years when it comes to treatment and management of psoriasis.
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“Psoriasis is a chronic, auto-immune skin condition where you have red, scaly patches on the skin,” Dr. Saakshi Khattri, a Dermatologist/Rheumatologist at Mount Sinai Health System, tells SurvivorNet. “It is a long-term condition, which can ebb and flow. You can have good days and bad days.”
Understanding the different types of psoriasis
Dr. Saakshi explains that while anyone can develop psoriasis, the disease is more common in people between the ages of 30 and 50. Researchers believe genetics, as well as environmental factors, may play a vital role in the development of this disease.
Dr. George Han, a Dermatologist at Northwell Health/Lenox Hill Hospital, tells SurvivorNet that psoriasis is also connected with many internal co-morbidities. “The most obvious of which is psoriatic arthritis, which is an inflammatory arthritis that if left untreated is quite debilitating, as well as a number of other co-morbidities that we are learning more and more about, such as inflammatory bowel disease and metabolic syndrome. So, there are a lot of different connections, also with psychiatric co-morbidities.”
What are the Symptoms of Psoriasis?
Psoriasis can often be asymptomatic (without symptoms), so people who have the disease will not be dealing with constant outbreaks or “flare-ups.”
“Some patients report itching [or a] burning sensation, but that does not tend to be the norm. It certainly can and does happen,” Dr. Khattri explains. “Then if you have psoriasis in the genital area, it can feel uncomfortable just because it is in a very sensitive part of the body. But for the most part, it tends to be asymptomatic, generally speaking.”
Signs and symptoms of psoriasis
Dr. Han says he sees many patients with itching. “It is interesting because if you look at the older dermatology textbooks, there was this concept that psoriasis is not supposed to itch. And so they made this distinction between the itchy rash, which is eczema dermatitis and psoriasis, which is supposed to be not itchy,” Dr. Han says. “But if you actually ask patients and in some of the modern literature now, upwards of 80% to 90% of patients do have itching associated with their psoriasis.”
Generalized symptoms associated with the disease include the following:
- Red patches of skin covered with silvery-like scales
- Small scaling spots
- Dry, cracked skin that may bleed or itch
- Itching, burning sensation, or soreness
- Thickened or ridged nails
- Swollen or stiff joints
Dr. Khattri recommends seeing a dermatologist if you notice red, scaly spots on the body so a specialized practitioner can make a proper diagnosis and treatment action plan. Psoriasis patches can vary in their appearance and location on the skin. The disease may present as just a few spots with dandruff-like scaling or as rashes that cover large parts of the body. The most commonly affected areas are the lower back, elbows, knees, legs, soles of feet, scalp, face, and palms.
Dr. Han says most types of psoriasis can be diagnosed clinically, meaning your healthcare team can determine psoriasis on sight. With more atypical (not typical; rare) forms of psoriasis, a biopsy may be needed.
What are the Different Types of Psoriasis?
There are several different types of psoriasis, with plaque psoriasis being the most common. The types differ in how they present and what they are caused by.
- Plaque psoriasis: This is the most common form of the disease and causes dry, raised skin patches that may be covered in scales. The patches may be itchy and tender.
- Nail psoriasis: This disease can affect fingernails and toenails and might cause nails to loosen from the nail bed.
- Guttate psoriasis: This disease typically affects young adults and children and is often caused by a bacterial infection, like strep throat.
- Inverse psoriasis: This type of psoriasis mainly affects skin folds, so it will often present in areas such as the groin, buttocks, or breasts, and can worsen with friction or sweating.
- Pustular psoriasis: This is an atypical (rare) form of psoriasis that causes pus-filled blisters to develop in widespread patches across the body.
- Erythrodermic psoriasis: This is also a rare form of the disease. It can cover the entire body with a red, peeling rash that may itch or burn intensely.
- Psoriatic arthritis: With this form of the disease, joints may become swollen, irritated, and painful. Sometimes, joint pain is the first or only symptom, while other times other symptoms like nail changes will occur for some people.
The treatment approach will depend on the type of psoriasis a person has, and what kind of symptoms they present with. Dr. Khattri notes that for some people, symptoms may resolve with over-the-counter (OTC) creams or ointments, while others with moderate to severe disease may need a more systemic approach.
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“It is hard to generalize and say whether it will be progressive for everybody or whether this will just be like a lesion here and there, which sort of self resolves with some over-the-counter (OTC) or topical treatment options,” she says.
“The one thing that I would say as a Rheumatologist is that everybody should know that psoriasis is just not limited solely to the skin. You can have a joint involvement in about a third of patient’s with psoriasis you can even go on to developing psoriatic arthritis.”
If a patient has developed rashes or scaly patches of skin and also begins noticing other symptoms, such as stiffness or joint pain, Dr. Khattri suggests seeking medical attention right away rather than trying to resolve the issue with mild over-the-counter (OTC) treatments.
“If you have psoriasis on the skin or what looks like psoriasis on the skin, along with the onset of joint pain or tenderness, whether it is sort of stiffness in the lower back or a swelling of the finger or a toe that is inexplicable, do think of psoriatic arthritis and then certainly reach out to healthcare providers sooner rather than later.”
Taking Care of Your Mental Health
Taking care of your mental health is of the utmost importance, but it’s not always easy. One place to start is to be aware of the following signs that there may be something affecting your mind:
- A change in eating or sleeping habits
- Losing interest in people or usual activities
- Experiencing little or no energy
- Numb and/or hopeless feelings
- Turning to drinking or drugs more than usual
- Non-typical angry, upset or on-edge feelings
- Yelling/fighting with loved ones
- Experiencing mood swings
- Intrusive thoughts
- Trouble getting through daily tasks
Symptoms of a mental health disease or issue can vary from person to person, so it’s always crucial to promptly speak with a healthcare provider if you’re experiencing any changes to your physical or mental health. There are many treatment options available and many different healthy ways to help you cope.
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One such option is therapy. In a previous conversation with SurvivorNet, ovarian cancer survivor Ni Guttenfelder talked about how finding the right counselor helped her process the feelings that came after her diagnosis.
“One of the things that my counselor has taught me from the very beginning that has helped me is the concept of acceptance,” she says. “Acceptance is a process. It’s like downloading a computer file in increments. Visualizing it in that way has really helped me.”
In addition to therapy, meditation and practicing mindfulness can also be used to cope with a mental health struggle. Dr. Deepak Chopra, acclaimed author and pioneer of mindfulness movement, spoke with SurvivorNet about how asking yourself who you really are is the first step down the path to practicing mindfulness.
“If we can combine our actions in the world with reflective self inquiry, love and compassion, and a state of secure, stable, ornamental, peaceful being without the addictions that humans have, then we can begin our journey of healing,” Dr. Chopra explained.
Medicating isn’t the right choice for everyone when it comes to addressing a mental health issue, but there should be no shame in turning to medication when you need it. That being said, it can be hard to find the right one. These days, however, there is a form of genetic testing that has shown the ability to match people with the best medication for mental health treatment.
We’ve seen genetic testing used for treatment plans for other diseases, such as certain types of cancer, but the ability to use it to help people who are suffering from things like anxiety and depression is relatively new.
How Can Genetic Testing Help Determine the Right Form of Mental Health Treatment?
“Doing the genetic testing has absolutely transformed the landscape of psycho-pharmacology,” psychiatrist Dr. Lori Plutchik told SurvivorNet. “It’s something that I highly recommend for anybody that is taking medication, whether they are being treated for cancer, or not … I recommend it for children who are taking medication. I recommend it for elderly people. Anybody who is taking medication, I think, can greatly benefit from genetic testing.”
Genetic testing can give a profile of how a person is likely to respond to different types of psychiatric medications, Dr. Plutchik explained. Testing is also available to create a profile of how patients will likely respond to different sorts of pain medications, which can be really beneficial for those going through some other sort of health issue.
Genetic testing “gives me information about which medications are likely to work without having problematic side effects. It also gives information about interactions between any of the psych medications that we choose,” and other medications a patient may be taking, Dr. Plutchik said.
The genetic test that Dr. Plutchik was discussing, Genomind, looks at multiple factors before determining which treatment is likely to have successful results and minimal side-effects. The test examines certain genes that are associated with responses to medications commonly prescribed for mental health issues and then looks into the patient’s ability to metabolize medication.
If you’re considering going on medication for mental health treatment, consider asking your doctor if genetic testing might be helpful for you.
Questions to Ask Your Doctor
If you are not feeling your usual self and are facing a diagnosis or some other traumatic event, you should consider contacting your doctor to see if your mental health needs a boost.
- Should I consider going on medication to help with mental health struggles?
- Would genetic testing help determine the best treatment for me?
- What is the likelihood that the test will recommend the proper treatment?
- What can we do if I don’t succeed with the recommended treatment?
Contributing: SurvivorNet Staff
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