I’m not afraid of wildfires encroaching on where my family and I live, down in the Sacramento Valley: We don’t have the forests that serve as fuel. But for almost two months now we’ve contended with unending smoke, which can be so dense and thick that, for days on end, we’re unable to go for a short walk in the park or open our windows. The unhealthy levels of particulate matter have became a menace both to body and mind. Two of us in my household live with asthma, and any poor-quality air can strain our ability to breathe. The mission to keep the smoke out of our house and lungs at times feels impossible. It leaks through windows, doors, and vents, causing me to experience anxiety attacks and insomnia and obsessively check air-quality levels on multiple websites. The strain of it all has even impacted my psoriasis and eczema. During those early weeks of the wildfires, I couldn’t figure out why my psoriasis lesions were thickening and becoming redder, or why my eczema patches felt itchier. Then a passing comment during a telehealth appointment with my allergist illuminated one possible reason. I asked my allergist if smoke in the air could worsen my skin conditions. She couldn’t say definitively one way or another, but pointed instead to the anxiety and stress I was feeling. She concluded by reciting the first line of a version of the “Serenity Prayer” by Reinhold Niebuhr: “God, grant me the serenity to accept the things I cannot change.” After that telehealth appointment I returned to meditation and prayer as a way to manage my fears. I thought more about what I could change instead of what I could not. While I still felt anxious, I stopped myself from thinking catastrophically about my ability to breathe or the wildfires spreading by distracting myself and telling myself we’d made it through worse. I went to bed each night worrying less about how much smoke could roll in while I slept. Doing so helped me address insomnia, another one of my psoriasis triggers. I’ve been through many painful times, though, when I could not control my psoriasis. Few treatments over the years have effectively kept my condition at bay. With the ones that did, I often experienced concerning side effects. Today I manage my psoriasis using a combination of therapies, with a biologic medication as the primary treatment. Even with the latest treatments, I still experience flares from time to time. During flares my skin feels like it catches fire, burning and bleeding to a point where I cannot sit still or sleep well. Psoriasis can spread from my scalp down to between my toes. The never-ending physical discomfort can send me through cycles of depression, anxiety, and hopelessness. That’s why finding peace while smoke envelops my house and neighborhood not only allows me to mitigate stress and insomnia, it also gives me the perspective and energy to better care for my skin. As I sat on the living room couch late one night during a particularly smoky time, I felt no energy or motivation. I needed to do home phototherapy, take a shower, moisturize my skin, and apply prescription ointments. At that moment I just wanted to close my eyes and forget about it all. I overcame the mental fatigue by considering that taking care of my skin means less to worry about. These thoughts gave me just enough energy to remove myself from the couch to go do my home phototherapy treatment and the rest of my skin care regimen. I’m glad I did, as keeping up with my treatments helped to clear up the flare I sustained during those early weeks of the wildfires. With clearer skin, I feel mentally stronger to face whatever smoke might come our way on a given day.
Maintaining Health Holistically
As I look outside my window today, I still see the haze of the smoke from multiple wildfires. It’s a cooler day, with a pleasant breeze, but the smoke comes into the valley from fires in every direction. I’m mentally fatigued from battling smoke in the air for almost two months, although I feel much better about how I’m approaching this unending irritant. The California wildfires and smoke reveal to me once again the interconnectedness of the mind, body, and soul. Psoriasis and eczema are certainly more than skin deep. They are visible skin diseases that come not only with physical discomfort, but also emotional, social, and mental impacts. At the same time, the stresses and strains of life can trigger inflammation, creating a negative cycle of physical and mental distress. The lesson is clear: Maintaining my psoriasis is a holistic endeavor. I need to pay attention to both the physical and psychological challenges of my life — all the more so when fires rage all around me. You can read more about my experiences in my blog for Everyday Health and on my website.
