An Introduction to anxiety, stress and depression 

Anxiety, stress and depression are three terms that are often lumped together. Here we want to discuss what they are, how they affect us, and different strategies for coping with them.

What do these terms mean? 

Anxiety is usually described as a persistent feeling of unease, fear, or panic. These feelings can be triggered for any number of reasons, but common examples include health, finances, and social situations. Living with a skin condition is often a trigger for anxiety, particularly social anxiety.

Stress is usually described as a feeling of being under sustained pressure and unable to cope. It can be emotionally and mentally damaging. Due to the way humans have evolved, stress is largely a physical response; hormones are released by the body to help deal with threats – for example, the ‘fight or flight’ hormones that are designed to help us act fast in emergency situations or danger. Unfortunately, these physical reactions are not always appropriate for modern-day pressures, and if you remain stressed for extended periods, these hormones stay in your body having a negative effect.

Depression can be used to describe temporary sadness or low mood; however, in this context depression is used to describe a long-term illness, which can include feelings of low mood, worthlessness, self-disgust, helplessness and even suicide. Depression is a complex illness and can be caused by a number of things, see the MIND page on depression for more details on the cause of depression.

These three issues are commonly seen in combination, as they often have similar triggers, if you have identified that you are suffering with one, or more, of these issues you should speak to your doctor.

Coping with stress, anxiety, and depression

If you are dealing with chronic stress, anxiety, or depression then you should consider booking an appointment with your GP to discuss the problems.

The key to coping with these issues is being able recognise the problems that you are having. Once you have recognised the problem it is easier to deal with it without judgement. You might be able to do this by talking with a friend or a healthcare professional, you may find that mindfulness and meditation help you be more self-aware of your issues, or you might train yourself to recognise negative thoughts and stop them.

If you feel that your level of anxiety, stress, or depression is catastrophic and you are at risk of hurting yourself or others then you should seek professional help urgently.

Samaritans operates round the clock, 24 hours a day, 365 days a year on 116 123. If you would prefer to write down your thoughts you can email Samaritans at

Dealing with negative thoughts

Dealing with negative thoughts related to our skin condition can be very tough. One technique that can really help is to keep a diary over the course of a few days or a week, tracking negative thoughts and feelings and the situations they occur in. This will help you recognise the circumstances that trigger your negative thoughts.

In the meantime it is worth practising two techniques. One is called ‘holding a relaxing image’ and the other ‘external focusing’. Details and tips on how to do this can be found from pages 5-7 of ‘Overcoming social anxiety associated with skin conditions: A self-help guide’ in the resources section below.

Alternatively you could try replacing these negative thoughts with rational alternatives, details of how to do this can be found on page 10 of ‘Psychological aspects of psoriasis’, although this resource is psoriasis-centric the exercises in it can relate to any skin condition, it can also be found in the resource section below.

Our skin, social anxiety, and self-confidence

Social anxiety is common in people with long-term health concerns. Overcoming these feelings of anxiety is important for our quality of life, and to improve how we manage our treatments. Social anxiety is particularly common amongst people with skin conditions, or a visible difference, such as scarring.

There are a number of common strategies that people use to reduce anxiety that can actually have a negative impact in the long term. These are often short term strategies that don’t resolve the underlying emotional issue, for more details see page six of ‘Building confidence in social situations: A guide for people living with a skin condition, including scars’. It is worth keeping an eye of for these behaviours in ourselves:

  • Avoiding social situations 
  • Only going out with other people
  • Concealment strategies
  • Avoiding eye contact or conversations

The key to overcoming social anxiety and improving self-confidence is to recognise these negative thoughts or behaviours, and to replace them with rational alternatives. There are a number of exercises to manage this, see pages 7-10 of ‘Building confidence in social situations’.

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