Chronic Hives and Mental Health: Self-Care Tips

On the surface, chronic hives (also known as chronic idiopathic urticaria) may seem like nothing more than a mere annoyance.

But the red, itchy skin welts, which can last more than six weeks, can take a toll on your self-esteem, body image and mental health. Chronic hives and stress can be a vicious cycle that worsens the skin disease.

So, what can you do? How can you take control of your life and not let chronic hives affect your mood?

Allergist Dylan Timberlake, MD, talks about the connection between chronic hives and your mental health and offers some self-care tips to help you navigate life with chronic hives.

How chronic hives can impact your mental health

There are two ways chronic hives can impact your mental health. First, chronic hives can affect your mental health and quality of life. Secondly, stress and anxiety can cause or trigger chronic hives.

“Research shows that in people who are living with chronic hives, more than half have a moderate to severe impairment of their quality of life. They experience poor sleep, angioedema (skin swelling) and itchiness,” relays Dr. Timberlake. “A lot of people who have chronic hives are embarrassed to go to work or go out in public.”

In fact, Dr. Timberlake says research shows that people who are living with chronic hives have a higher rate of depression and anxiety than the general population.

And when it comes to how stress affects chronic hives, Dr. Timberlake says it’s important to note that there’s a subset of people with chronic hives who only get hives when they’re stressed or anxious. (Other potential triggers include exercise, body temperature, heat and cold.)

“When we get stressed or anxious, our core body temperature increases, which for some people may be a trigger for their hives,” explains Dr. Timberlake. “So, you can have chronic hives that can then be worsened when you are stressed or anxious about something.”

Self-care tips

Living with chronic hives can be overwhelming, so self-care is vital to help you be the best version of yourself. Dr. Timberlake offers the following advice:

Prioritize sleep

If you have chronic hives, there’s a good chance it affects the quality of your sleep. Sure, you know you should get around seven to nine hours a night. But that can be tough. To help combat sleep issues, Dr. Timberlake stresses the importance of a bedtime routine that you follow every night.

“I focus a lot on sleep because it’s so important — it plays a role in depression, anxiety, daytime sleepiness and being attentive,” he continues. “Even a warm bath or a warm shower right before bedtime can really help with sleep.”

Another big thing he discusses with his patients? Avoiding TVs and cellphones in your bedroom.

And if you take glucocorticoids, which are corticosteroids commonly used for hives, you may want to speak with your healthcare provider about alternative options.

“Glucocorticoids can cause anxiety and poor sleep, and when you’re already having those problems, glucocorticoids can definitely exacerbate them,” he warns.

Stay active

In some cases, exercise may trigger your chronic hives, as it raises your core body temperature. But exercise also releases endorphins, which can improve your overall mood.

If you know exercise is one of your triggers, it may be worth modifying how you work out and stay active. Instead of intense exercise like weightlifting or running that makes you sweaty, opt for low-impact exercises such as yoga or swimming.

Try alternative therapies

Dr. Timberlake says that practicing meditation and mindfulness can be beneficial for people who have chronic hives.

“There’s something called the mindfulness-based stress reduction (MBSR) program and the goal is accepting your body the way it is and living in the moment,” he explains. “This can be used for people with chronic illnesses to help decrease stress and anxiety and improve their self-confidence.”

Spend time with loved ones

Lean on your loved ones — family members and friends. They can be a great support system as you navigate living with chronic hives.

“There’s plenty of data about the importance of the connections that we have with other people,” stresses Dr. Timberlake. “If you’re going through a difficult time, if you don’t want to go out in public and if you’re not wanting to go to work, maintaining those social connections with loved ones is going to be really important for you.”

Don’t be afraid to open up to your loved ones and talk to them about your fears and worries. They can be a good sounding board to help you work through difficult situations and can make you feel less alone.

Join a support group

It can be helpful to talk to others who have chronic hives. You may have shared experiences and can offer advice, tips and guidance to one another.

“A support group is a great idea because you’re going to meet people at all different stages of living with chronic hives,” says Dr. Timberlake.

Consider talk therapy

If you’re struggling with feeling comfortable going to work or out in public, it may be helpful to talk to a mental health therapist.

“They can talk to you about social isolation and work with you on acceptance and decreasing your anxiety and depression,” says Dr. Timberlake.

Avoid or limit alcohol

Dr. Timberlake talks to all of his chronic hives patients about their alcohol consumption, as alcohol can be a trigger.

“Have you noticed that if you’re drinking alcohol your hives flare up immediately afterward or are worse around the times when you’re drinking?” questions Dr. Timberlake. “If you do notice a change, I would suggest abstaining from alcohol.”

Focus on hobbies

Whether it’s painting, reading a book or gardening, making time for hobbies you enjoy can have a positive impact on your mental health. You’ll feel a sense of joy and accomplishment by spending time doing something you love.

“It all comes back to having a strong social connection,” notes Dr. Timberlake.

Keep a journal

Your doctor may suggest that you keep a journal of your potential triggers and when you experience hives. You can use pen and paper or even a notes app on your cellphone — whatever works best for you.

“Journaling can be very beneficial for people from a self-care standpoint,” encourages Dr. Timberlake. “It gives you a space to document your symptoms, but also a place to track how you’re feeling.”

Bottom line?

If you have chronic hives, focusing on your mental health is an important part of managing your condition. If you feel like no one understands what you’re going through, don’t hesitate to talk to your doctor who can help you in a variety of ways from suggesting treatment options to advising you on self-care solutions.

And as you go through it all, remember that you’re not alone and you don’t deserve to feel miserable.

“Chronic hives can affect the quality of your life,” says Dr. Timberlake. “I recommend talking to your doctor about it so that we can work to get your symptoms under control. We have a lot of different medicines and nonmedical options that can improve your daily life.”