Living with atopic dermatitis (AD) can significantly impact your mental health. The constant itching, sleepless nights, and unsightly red rashes can be emotionally challenging. Anxiety and stress are common triggers for AD flare-ups, creating a vicious cycle of more anxiety and stress, leading to more AD. Here's why this happens and how to break the cycle. Stressful situations trigger your body's fight or flight response, increasing stress hormones like adrenaline and cortisol. While useful in immediate danger, too much cortisol suppresses your immune system and causes an inflammatory response in your skin. People with AD are already susceptible to this inflammation. Reducing stress won't cure AD, but it can help alleviate some symptoms. According to the National Eczema Association, over 30% of people with AD also have depression or anxiety, much higher than the general population's 7.6%. AD can make you feel sad or anxious, and the skin inflammation can affect your brain, causing anxiety, depression, fatigue, and confusion. If you have AD, watch for these symptoms. Everyone experiences these occasionally, but if they occur most of the day, nearly every day for at least two weeks, you may have depression. Talk to your doctor immediately. They may recommend psychotherapy and, if necessary, prescribe medication. Some people with AD take montelukast (Singulair) for underlying allergies and asthma. This medication may be linked to severe behavioral and mood changes, including suicide. If you notice these symptoms, inform your doctor immediately. Lifestyle changes can improve your mental health and make living with AD easier. These include: Practicing mindfulness. This can help reduce anxiety and relieve some itching associated with AD. Both AD and chronic itching activate brain areas related to chronic stress and pain. Mindfulness meditation deactivates these brain areas, reducing stress hormones and inflammatory chemicals. A study found that people with AD who meditated for 8 weeks reported better quality of life and less itching. There are many ways to practice mindfulness, including: You may need to try several techniques to find what works best for you. Getting enough sleep. AD can make it harder to sleep well, worsening anxiety or depression symptoms. Some ways to improve sleep include: Joining a support group. Connecting with others who have AD can be helpful. Contact the National Eczema Association or Eczema Wise, an online support group for people with AD. Staying active. Regular exercise releases endorphins, hormones that help you feel calm and happy. However, exercise-induced dehydration can dry out your skin, and sweat can cause irritation or itching, worsening your AD. To avoid this: