Mental Health and HS: Coping with Anxiety and Depression

Living with Hidradenitis Suppurativa (HS) is more than a physical struggle. The chronic pain, recurring flare-ups, and visible scars can take a serious toll on a person’s emotional well-being. Over time, the constant discomfort, frustration, and social stigma can lead to deep feelings of anxiety, depression, and isolation. For many people with HS, the mental health challenges are just as overwhelming as the condition itself—sometimes even more so.

HS often affects parts of the body that are intimate and sensitive, like the groin, underarms, buttocks, and breasts. The location and nature of these wounds—combined with draining abscesses, scarring, odor, and ongoing flare-ups—can leave people feeling embarrassed or ashamed. It’s common to avoid social situations, romantic relationships, or even trips to the doctor out of fear of judgment or misunderstanding. This self-isolation, compounded by years of misdiagnoses or being told to simply “keep clean” or “lose weight,” can foster feelings of helplessness, anger, and low self-worth.

Anxiety and depression are unfortunately common among those living with HS. The unpredictability of flare-ups can make daily life feel uncertain, while the pain and limited mobility often disrupt sleep, work, and social interactions. Over time, this ongoing stress can lead to chronic mental health concerns, especially if the person doesn’t have access to supportive care or mental health resources.

Despite how overwhelming these emotional struggles can be, there is hope. Coping with the mental health challenges of HS starts with understanding how the condition affects your emotional well-being and finding ways to reclaim your peace of mind. You’re not alone—and you don’t have to suffer in silence.

In this article, we’ll explore:

The connection between chronic illness and mental health
How anxiety and depression can manifest in people with HS
Practical coping strategies to protect your emotional wellness
Where to turn for help and support when things feel too heavy

Your mental health matters just as much as your physical health. With the right tools, support systems, and self-care, it’s possible to live with HS while also nurturing your emotional resilience.

The Connection Between Chronic Illness and Mental Health

Living with a chronic illness like Hidradenitis Suppurativa (HS) means more than just dealing with persistent symptoms—it often means carrying an emotional burden as well. Chronic illness doesn’t simply affect the body; it deeply influences how we think, feel, and engage with the world around us. For many people with HS, the connection between their physical and mental health becomes an ongoing challenge, as the pain, limitations, and stigma of the condition lead to increased risk of anxiety, depression, and emotional exhaustion.

Chronic illness impacts mental health in several interconnected ways. First, there’s the daily stress of managing the condition. Whether it’s waking up in pain, needing to change bandages, or worrying about what clothes will be comfortable enough to cover lesions and allow mobility, HS can make even small daily tasks emotionally draining. The unpredictability of flares means that people often live in a state of tension, unsure when the next painful episode will strike. This ongoing stress can lead to hypervigilance, burnout, and eventually anxiety or depressive symptoms.

Second, there’s the emotional fallout from living in a society that often stigmatizes visible or “unattractive” medical conditions. HS commonly causes draining abscesses, scarring, and inflammation in intimate areas of the body. Because of this, many individuals with HS feel embarrassment, shame, or fear of judgment from others. These feelings can result in social withdrawal, which leads to loneliness and a worsening sense of self-worth.

And finally, there’s the feeling of not being believed or taken seriously, especially in the early years before a proper diagnosis. Many patients report being dismissed by doctors who attribute their symptoms to hygiene, weight, or acne. This repeated invalidation can erode a person’s confidence, creating a cycle where they stop advocating for their health needs altogether—often leading to delayed treatment and emotional distress.

These emotional challenges aren’t simply a reaction to pain—they are part of a broader psychological response to long-term stress, discomfort, and isolation. Research shows that people with chronic conditions are two to three times more likely to experience anxiety and depression compared to the general population. HS, in particular, has been closely linked to mental health challenges due to its visible, painful, and socially isolating symptoms.

How Anxiety and Depression Manifest in People With HS

Anxiety and depression don’t always show up in obvious ways, especially when someone is already dealing with chronic pain. Many people living with HS may not realize that their mood changes, energy loss, or social withdrawal are signs of a deeper emotional struggle.

Here’s how these conditions often present in people with HS:

Anxiety

Anxiety related to HS can be generalized, or it may show up in more specific forms, like social anxiety, health anxiety, or even panic attacks. The physical discomfort of the disease is only one part of the equation—people often feel intense worry over how their symptoms will affect their personal and professional lives.

Common signs of anxiety in HS patients include:

Constant worry about flare-ups, especially before important events like work, travel, or social gatherings
Avoidance of public spaces due to fear of body odor, drainage, or visible lesions
Panic or racing thoughts when symptoms worsen
Over-preparing or hypervigilance (e.g., always carrying extra clothes, bandages, or pain medication “just in case”)
Difficulty sleeping, especially when anticipating pain or discomfort
Tension, irritability, or restlessness, even on relatively calm days

Anxiety can become exhausting, both mentally and physically. It wears down confidence, increases fatigue, and can even amplify the perception of physical pain—making HS flare-ups feel more intense or unbearable.

Depression

Depression is especially common among people with chronic conditions, and HS is no exception. The long-term nature of the disease, coupled with its impact on self-image, social life, and physical comfort, makes people with HS particularly vulnerable to feelings of sadness, hopelessness, and emotional numbness.

In people with HS, depression can show up as:

Loss of interest in activities once enjoyed
Low energy or persistent fatigue, even after sleeping
Feelings of worthlessness or guilt, often tied to body image or the belief that they’re a “burden” to others
Appetite changes, including eating too much or not enough
Difficulty concentrating, remembering things, or making decisions
Withdrawal from relationships, including romantic or sexual ones
Thoughts of death or suicidal ideation in severe cases

Unlike situational sadness, depression tends to persist over time and may not be linked to any particular event. Some people with HS may fall into depression after a particularly severe flare, while others experience it gradually as they realize how deeply the condition has affected their lives.

It’s important to note that not everyone will experience anxiety and depression in the same way, and some people may experience both simultaneously, a condition known as comorbid anxiety and depression. In HS, this combination is especially common due to the complex physical and emotional aspects of the disease.

The Psychological Weight of Stigma and Isolation

One of the most devastating emotional impacts of HS is the feeling of being alone. Because HS affects areas of the body that are usually kept private—and because it’s not widely known or understood—many people hide their symptoms for years. Some avoid intimate relationships altogether, while others retreat from social circles to avoid questions, embarrassment, or judgment.

This kind of isolation increases the risk of both anxiety and depression. The less people talk about their condition, the harder it becomes to seek support or ask for help. And when medical providers also fail to take the condition seriously, patients may internalize the message that their pain is unimportant.

In some cases, the stigma of HS leads to emotional numbness, emotional detachment, or a sense of hopelessness. People may stop believing that life can get better or that they’ll ever feel “normal” again. This is especially heartbreaking because, with the right support and treatment, people can regain confidence, social connection, and emotional balance.

In Summary

The connection between chronic illness and mental health is complex, but very real. For those living with HS, the emotional burden can be just as painful as the physical symptoms—sometimes even more so. Anxiety and depression are not weaknesses, nor are they something to be ashamed of. They are a natural response to the overwhelming experience of living with a condition that affects every part of life—body, mind, and spirit.

Recognizing how anxiety and depression show up in your life is the first step toward healing. Whether it’s noticing your withdrawal from loved ones, persistent sadness, racing thoughts, or simply feeling like you’ve lost your sense of self—your experience is valid, and it deserves care.

In the next section, we’ll explore practical ways to cope with these emotional challenges and protect your mental health while living with HS. Support is out there—and you don’t have to carry this burden alone.

Practical Coping Strategies to Protect Your Emotional Wellness

Living with Hidradenitis Suppurativa (HS) means navigating not only physical pain but also the emotional toll that comes with chronic illness. Whether it’s the stress of managing symptoms, the anxiety over unpredictable flare-ups, or the emotional weight of stigma and isolation, maintaining your mental health is just as important as treating your skin. While you can’t always control the condition itself, there are many strategies you can use to care for your emotional well-being and build resilience over time.

1. Create a Daily Routine with Flexibility

Having a routine can bring a sense of structure and control, which is especially helpful when you’re dealing with a condition that often feels unpredictable. Start by building a manageable daily schedule that includes:

Gentle hygiene routines or wound care
Time for rest and movement
Scheduled meals
A moment for emotional check-ins (journaling, mindfulness, or quiet reflection)

It’s important to remain flexible. There will be days when your energy is low or your symptoms flare—be kind to yourself and allow your schedule to shift when needed without guilt.

2. Practice Mindfulness and Meditation

Mindfulness helps you stay present and grounded, especially during moments of pain, frustration, or emotional distress. You don’t need hours to benefit—a few minutes of quiet, focused breathing can lower stress levels and help reset your thoughts.

Simple mindfulness exercises include:

Box breathing: Inhale for 4 seconds, hold for 4, exhale for 4, hold again for 4.
Body scans: Mentally scan your body from head to toe, observing where tension or pain lives, without judgment.
Gratitude journaling: Write down three small things you’re thankful for each day—no matter how minor they seem.

Mindfulness isn’t about ignoring pain—it’s about learning to live alongside it without letting it consume you.

3. Engage in Gentle Movement

Chronic pain often makes physical activity feel daunting, but gentle movement can help relieve tension, reduce inflammation, and improve mood through the release of endorphins.

Some helpful options include:

Stretching or yoga tailored for people with chronic pain
Walking in short bursts throughout the day
Low-impact workouts like swimming or water aerobics
Chair exercises if mobility is limited

Exercise isn’t about pushing your limits—it’s about tuning into your body and offering it care through movement.

4. Connect With Others

One of the most powerful tools for emotional well-being is connection. HS can make you feel like no one understands what you’re going through—but you’re not alone. Whether it’s one trusted friend, a support group, or an online community, having people to talk to can reduce feelings of isolation and help you feel validated.

If in-person socializing is tough, consider:

Joining HS support groups on platforms like Facebook or Reddit
Talking to others on dedicated forums like MyHSteam or Inspire
Following and engaging with HS advocates on social media
Scheduling virtual check-ins with friends or family

Just having one person to share with can ease emotional pain.

5. Use Positive Self-Talk

It’s easy to slip into negative self-talk when you’re frustrated, in pain, or exhausted. Over time, these internal messages can damage your self-esteem and emotional health. Start by catching those thoughts and replacing them with gentler alternatives.

Examples:

Instead of “I’m disgusting,” try: “I’m dealing with a painful condition, and I deserve compassion.”
Instead of “I’m useless today,” try: “My body needs rest, and rest is healing.”
Instead of “No one understands me,” try: “I am allowed to ask for support.”

You don’t need to force blind optimism—just aim for kind, truthful words.

6. Engage in Creative Outlets

Expressing yourself creatively can be a great emotional release. Whether it’s journaling, painting, crafting, or playing music, creative outlets allow you to process emotions and regain a sense of control and accomplishment.

Ideas include:

Starting a “flare journal” to track symptoms and emotional reactions
Making a vision board with things that bring you hope or peace
Creating art or poetry that expresses your experience with HS
Taking part in advocacy by sharing your story

Creativity doesn’t need to be polished to be powerful—it simply needs to be honest.

Where to Turn for Help and Support When Things Feel Too Heavy

There will be times when coping strategies and daily tools aren’t enough—when the emotional weight of living with HS becomes overwhelming. That’s when it’s not only okay but necessary to seek additional help. You are not weak for needing support; you are strong for reaching out.

1. Talk to a Mental Health Professional

Therapists, counselors, and psychologists can provide essential guidance, especially when you’re experiencing depression, anxiety, or trauma related to HS. Look for professionals who are experienced in working with chronic illness or disability.

What therapy can help with:

Processing medical trauma or stigma
Developing healthy coping strategies
Navigating relationship challenges related to HS
Addressing body image or self-worth issues
Managing grief or emotional burnout

If cost is a concern, consider:

Sliding scale therapists
Community mental health clinics
Online platforms like BetterHelp, Talkspace, or Open Path Collective

Even just a few sessions can provide significant relief and insight.

2. Consider Medication for Mental Health

If your anxiety or depression is persistent and interfering with daily life, talk to a psychiatrist or primary care doctor about medication options. Antidepressants or anti-anxiety medications can help rebalance brain chemistry and improve emotional resilience.

There’s no shame in using medication to support your mental health—it’s a tool, just like wound dressings or topical treatments are tools for your skin.

Always discuss potential interactions with your HS medications and make sure to monitor how you’re feeling with regular follow-ups.

3. Build a Medical Support Team

In addition to mental health providers, having a supportive medical team—dermatologists, gynecologists, endocrinologists, or pain specialists—can make a big difference. A compassionate doctor who validates your symptoms and helps you feel heard can reduce emotional stress and help you feel more in control of your condition.

When looking for providers:

Don’t hesitate to switch doctors if you feel dismissed or judged.
Ask questions about treatment options and be honest about emotional symptoms.
Advocate for your needs—it’s okay to say, “This is affecting my mental health. Can we talk about ways to manage both?”

Your care should address the whole you, not just your skin.

4. Utilize Crisis Resources When Needed

If you are feeling hopeless, overwhelmed, or having thoughts of harming yourself, reach out for immediate support. You are not alone, and help is available.

In the U.S.:

Call or text 988 to reach the Suicide & Crisis Lifeline
Chat online at 988lifeline.org
Contact your local emergency services if you are in immediate danger

Internationally, many countries have crisis lines and mental health support organizations. Seek help right away—you deserve support and safety.

5. Lean Into Support Groups and Community Spaces

Support groups—whether virtual or in person—offer understanding and connection that even well-meaning friends and family might not be able to provide. Speaking with others who share your experiences can normalize your feelings and help you learn new coping tools.

To find support groups:

Ask your dermatologist or local clinic for referrals
Visit nonprofit sites like Hope for HS or the HS Foundation
Search social media hashtags like #HidradenitisSuppurativa or #HSWarrior

Community brings strength, and shared experience can provide deep emotional healing.

In Summary

Living with HS is a full-body and full-heart experience. While flare-ups and physical pain are part of the condition, the emotional challenges—like anxiety, depression, and isolation—are just as real and valid. You don’t have to carry the weight of this condition alone.

With the right combination of daily coping tools, support systems, and professional care, it is possible to protect your mental health, find relief from emotional distress, and reconnect with hope. Healing isn’t linear—but every step you take to care for your emotional well-being is a step toward resilience.

You are more than your condition. You are worthy of support, rest, joy, and peace. Reach out. Speak up. Let others in. You deserve to feel better—and there is help out there waiting for you.

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