It may be the era of “Netflix and chill,” but research shows that we are as stressed out as ever. And according to the American Psychological Association’s 2019 “Stress in America” report, 69 percent of Americans say health care is a significant source of that stress.

For those of us with a chronic disease like psoriatic arthritis or psoriasis that’s bad news. “Stress acts as a catalyst for the onset as well as the exacerbation of psoriasis,” a recent study in the Indian Journal of Psychiatry found. And a report from Harvard Medical School adds that the most common trigger for flare-ups is stress: “Mental stress causes the body to release chemicals that boost the inflammatory response. Scientists suspect this is the mechanism for stress-induced psoriasis flare-ups,” it says.

Since stress is a normal part of life—from work stress to the political climate to our day-to-day personal challenges—nobody can escape it completely. But the good news is that it can be lessened. And for psoriasis patients, especially female patients, it’s vital to mitigate it. “Women seem particularly vulnerable to stress due to psoriasis,” the National Psoriasis Foundation affirms.