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The powerful connection between the mind and the skin is well-known, and many skin disorders show a clear relationship to the state of mind: stress and sleep deprivation, for example, can directly damage skin barrier function, in patients with atopic dermatitis and even in patients with normal skin.
However, the reverse is also true and perhaps even more important: skin problems can lead to stress, depression, and anxiety, both directly and possibly via sleep deprivation and other means.
Recently there has been more focus on the connection between eczema and depression, poor sleep, and a connection with attention deficit hyperactivity disorder (ADHD). This relationship is complex and may be simply related to the disruption of normal sleep that accompanies most moderate or severe eczema, but there may be something deeper that explains them independently, such as a more sensitive nervous system.
In the meantime, it is important to recognize these issues and seek treatment as each can affect other aspects, creating a vicious cycle that can spiral out of control, affecting the entire family, school, and work environments beyond just the patient with eczema.