Wow. Just, wow.
First off, let me just say: Marriage is hard. Marriage is so freakin' difficult, and I can't even use the "f" word I really want to use, out of deference to other people on this site. So no matter what you've been told or have seen on TV or what other people seem to have -- marriage is already a giant stressor without the benefit of chronic illness.
Now throw in a difficult, incurable illness that makes you tired and has you in pain, along with treatment that may include scary-expensive medications that can kill you. You're in your early thirties, right? The prime of life, and this happens to you, when you should be at the point where things are really falling into place.
What concerns you?
Are you feeling like your spouse may not find you as attractive (psoriasis is not sexy, and PsA can make sex awkward or painful), and so maybe you don't feel as appealing to him? Or did the illness just zap your sex drive completely? Or maybe you're so depressed that the last thing you feel like doing is having sex?
Do you feel like the person you're married to has to take care of you all the time while you do nothing to take care of him? Or he has to keep his job so he can keep the health insurance you desperately need? That he feels trapped? Are you thinking he might be staying with you strictly out of guilt, that even though he wants out of the marriage he's a good person and couldn't do that to another person he loves but maybe doesn't like too much right now?
Are you afraid to talk to him about this because of what he won't say -- or what he might say?
Ideal relationships are those where the two people love each other, want to be together, and see a future together. I'm not including everything else that helps -- having stuff in common, mutual respect and caring, etc. -- because it's a long list, but is there a possibility that you and your future are suddenly very murky? Not just to him, but you? All of us on this site hope for a miracle cure, but that's still a long shot. Having PsA means that remission may not be possible, or short-lived, and that things can get a lot worse.
I remember watching a movie where the guy falls for a woman who has Parkinson's, and a spouse of another Parkinson's sufferer tells him to get out while he can. Because Parkinson's took away the woman that this man loved, and left him nothing but a burden where his wife used to be. I think about this movie all the time. I wish I didn't.
There's also a warped faction of people that have spouses/partners/whatever whose main appeal is that they are ill, because those people desperately need someone who needs them, or need someone who has to depend on them. There's a psychological term for it I'm having trouble recalling, and it's not co-dependence -- although co-dependence can also be an issue.
I've been with the same guy for more than twenty years. I've been diagnosed for four years. I also found out I was pregnant (shortly after diagnosis) and then lost my job in the giant economic meltdown of 2008. I actually worked in the sector that was the catalyst for the whole meltdown. And my toddler -- and toddlers are already stressful, just by themselves -- is diagnosed as being in the autism spectrum. Plus, my husband hurt his back working, and has been more disabled than me for the last four months. I am a giant stress monster.
I do love my husband. And about two hours ago, I considered beating him to death with the teakettle that he -- once again -- shoved into that place between the stovetop and the ventilation hood where it bends and distorts the teakettle. Why he doesn't just put it on another burner or on the counter is beyond me. But I didn't beat him to death, for a number of reasons, although I wish the top two weren't that (1) it would be too hard on my hands, wrists, elbows and shoulders and (2) that California is a death penalty state.
But this isn't about me. This is about you. What's going on, specifically? Venting to other PsA spouses is a good start. A lot of people on here have an even harder time than me. What's bothering you the most?