Urticaria is classified as a skin disease, yet it exerts significant impact on psychological functioning and behavior of patients. It impairs quality of life, disturbs sleep, and increases the prevalence of anxiety and depressive disorders, all associated with stigmatization and chronic pruritus. Disease-related stress may exacerbate the clinical course through neuroimmunological mechanisms involving interactions between skin cells, mast cells, and neurons. The aim of this review is to present the relationship between urticaria and psychosomatic aspects of patient’s functioning. A narrative literature review was conducted using the PubMed database. The analysis included original research articles, review articles, meta-analyses, and case reports published between 2015 and 2025. The analysis demonstrated a significant association between urticaria, particularly its chronic form, and increased prevalence of mental disorders. Stress plays a dual role, acting both as a factor exacerbating disease severity and as a direct trigger for mast cell degranulation via catecholamine release or cholinergic stimulation in specific subtypes, such as adrenergic and cholinergic urticaria. The clinical picture is frequently compounded by anxiety disorders, phobias, and low self-esteem, although severity of psychological symptoms does not always correlate with severity of skin lesions. Urticaria represents a systemic condition with complex pathogenesis, in which psychological and immunological factors interact and reinforce each other, creating a vicious cycle. Effective clinical management requires a holistic, individualized approach that includes psychological support, improving treatment outcomes, and quality of life.