Asthma can be difficult to live with individuals at times feeling isolated, frustrated, and anxious about unexpected breathing problems. Medical monitoring, medication, and trigger avoidance can reduce the risk of severe or life-threatening asthma symptoms. But understanding the connections between asthma and mental health issues is essential for effective treatment outcomes.
First, learn about the links between chronic medical conditions and mental health. Then understand what asthma is and how it intersects with mental health conditions. Finally, review essential aspects of effectively treating asthma and mental health conditions occurring together.
Asthma is a chronic, inflammatory, respiratory condition that affects more than 24 million Americans, often those with allergic conditions or a family history of asthma. An episode called an asthma attack develops when the immune system overreacts to environmental triggers in the lungs, causing inflammation and excess mucus. Asthma attacks can range from mild to severe, even life-threatening at times.
Asthma cannot be cured, but it can be managed effectively with ongoing monitoring and treatment. Symptoms can develop quickly, so many individuals keep fast-acting medication on hand to prevent and manage symptoms. However, asthma still accounts for about 1.5 million emergency room visits annually and affects individuals of all ages. Asthma also elevates the risk of developing cardiovascular disease, a group of conditions impacting the heart and circulatory system that can reduce life expectancy.
Asthma Symptoms Include:
Individuals with asthma have sensitive airways that are prone to inflammation. Even when symptoms are well-managed, asthma attacks can be triggered by various exposures.
Common Asthma Attack Triggers Can Include:
The risk for co-occurring medical and mental health conditions is bi-directional, where one condition heightens the risk of developing the other. However, this is not the same as causality, meaning that one condition directly causes the other to occur. Several potential explanations have unfolded as studies have looked more closely at the connections between physical and mental health conditions.
Some medical and mental health disorders may have similar risk factors. Additionally, the psychological distress of coping with a long-term illness may make some individuals prone to developing conditions, such as asthma with anxiety and depression.
Individuals with mental health disorders are often less able to care for themselves. This lowered capacity can make individuals more vulnerable to poor health and may allow existing chronic conditions to worsen.
Researchers continue to explore the connective pathways between medical and mental health disorders. And while findings are not necessarily conclusive, some links have emerged, such as:
Individuals with serious mental illnesses (SMI), such as major depression and bipolar disorder, have up to a 25% shorter life expectancy due to co-occurring medical conditions, many of which are linked with cardiovascular disease. Additional support and guidance may be needed for those with more significant psychiatric symptoms.
As the following review of asthma unfolds, some common traits with previously mentioned chronic conditions become apparent.
Asthma is one of several chronic medical conditions that co-occur with mental health disorders, meaning they happen simultaneously. The following are some of the most common mental health issues individuals with asthma encounter, and some reasoning behind their co-occurrence.
Stress-Induced Asthma: Because the respiratory systems of individuals with asthma are particularly sensitive, stressful situations can trigger asthma attacks. When individuals identify a stressful situation, the stress response is initiated. The body regulates itself by releasing specific hormones: epinephrine, norepinephrine, and glucocorticoids. While these hormones help the body adjust quickly to stress, their accelerated activity can also increase lung inflammation.
Depressive Disorders: Depression may result from the ongoing strain of coping with a chronic condition. But research also suggests common biological underpinnings for asthma and depression. One study found that maternal and child depression were related and were associated with asthmatic disease activity. Asthmatic children who were depressed and less securely attached tended to have stronger vagal nerve activity, meaning that their stress response was associated with passivity and fatigue, a pattern that can impair lung functioning.
Anxiety Disorders: Research suggests that individuals with asthma develop anxiety disorders at higher-than-expected rates, especially panic disorder. Hyperventilation associated with both panic and asthma attacks can exacerbate both conditions. Unsurprisingly, higher rates of panic attacks are associated with asthma currently under treatment as opposed to asthma in remission. Because the co-occurrence of panic and asthma can be self-perpetuating, understanding the interplay of both conditions is essential for positive health outcomes.
Co-occurring asthma and mental health disorders create complex health situations for individuals and clinicians. The following factors underscore the importance of a thoughtful and comprehensive treatment approach.
Some treatments may help one condition and exacerbate the other, so care must be taken to direct treatment that creates the most benefit and least harm.
Cognitive-Behavioral Therapy: Typical panic disorder treatment includes exposure therapy, where individuals are gradually exposed to anxiety-inducing stimuli to reduce emotional responses. But short-term anxiety can trigger hyperventilation, which can worsen asthma outcomes. One study shows that an adapted form of cognitive-behavioral therapy (CBT), which addresses thoughts and behaviors related to psychological symptoms, may be a treatment option that supports symptom improvement without the hyperventilation risk.
Breathing Exercises: The impact of breathing exercises on asthma has been under researched, and individual results may vary. But one study shows moderate support for using them to improve quality of life, hyperventilation, and lung functioning. Breathing exercise regimens include deep diaphragm breathing, rhythmic yoga breathing, and relaxation techniques.
Exercise: Consistent physical exercise improves lung capacity and blood circulation, promoting better overall health and lung functioning for those with asthma. Some individuals may experience exercise-induced asthma, but a comprehensive symptom treatment approach can help individuals reap the benefits of exercise while reducing risks.
Social Support: Social support can help individuals with common challenges feel less isolated, and more empowered to cope with their circumstances. Some communities have in-person support organizations for asthma, and online support groups are available to those without local meetings in their area.
Psychological factors can make symptom management challenging if not adequately addressed. The following aspects of asthma care need careful attention to ensure better health outcomes.
Coping Strategies: Regardless of severity, asthma can lead to feelings of distress, fear, and isolation. Passive or avoidant coping strategies are associated with worse outcomes, so a flexible, problem-solving approach is encouraged whenever possible.
Steroidal Medication and Psychological Symptoms: Severe asthma is typically treated with steroidal medications, which may lead to a higher incidence of anxiety and depression symptoms.
Accurate Perception of Asthma Symptoms: Signs of physical distress and asthma overlap in many ways, sometimes leading to inaccurate perceptions of harmful asthma symptoms.
While researchers have identified many overlaps between mental health and asthma, there is much to be learned about effectively managing both types of conditions together. The complex interaction of both conditions requires careful attention and evaluation to balance benefits and risks. With social support and a proactive approach, individuals can maintain their health, and minimize the impact of symptoms on their life.