Asthma and Anxiety

Does Wheezing Leave Your Child Strung Out?

Asthma and Anxiety
Asthma and Anxiety. Brand X Pictures

There has been debate for some time related to whether or not asthma and anxiety were related in children. New research indicates that if your child’s asthma is well controlled, their risk of mental health issues is really no different from their non- asthma peers.

What Is The Research Telling Us?

Previous research from Seattle Children’s Hospital Research Institute indicated that kids with asthma were twice as likely suffer from anxiety and depression compared to children without asthma.

Researchers interviewed more than 1300 adolescents in a Seattle area health maintenance organization. Sixteen percent of asthmatics had depressive or anxiety disorders compared to 9% of adolescents without asthma. Additionally, parents of asthmatics were also more likely to think their child with asthma had anxiety or depression compared to parents of kids without asthma.

What Are The Implications?

According to the study's authors, physicians treating young people with asthma need to be mindful that these patients are at greater risk for depressive and anxiety disorders. Further, physicians need to also educate patients and their families about this risk. The study points out that the healthcare system currently only identifies 4 in 10 asthmatics that are experiencing mental health symptoms.

Awareness Is Key!

Adolescents may go extended periods of time without seeing a doctor and anxiety and depressive symptoms can easily, and incorrectly, be put of as "hormones" or "adolescence is just hard." If parents and school systems are aware of these associations we may be able to identify more asthmatics suffering from mental health problems and begin treatment.

Currently most asthma patients suffering from anxiety or depression would be treated similarly to their peers without asthma. However, this is an evolving science and the day may come where the groups are treated differently because a treatment provides more of a benefit.

Asthma Control Matters

Not surprisingly, other research has indicated that asthmatics with more severe functional limitations were more likely to have symptoms of anxiety and depression.

Additionally, a more recent asthma diagnosis was also associated with symptoms.

Smoking May Make Asthma and Depression Worse

A particularly alarming finding of the research has been that the group of asthmatics with depressive symptoms were much more likely to be smokers. Smoking may further worsen functional impairments, is associated with asthma exacerbations, and is also associated independently with anxiety and depression.

A more recent study, however, indicates that children who take their controller medications regularly and achieve good control are no different from their friends without asthma in terms of experiencing depression and anxiety. The researchers examined anxiety and depressive symptoms among 70 Dutch asthmatics with well controlled asthma and 70 of their friends without asthma. In this group of asthmatics, 10 patients had experienced a worsening of symptoms in the last year. These patients had more anxiety and depressive symptoms than their non asthmatic peers. When you look at the asthmatics with good control, anxiety and depressive symptoms were similar compared to the kids without asthma.

As a result, the authors suggest that it is not asthma as an underlying chronic illness that leads to anxiety and depressive symptoms, but lack of control and the the resulting poor

Final Thoughts

As a parent you would want to do the following to make sure your child has the best shot at achieving good asthma control:

  • Use their controller medication daily.
  • Adhere to a good action plan.
  • Consider a visit with an asthma educator if your doctor’s office does not have a good education program.
  • Talk with your child about feeling stigmatized about using an inhaler. If your child adheres to a daily regimen, they may never need a rescue inhaler.
  • Make sure that as a parent you understand that anxiety and depression may impact your asthmatic child.
  • Make sure you know the symptoms of anxiety and depression and watch for them in your child.
  • Don't attribute any behavior changes to adolescence before looking into it more deeply.
  • If your child seems to be suffering from anxiety or depression, talk with them about it and make sure to mention it you your doctor. If we fail to recognize the symptoms, your child will not have the opportunity for appropriate treatment.


  1. Ortega AN, Huertas SE, Canino G, Ramirez R, Rubio-Stipec M. Childhood asthma, chronic illness, and psychiatric disorders. Journal of Nervous and Mental Disease. 2002;190:275–81.
  2. Goodwin RD, Fergusson DM, Horwood LJ. Asthma and depressive and anxiety disorders among young persons in the community. Psychological Medicine. 2004;34:1465–74.
  3. Feldman JM, Ortega AN, McQuaid EL, Canino G. Comorbidity between asthma attacks and internalizing disorders among Puerto Rican children at one-year follow-up. Psychosomatics. 2006;47:333–9.
  4. Goodwin RD, Jacobi F, Thefeld W. Mental disorders and asthma in the community. Archives of General Psychiatry. 2003;60:1125–30.
  5. Leitre SL, de Groot EP, Draaisma E, Brand PL.Anxiety depression and self-esteem in children with well controlled asthma: case control study. Arch Dis Child. 2014; May 8.

Continue Reading