Why Stress Makes Asthma Worse

Is Stress Worsening Your Asthma?
Asthma and Stress. Natalie Faye/Image Source/Getty Images

"I'm happy to say it's not all in your head" was what I told a parent of an asthmatic patient that was concerned that a stressful divorce was contributing to worsening asthma. The divorcing parents were frustrated that despite real efforts to make sure their child's asthma was controlled, they could not seem to get them under control. After ensuring that there were not issues with compliance, inhaler technique or other common issues, I encouraged the parents to make sure that they addressed their child's uncertainties and other concerns about the divorce.

As the child realized they would be ok in the new dual home situation, their child's asthma slowly came under control. There is a strong relationship between asthma symptoms and anxiety.

Have you ever noticed a relationship between your stress levels and asthma? It is not uncommon for stress to be a trigger of asthma as well as asthma itself leading to anxiety symptoms. When asthma is poorly controlled, your odds of developing an anxiety disorder increase compared to the general population. Some studies have demonstrated an increased risk of anxiety among asthma patients even with good control of symptoms.

Stress has been shown to worsen asthma in numerous studies. Stress can make you feel breathless and may even worsen your asthma symptoms. If stress is a trigger for your asthma, you need to be realistic. It is unlikely that you can eliminate all stress from your life. Instead, it is important to learn how to avoid unhealthy stress, manage stress that cannot he avoided, and learn to relax to prevent asthma symptoms and not panic.

Is All Stress Unhealthy?

While we generally think of stress as a bad thing, not all stress is unhealthy. It is often what drives us to succeed and get things done. How we deal with stress is very personal. Some people need tight deadlines to get their best work done, while others need to plan everything well in advance.

Going after a promotion at work or trying to meet new people can be stressful, but the benefits can lead to excitement and rewards that far outweigh the stress. Just knowing how you deal with the everyday stresses of getting stuff done may be important for you to manage the stresses of everyday life.

Yes, some levels of stress can a good thing. But chronic stress, on the other hand, is not good for you or your asthma. It can come from many different sources, and can impact your immune system and impact your health and your asthma. Stress causes are bodies to release chemicals such as hstamines that can lead to inflammatory reactions and symptoms such as chest tightness, cough, shortness of breath, or wheezing.

Stress also impacts our regular routines- like taking medication. If you are stressed out about school or work you might forget to take your controller medication or walk out of the house without your rescue inhaler. Both situations potentially put you at risk for a worsening  of your asthma symptoms.

What Can I Do to Manage My Stress?

There are a number of lifestyle changes and active strategies that you can implement as part of a stress management program, such as:

  • Eating a well-balanced, healthy diet
  • Maintaining a healthy weight
  • Getting enough sleep
  • Exercising regularly
  • Limiting caffeine and alcohol
  • Identifying your stressors and trying to reduce them
  • Practicing relaxation techniques

Like many other things in life, if you can measure or identify something you can take action. If you know the situations or stressors that worsen your asthma, you can develop a plan to either avoid the situation or learn some management techniques. If you are not able to do this on your own than you can talk with your doctor about Exposure and Response Prevention Therapy. You might also consider deep breathing techniques like the Buteyko breathing exercises. These techniques have been associated with decreased asthma symptoms, decreased use of rescue inhalers, lowering doses of regular daily asthma medication, and improved quality of life.

Exercise is also a great activity to help prevent or manage anxiety. Exercise helps you improve psychological well-being, maintain  a healthy weight, and decreases your risk of heart disease. Talk with your doctor about an exercise regimen that is both good for your asthma and good for your overall health.

Along with more exercise most of us could use a little more sleep. Poor sleep not only can make your asthma worse but leave you tired with a result of poor school or work performance. If you are waking up at night to use your asthma inhaler you have poor control and need to discuss this with your doctor.

Stress does not have to be a big deal for your asthma if you can identify it and make appropriate changes.

Sources:

Bienenstock, S. Stress and Asthma: The Plot Thickens Am. J. Respir. Crit. Care Med., Volume 165, Number 8, April 2002, 1034-1035.

Rietveld S, Everaerd W, Creer TL. Stress-induced asthma: a review of research and potential mechanisms. Clin Exp Allergy 2000; 30: 1058-1066.

Liu LY, Coe CL, Swenson CA, Kelly EA, Kita H, Busse WW. School examinations enhance airway inflammation to antigen challenge. Am J Respir Crit Care Med 2002; 165: 1062-1067.

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