What Are Good Questions To Ask About Asthma
If you have been diagnosed with asthma, it is important to learn all you can about the symptoms and treatment of it. Since this is a potentially life-changing diagnosis, take some time to discuss the following with your doctor.
- How can the risk of an asthma attack be reduced?
- How should I handle an asthma attack?
- Are there ways to monitor my asthma?
- Can an inhaler help with my asthma?
Can Emotions Trigger Allergic Asthma
Emotions have a powerful effect on how you feel each day. In fact, if you have asthma, you may notice that your emotions play a part in your symptoms.
Even though allergens are the major trigger of allergic asthma symptoms, you may experience more severe asthma symptoms or more frequent asthma attacks if youre feeling stressed, depressed, or anxious.
Read on for more information about how your emotions can affect allergic asthma.
Anxiety Does Not Cause Asthma
Some people worry that anxiety causes asthma. There is currently no evidence that anxiety can create asthma in those that did not originally have the condition. But there is a great deal of evidence that anxiety can worsen existing asthma symptoms.
The most likely reasons for why anxiety exacerbates asthma symptoms include:
- Hyperventilation Anxiety changes breathing habits. Many studies have shown that hyperventilation, whether it’s caused by a disorder or no disorder at all, appears to increase the likelihood of an asthma attack. So those with anxiety that may be more prone to hyperventilating may be unintentionally forcing their own attack symptoms.
- Inflammation Stress can lead to inflammation. Asthma is the inflammation of airways. It’s unlikely that stress causes the inflammation that leads to asthma, but it’s possible that stress makes it harder to control inflammation when your asthma symptoms are acting up.
- General Physiological Changes On a physical level, stress does cause some issues that may contribute to asthma. For example, anxiety can release an excess of histamine that can lead to asthma attacks. Stress may also weaken your immune system in such a way that you become more vulnerable to viruses and external asthma triggers.
- Muscle Constriction Muscle constriction is also very common with anxiety. Muscle constriction can lead to tighter chest and other issues that may trigger asthma.
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How Do I Know If Stress Is Triggering My Asthma Symptoms
The first step is knowing that youre under stress sometimes we dont recognise the signs. Stress can make you feel more irritable, tired, more worried than usual. You might feel teary, restless or find it hard to make decisions.
The second is understanding that stress levels can make your asthma worse sometimes we dont make the connection between stressful events and our asthma symptoms.
To see if stress might be triggering your asthma symptoms try keeping a diary write down when and why youre stressed alongside any asthma symptoms.
You might start noticing patterns. For example, perhaps you got asthma symptoms more when you were moving to a new house, or your asthma seemed worse when you had exams coming up.
A written asthma action plan helps you keep an eye on symptoms getting worse and reminds you what to do if you notice any.
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 our bodies to release the hormone cortisol chronic elevation of cortisol can have cause inflammation.
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.
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Finding Support With Asthma
Getting support when you have asthma is important. The people around you — family members, friends, co-workers — can all help. These people should know what to do in case you have a severe asthma emergency. They should also know you can control and manage your asthma. You can find support with asthma through online organizations, such as the WebMD asthma message boards, support groups in your community, and by staying in touch with others who have asthma. Talking to others can help east some of the stress you might feel.
Asthma Exacerbations Can Last A Week Or Longer
Fran Lowry
Patients can also experience worsening of several symptoms at once, Michael Blaiss, MD, from the University of Tennessee at Memphis, told Medscape Medical News.
Dr. Blaiss and his team conducted the Asthma Insight and Management survey to examine the reported duration of episodes with asthma symptoms that were frequent or severe.
The survey is the sequel to the Asthma in America study, which was done more than a decade ago.
Dr. Michael Blaiss
We wanted to know what has happened as far as asthma management in patients since that survey was done. We also added some new questions to get a better idea of how asthma was affecting the adult and adolescent population, Dr. Blaiss explained.
AIM quizzed 2500 asthma patients 12 years and older about duration of episodes with asthma symptoms that were frequent or severe. The participants were interviewed from July to September 2009.
Dr. Blaiss said he found it striking that patients reported a variety of symptoms.
Physicians often think that an asthma flare up will last 1 or 2 days and then be gone, but this survey shows that is not true, he added.
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How Does Stress Modify Inflammation
Having provided support for the basic premises of our working model, we now turn to details of how stress amplifies the immune response to asthma triggers. provides an overview of the relevant pathways, including the hypothalamic-pituitary-adrenal axis, the sympathetic-adrenal-medullary axis, and the two major divisions of the autonomic nervous system, sympathetic and parasympathetic .
Adverse Impact Of Stress On Health
A common clinical observation is the often adverse relationship between stress and human diseases. Various sources have estimated that up to 75% of all visits to physicians offices are stress-related. This appears to be particularly true in relationship to other immune-based dysfunction such as increased susceptibility to infections and various autoimmune diseases. Stress is also implicated in morbidity and mortality of other inflammatory based diseases such as cancer, HIV/AIDS, inflammatory bowel disease and even immune senescence associated with aging. Stress may also cause persistent increases in sympathetic nervous system activity, including increase blood pressure, heart rate and catecholamine secretion as well as platelet aggregation which may explain, at least in part, the known association between stress, immune alteration and cardiovascular disease. In addition, altered sleep can modulate stress-health relationship. Sleep disturbance have been associated with adverse physical health outcomes including increase morbidity and mortality compared to population with adequate pattern and duration of sleep. Other pathologies associated with allostatic overload from chronic stress include depression, tendencies towards unhealthy behavior, diabetes, dyslipidemia irritable bowel syndrome and cerebrovascular accidents.
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Impact Of Stress On Immune System
The link between the brain and immune system involves two main pathways: the autonomic nervous system and the-hyphophyseal-pituitary – adrenal axis. Perception of stress leads to activation of HPA system which begins with the secretion of corticotrophin releasing hormone which in turn induces the secretion of adrenocortictrophic hormone by the anterior lobe of the pituitary lobe. ACTH activates the secretion of corticoids by the adrenal cortex and catecholamines by the adrenal medulla. The catecholamines and corticoids suppress the production of IL-12 by the antigen-presenting cells which is a primary TH1 cytokine-inducing inducing stimulus. Corticoids can also exert a direct effect upon TH2 cells thus increasing the production of IL-4, IL-10 and IL-13. The end result is the predominance of a TH2 cell mediated response which would favor an allergic inflammatory response in a susceptible individual.
The CNS modulates immune system through neurotransmitters , glutamic acid), neuropeptides , neurological growth factors ), and hormones whereas the immune system can also modulate CNS function via various molecules including cytokines , chemokines and nitric oxide . Perception of acute stress stimulates the locus ceruleus which secretes noradrenalin. Noradrenalin activates the sympathetic nervous system leading to decrease production of IL-12 as described earlier.
What Are The Signs Of A Severe Asthma Attack
Asthma may lead to a medical emergency.
Rescue inhalers can help you: inhalers
Seek medical help immediately for:
- Fast breathing with chest retractions
- Cyanosis which is tissue color changes on mucus membranes and fingertips or nail beds the color appears grayish or whitish on darker skin tones and bluish on lighter skin tones
- Rapid movement of nostrils
- Ribs or stomach moving in and out deeply and rapidly
- Expanded chest that does not deflate when you exhale
- Infants with asthma who fail to respond to or recognize parents
- Talk with your teen about the dangers of vaping.
- Vaping can cause severe lung damage. It can become permanent.
- Vaping can even cause death .
- Vaping tobacco also causes nicotine addiction.
- For these reasons, the legal age to purchase vaping products is 21 in the US.
- Encourage your teen to not start vaping or to give it up.
- Warning: home-made or street-purchased vaping solutions are the most dangerous.
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Managing Emotions And Allergic Asthma Symptoms
Managing your emotions and emotional responses may help you better manage your asthma.
Since day-to-day stress and emotions can impact your symptoms, experts suggest using different coping methods and relaxation techniques to handle stress, emotions, and strong emotional responses.
Researchers increasingly suggest practicing mindfulness to help reduce stress and manage asthma symptoms.
A 2020 study noted that when people with asthma or COPD apply mindfulness techniques, the psychological response may have a positive impact on symptoms.
The AAFA recommends trying mindful breathing and observation to help reduce stress.
If you want to try mindful breathing:
If you want to try mindfulness through observation:
A Typical Treatment Plan
A common treatment plan for a typical person with moderate asthma is:
- A preventer inhaler , taken each morning and at bedtime. This usually prevents symptoms throughout the day and night.
- A reliever inhaler may be needed now and then if breakthrough symptoms occur. For example, if symptoms flare up when you have a cough or cold.
- If exercise or sport causes symptoms then a dose of a reliever inhaler just before the exercise usually prevents symptoms.
- The dose of the preventer inhaler may need to be increased for a while if you have a cough or cold, or during the hay fever season.
- Some people may need to add in an LTRA and/or a long-acting bronchodilator if symptoms are not controlled with the above.
At first, adjusting doses of inhalers is usually done on the advice of a doctor or nurse. In time, you may agree an asthma action plan with your doctor or nurse.
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Immunopathophysiology Of Allergic Disease
IgE-mediated allergic disorders may manifest clinically as any combination of conjunctivitis, rhinitis, asthma, atopic dermatitis, food and/or drug intolerance and/or anaphylaxis. It has been well recognized that atopic dermatitis and food allergies are often the earliest manifestation of atopic predisposition in a young child. Nearly 50% of children with atopic dermatitis develop asthma and 75% develop allergic rhinitis. The allergic march is a sequential or sometimes simultaneous expression of two or three of the above mentioned allergic disorders in an individual progresses from infancy to adolescence and adulthood.
The prevalence of allergy and asthma has increased in nearly all countries worldwide and is more common in Westernized and economically developed countries. As many as 1 in 3 individual suffer from some form of allergic disorder. Development of allergic disorders involves multiple factors including genetic components , both indoor and outdoor environmental exposure as well as other life style factors including maternal diet, reproductive physiology and birth outcomes, breast feeding, child nutrition and vitamin D level, obesity, physical activity and psychological stress.
When To Talk With A Doctor
If your symptoms are otherwise well controlled, you may not need to speak with your doctor. But if your symptoms are starting to increase in intensity, you may want to talk with your doctor about changing your treatment routine.
If you experience symptoms of depression, you should talk with your doctor or another mental health professional.
According to the National Institute of Mental Health, signs and symptoms of depression can include:
- loss of appetite
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Anxiety Can Worsen Asthma Symptoms
Response from Theresa Cannizzarro, Respiratory Therapist:
Anxiety can most definitely make asthma symptoms worse. Stress and anxiety can cause physiological changes which can provoke and worsen an asthma flare up. Strong emotions can cause your body to release leukotrienes and histamine which cause narrowing of the airways. It is a pretty normal reaction to have anxiety when your asthma is flaring up. I know I experience it. It’s almost impossible to remain calm, cool & collected when you can’t breathe.
What I like to do when my asthma is acting up and I teach my asthma patients, is to focus on your breathing. There are also plenty of relaxation exercises you can try that can help tremendously. I would recommend trying one of them when your asthma isn’t flaring until you’re comfortable with it and will know what to do when you’ll need to be able to try & calm your anxiety.
Advice For Friends And Family
Its important that your friends and family know how to help in an emergency.
It can be useful to make copies of your personal asthma action plan and share it with others who may need to know what to do when you have an attack.
You can photocopy your existing plan, or you could download a blank personal asthma action plan from Asthma UK and fill it in for anyone who might need a copy.
Or you could take a photo of your action plan on your phone, so you can show or send it to others easily.
Page last reviewed: 19 April 2021 Next review due: 19 April 2024
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Try Relaxation Or Breathing Techniques
Mind-body practices like meditation, yoga, and tai chi can promote relaxation, but theres not enough research currently to show definitively that they help relieve asthma symptoms. However, a review of studies published in September 2012 in the journal AHRQ Comparative Effectiveness Reviews suggests that hyperventilation-reduction breathing techniques and yoga breathing techniques may possibly help improve asthma symptoms or at least reduce the need for quick-relief medications.
Addressing Stress In Comprehensive Allergic Disease Management
Similar to allergic diseases, progression of the other immune-based diseases such as cardiovascular disease, diabetes mellitus, development of AIDS in HIV+ patients and certain malignancies has been suggested for high-stress population. Thus it follows that managing stress in these patients could be expected to have salutatory effects on their underlying disease course.
Strategies for stress management as part of a comprehensive treatment plan should involve identification of high-risk population or , ideally, individuals. Current efforts are underway in our group and others to identify biomarkers that would categorize individuals into risk categories for adverse effects of psychological stress on their immune system which, in turn, would effect risk for or activity of underlying immune-based diseases. The categorization would be followed by individualized prophylactic interventions in the highest at-risk individuals to prevent immune based diseases or therapeutic intervention in the diseased individuals with the intent to minimize the immunoregulatory imbalance that characterizes chronic stress induced immune changes.
Stress reduction/elimination would be the most desirable intervention but is often difficult to achieve in our fast paced, high pressure societies. Accordingly, , methods to improve individual coping abilities to stressful situations are more likely to be clinically valuable as a core of the interventional strategies for stress management.
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Side Effects Of Relievers And Preventers
Relievers are a safe and effective medicine, and have few side effects as long as they are not used too much. The main side effects include a mild shaking of the hands , and muscle cramps. These usually only happen with high doses of reliever inhaler and usually only last for a few minutes.
Preventers are very safe at usual doses, although they can cause a range of side effects at high doses, especially with long-term use.
Using a spacer can help prevent these side effects, as can rinsing your mouth or cleaning your teeth after using your preventer inhaler.
Your doctor or nurse will discuss with you the need to balance control of your asthma with the risk of side effects, and how to keep side effects to a minimum.
