Asthma and Depression: Which Comes First?
I was talking with a friend who like me had serious childhood asthma. After seeing all the best doctors in New York City, without satisfying results, her family brought her the Colorado Allergy & Asthma Centers. It was there that they diagnosed her with depression. Once diagnosed and treated with depression medication, her asthma symptoms abated.
In her words: "I was a beyond sickly child and once the depression was diagnosed I stopped getting sick every month, 99% of my allergies disappeared, no more asthma, etc."
Clearly, my friend's depression was a huge component to her asthma symptoms. Luckily, she has remained asthma-free since that diagnosis but she still struggles with severe depression. I'm defining depression here not as simply feeling blue or low every now and then but as defined by the American Academy of Allergy Asthma & Immunology (AAAAI):
"Major Depressive Disorder is diagnosed when five or more of the following symptoms have been present during a two-week period (or longer):
- Depressed mood
- Diminished interest in activities
- Significant weight loss or weight gain
- Sleep disturbances
- Coordination difficulties
- Feelings of worthlessness
- Diminished ability to think or concentrate
- Recurrent thoughts of death"
I'm wondering if any of you that have had mild to severe asthma over prolonged periods of time have experienced symptoms of depression at one time or another or have battled with depression on an ongoing basis?
I looked at two studies that come at that question from the opposite poles.
Health Central posted an article culled from the Journal of Clinical Psychiatry that studied children being evaluated for a psychiatric condition. The study found that many of these children had allergies or asthma.
"Psychiatric evaluations revealed that 124 (67%) had an internalizing disorder, either alone or in combination with an externalizing disorder, such as ADHD, oppositional defiant disorder and conduct disorder. The children in the sample were between 4 and 20 years old; their average age was 13. Researchers found that youth with internalizing disorders were almost twice as likely to have a history of allergies than those with a diagnosis that wasn't classified as an internalizing or externalizing disorder.
"These findings add to the growing body of evidence supporting an association between anxiety, depressive, and allergic disorders,' write Dr. Mauricio Infante and colleagues from University of Wisconsin, Madison in the Journal of Clinical Psychiatry... The findings also suggest that these psychiatric and medical disorders ‘may share risk factors and underlying pathways that contribute to the development of both types of disorders'."
The study seems to be making the correlation that the internalizing disorders and allergies and asthma can go hand in hand but that the emotional disturbance is the primary disease, as with my friend.
"For people living with diseases that can lessen their quality of life like asthma, depression can be common. Sometimes asthma, especially untreated or improperly managed asthma, can prevent patients from doing all the things they want to do physically, resulting in isolation or frustration."
"People with asthma report depression at a rate of 20% to 50%...Research has also indicated that people with asthma who are depressed may not follow their asthma management plan, and that they may have difficulty adjusting their behaviors overall. Thus, one can get into a cycle whereby asthma symptoms lead to feelings of helplessness and depression, which then lead to poor self management of asthma, resulting in worsening of asthma symptoms."
So I still wonder, which comes first: asthma or depression?