Is it Asthma or Anxiety?by Jerry Kennard, Ph.D. Medical Reviewer
Tightness in the chest, lightheadedness and shortness of breath are all symptoms of anxiety, but also of asthma. When Worryqueen asks, 'how do I know when one or the other is occurring?' she touches on a very interesting and important issue. As the incidence of both asthma and anxiety-related disorders is increasing, I'm slightly surprised this question isn't asked more frequently. Now it has, and so this is the focus of my Sharepost.
It is estimated that more than 20 million people in the US suffer with asthma and the numbers are increasing. There appears to be no single reason as to why the incidence of asthma is increasing but suggestions include pollution, greater use of vaccines and antibiotics, greater amounts of time spent indoors, smoking, and whether you were born prematurely. In the past month alone the press has reported possible links between eating burgers and asthma and stressful jobs and asthma. The things that can trigger an asthmatic episode also vary. People commonly think of allergens such as pollen, cat hairs and dust, but just as significant are emotional states like laughing and anxiety.
Rather like a panic event, asthma can vary in severity and duration. Similarly, there is no golden rule as to the nature of any particular stressor as to whether or not it can trigger asthma. The things that trigger emotional arousal are highly varied. In some people there is evidence that emotional arousal can and does trigger physical changes. One example of this was reported at the annual meeting of the American Psychiatric Association, in New Orleans, in 2001. Psychiatrist Glenda MacQueen, MD, identified a sample of asthmatic patients found to rate more responsively to cues in their environment. MacQueen gave the volunteers a mock inhaler and told them it would cause some constriction of the airways. After the harmless solution was administered, a number of volunteers experienced airway constriction and changes in lung function.
It is not uncommon to find that many people with asthma also suffer with anxiety. For example, the health information site WebMD, reported that of 86 patients with asthma in an outpatient clinic, 45 had at least one anxiety disorder, according to Isabella Nascimento, MD, of the department of psychiatry at Federal University in Rio de Janeiro, Brazil.
Unpicking the cause of an asthma event can be tricky, even without the added issue of anxiety. However, there is an approach that sufferers can take. As asthmatics already know a variety of tests can be undertaken to help determine what triggers asthma. Skin tests for example may help to identify allergens but this is not quite the same as knowing whether the allergen alone is responsible for an asthma event. Blood tests can be used to assess the level of antibody response to an allergen, but often it is the person themselves who is best able to identify whether asthma results following particular exposures.
With anxiety, the situation isn't so very different. Only the person who suffers with anxiety can best reflect on the situations and events that preceded their asthma and establish whether a pattern is emerging. Unfortunately, the techniques that might be used in the case of a panic event are probably not suitable during asthma. For this reason it is always safest to take medication if an asthma event has or is about to occur. If excitement, exercise, or even emotional movies, appear to be a trigger for asthma, then it falls on the shoulders of the person affected to try out different ways to manage these situations. In the case of stress, the therapies, preventative techniques and exercises are well documented, and should be used to their full potential.
Brooks, J (2001) The Anxiety of Asthma: Emotions Can Trigger Attack. WebMD.com. http://www.webmd.com/news/20010407/anxiety-of-asthma-emotions-can-trigger-attack