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Asthma and Mental Health: Depression, Anxiety, and More

Medically reviewed by Sarah Gray, Psy.D.
Written by Anika Brahmbhatt
Updated on March 1, 2024

Have you been feeling not quite yourself but not quite sure why or when this started? Because the physical impact of asthma can be all-consuming, you may be experiencing psychological effects that slowly took hold without your noticing. But if you take steps to boost your mental health, you may improve overall your quality of life.

Members of MyAsthmaTeam often talk about the effects of asthma on their mental health. “My anxiety gets really bad, and I get very irritated when having asthma flares,” said one member. “Sometimes those symptoms show up before I notice my asthma.”

“It is hard to deal with both asthma and anxiety,” said another member.

How Does Asthma Affect Mental Health?

According to the National Institute of Mental Health (NIMH), people with chronic conditions are more likely to develop symptoms of depression than are those who aren’t chronically ill. This also works the other way around: People who experience depression are at an increased risk of developing certain chronic illnesses compared with those who aren’t depressed.

Children with asthma, as well as their caregivers, may be more likely to experience mental health struggles than other kids and parents.

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Some people with asthma may veer away from treating mental health problems because they feel it might take their attention away from managing asthma and keeping their airways open. However, the opposite is true: If you’re suffering from depressive symptoms, anxiety, or mood disorders, treating them with medication such as antidepressants, psychotherapy (also called talk therapy), or both “may help improve the physical symptoms of a chronic illness or reduce the risk of future problems,” NIMH says.

Your health care provider can work with other mental health professionals, such as experts in psychology or psychiatry, to ensure that you stay both mentally and physically healthy.

Anxiety is also common in people with chronic conditions, particularly as they deal with the unknowns of what their disease might bring — such as other conditions. For instance, sleep issues, including both insomnia and extreme oversleeping, have been linked with a lower health-related quality of life in people who have chronic conditions.

“Anyone dealing with chronic illness of any kind can really come up against challenges, particularly when there is no cure, or there’s uncertainty in the progression of the illness,” said Dr. Sarah Gray, a pain psychologist with Integrative Psychology in Arlington, Massachusetts and an instructor of psychology at Harvard Medical School.

Children with asthma, as well as their caregivers, may also be more likely to experience mental health struggles than other kids and parents. If you’re parenting a child with asthma, it may be doubly important to understand the connection between asthma and mental health so you can take care of both your child and yourself.

Understanding the Link Between Asthma and Your Mind

Having a chronic health condition may put people at a higher risk of mental health difficulties for several reasons, according to Mental Health America. For example, you might feel isolated because you spend so much time at the doctor’s office or aren’t as mobile as you used to be. In addition, you may worry excessively about your condition, develop inflammation over the long term because of the stress, or go through chemical and hormonal changes.

Depression is about twice as common in people who have asthma than in those without the condition.

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In some cases, you may feel depressed or anxious because you aren’t getting the right medical care. Research published in 2011 found that people who felt stigmatized by health care workers had a decreased quality of life, partly because they accessed health care services less often than people who didn’t internalize stigma and anticipate a negative response.

This situation can prevent some people from seeking care for their mental health conditions, Dr. Gray noted: “Unfortunately, sometimes there can still be a stigma around seeking help for mental health concerns. Thankfully, that’s changing and continues to improve, but that can still exist.”

Asthma and depression may go together more often than many people might think. “Physical and mental health comorbidities are the norm in adults with asthma,” concluded the authors of a 2017 population-based study. The results indicated that depression is about twice as common in people who have asthma than in those without it. The researchers also found that seven of the eight mental health comorbidities (co-occurring conditions) they looked at, including eating disorders and substance use disorders, were more common in people with asthma than in those who did not have asthma.

Is Asthma a Mental Illness?

Asthma is not a mental illness — it’s a separate medical condition and doesn’t fall under mental health disorders. In addition, asthma control can’t typically be reached through mental wellness efforts alone. Instead, asthma and mental illness are connected in other ways.

Recognizing Symptoms of Depression and Anxiety

In some cases, you may not recognize that you’re dealing with depression or an anxiety disorder. The feelings may have come on and strengthened slowly, without you noticing them, or perhaps you’re so accustomed to feeling blue or stressed that you assume this is just a way of life now. But recognizing when you may actually have a condition that requires a professional evaluation is important.

Parents who pick up on mental health symptoms in themselves or in their child should talk to a doctor or to their child’s pediatric team right away.

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“In my experience, and working with so many patients at different phases and stages, the type of stress that comes up early evolves over time,” Dr. Gray said. “Often, people along the way will find ways to cope, to draw on that inner strength that’s there, and hopefully get linked in with a number of supports, but the stressors change over time — and that requires ongoing support.”

Symptoms of depression may include:

  • Sadness
  • Feelings of worthlessness or hopelessness
  • Guilt
  • Loss of interest in things or people you typically enjoy
  • Changes in sleep, nutrition, or energy levels
  • Difficulty with concentration or cognition
  • Agitated or slow movements
  • Suicidal thoughts

Common symptoms of anxiety can include:

  • Nervousness or agitation
  • Feeling a sense of upcoming doom
  • Heart palpitations, rapid breathing, or sweating
  • Trouble sleeping
  • Gastrointestinal issues
  • Trouble focusing

If you’re experiencing these types of feelings, talk to your health care team or contact a mental health provider for help.

Getting Support and Practicing Self-Care

Your health care team will determine what type of treatment you should pursue. You have many options for treatments, including inhaled steroids like fluticasone propionate (Flovent), anticholinergics like tiotropium (Spiriva), and biologics like dupilumab (Dupixent). In addition to the treatments that your physician recommends, you can find other ways of treating depression and anxiety with lifestyle changes and therapies that go beyond medication.

Dr. Gray recommends tools such as cognitive behavioral therapy (CBT) and biofeedback for coping with the many unknowns that come with having a chronic disease. She also works directly with people to identify their specific stressors. “For instance, if there’s a family member who is bringing up some conflict and the patient finds it particularly difficult to navigate setting boundaries with a certain person, then we might work on concrete, specific tools to address any troublesome interactions there,” she said.

It’s essential that you remain on your asthma management plan as you address your mental health condition, while also making lifestyle modifications. A 2020 study in the Journal of Advanced Nursing found that for older adults with multiple chronic conditions, maintenance behaviors — such as being physically active and sticking with treatment — were the most critical components of self-care to combat depression. The authors wrote that even mild depression symptoms ”can be associated with poor self-care maintenance.” They emphasized the importance of screening people with chronic conditions for depression of any severity.

In addition, make sure you have a supportive team around you, which can help when dealing with asthma. A 2020 study in the journal Heart & Lung found that people with certain chronic conditions reported family as their most important psychosocial resource. Positive relationships with other people “are assumed to contribute to physical and mental health either directly by meeting basic human needs, or through enhancement of coping performance by buffering stress,” the study authors noted.

Can Stress Trigger Asthma?

Stress can sometimes trigger an asthma flare-up. Lowering your stress levels may improve your asthma symptoms and asthma attacks, too, since stress is a known trigger of asthma symptoms.

Remember that your health condition and current health status may affect every area of your life, Dr. Gray said. “Relationships, activities that one may enjoy — they may be impacted by the chronic illness and the symptoms,” she noted. “Your sense of self can be affected by the change in activities and relationships, so that in and of itself can really, validly lead to feelings of loss and worry.”

Some risk factors for developing mental health issues — as well as for having chronic illnesses — are easier to modify than others, according to the Centers for Disease Control and Prevention (CDC). Stressful life circumstances, a history of trauma, and lack of social support may be out of an individual’s control. On the other hand, poor diet, lack of exercise, and drug use are among the “modifiable risk factors” the CDC identifies for reducing one’s risk of chronic disease.

You can also consider using mindfulness as part of your plan to improve mental health issues. Dr. Gray points out that “at its core, mindfulness is really approaching the present moment with openness, with curiosity, purposefully, and just being aware of what’s around you. It takes a lot of practice, repetition, and time — it’s really important for people to know it doesn’t just happen.”

Addressing Mental Health and Asthma in Children and Parents

Higher levels of anxiety and depression, as well as other mental health concerns, are associated with children, adolescents, and young adults who have asthma. Not every child living with asthma will develop mental health disorders, but it’s important to watch for parents to watch for the signs. Both depressive disorders and anxiety, but especially anxiety, are likely associated with a lower quality of life in kids with asthma and with more severe asthma symptoms. These connections are stronger in girls with asthma than in boys, according to the The Journal of Allergy and Clinical Immunology: In Practice. It’s possible that girls see asthma more negatively than boys do, noted the researchers, but more studies are needed to determine the reason for the gender gap.

Parents who care for child with asthma are also more likely than other parents to experience anxiety and depression. This can make it harder to care for their child’s asthma effectively and address symptoms appropriately, which can lead to worse asthma outcomes.

Parents who pick up on mental health symptoms in themselves or in their child should talk to a doctor or to their child’s pediatric team right away and follow up as needed. Getting treatment for your or your child’s mental health, as well as getting all your questions about asthma answered, could help you lower stress and feel better overall.

Find Your Team

MyAsthmaTeam is the social network for people with asthma and their caregivers and loved ones. On MyAsthmaTeam, more than 11,000 members come together to ask questions, give advice, and share their stories with others who understand life with asthma.

Are you experiencing anxiety, depression, or other mental health issues in addition to asthma? Do you have tips for practicing good self-care? Share your thoughts in the comments below, or start a conversation by posting on your Activities page.

References
  1. Chronic Illness and Mental Health: Recognizing and Treating Depression — National Institute of Mental Health
  2. Emotional Dimensions of Chronic Disease — Western Journal of Medicine
  3. Association Between Sleep Problems and Health-Related Quality of Life in Canadian Adults With Chronic Diseases — Sleep Medicine
  4. Psychological and Sociocultural Determinants in Childhood Asthma Disease: Impact on Quality of Life — International Journal of Environmental Research and Public Health
  5. Fact Sheet: Childhood Asthma — Society of Pediatric Psychology
  6. Infographic: Chronic Health Conditions and Mental Health — Mental Health America
  7. The Impact of Stigma in Healthcare on People Living With Chronic Illnesses — Journal of Health Psychology
  8. Depression (Major Depressive Disorder) — Mayo Clinic
  9. Symptoms: Generalized Anxiety Disorder — Anxiety & Depression Association of America
  10. Asthma — Mayo Clinic
  11. Depression and Self-Care in Older Adults With Multiple Chronic Conditions: A Multivariate Analysis — Journal of Advanced Nursing
  12. Coping Resources of Heart Failure Patients — A Comparison With Cancer Patients and Individuals Having No Chronic Condition Results From Esther Study — Heart & Lung
  13. Emotions, Stress, and Depression — Asthma and Allergy Foundation of America
  14. Lifestyle Risk Factors — Centers for Disease Control and Prevention
  15. Comorbidities in Adults With Asthma: Population-Based Cross-Sectional Analysis of 1.4 Million Adults in Scotland — Clinical & Experimental Allergy
  16. Multivariate Association of Child Depression and Anxiety With Asthma Outcomes — The Journal of Allergy and Clinical Immunology: In Practice
    Updated on March 1, 2024
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    Sarah Gray, Psy.D. is an Instructor of psychology at Harvard Medical School and a psychologist in the Department of Psychiatry at Massachusetts General Hospital. Learn more about her here.
    Anika Brahmbhatt is an undergraduate student at Boston University, where she is pursuing a dual degree in media science and psychology. Learn more about her here.

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