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How stress triggers asthma

WebMD Medical Reference
Medically Reviewed by Dr Rob Hicks

Stress is a common asthma trigger. An asthma trigger is anything that brings on asthma symptoms. When you have stress and asthma, you might feel short of breath, anxious, and even panicked. Stress may cause your asthma symptoms to worsen and cause you to feel frightened.

When stress levels start to creep upward - whether it’s over bills, work, or your children’s jam-packed calendar - asthma symptoms can become worse. As the wheezing and coughing gets worse, your health becomes one more reason to worry. Asthma, stress, and anxiety make for a vicious cycle, and one that can spiral downward quickly.

Stress and asthma: What's the connection?

Stress can affect the cardiovascular, gastrointestinal, musculoskeletal, immune, and central nervous systems. Asthma is no exception.
Stress can create strong physiological reactions that lead to airway constriction and changes in the immune system, which can worsen asthma symptoms.

The mechanism between asthma and anxiety is many-fold. Uncontrolled emotions can work the nerves and cause constriction of muscles, like the smooth muscles of the airways in the lungs. They tighten up and constrict, which can worsen wheezing, coughing, and chest tightness in people with asthma.

Although stress and anxiety start in your mind, asthma is a physical disease of the lungs.

It is important to note that asthma is not a psychosomatic condition. It's not in your head. Stress can trigger symptoms if you already have the condition, but if you don't have asthma, stress does not all of a sudden cause a person to develop the condition.

The brain's impact on asthma and stress

The brain-body link between asthma and anxiety is starting to be better understood. Led by researchers from the University of Wisconsin in the US, a group of scientists found that certain areas of the brain cause worsening asthma symptoms when a person is under stress.

Researchers exposed a group of people with mild asthma to triggers that caused both inflammation and muscle constriction. When symptoms flared up, the participants were asked to read words that were either emotionally charged, such as "lonesome"; neutral, such as "curtains"; or asthma-related, such as "wheezing".

They found that the words linked with asthma increased inflammation and activity in parts of the brain that control emotions.

The results, published in the Proceedings of the US National Academy of Science, show a possible link between emotions and asthma.
Although it's only preliminary research, it does start to join up the dots. Until researchers find a clear link between anxiety and asthma, keep symptoms in check by managing stress and treating asthma with appropriate medication.

When treatment makes asthma and stress worse

Persistent asthma means you have symptoms more than once a week, but not constantly. Treating persistent asthma requires long-term maintenance therapy, such as an inhaled corticosteroid, plus rescue therapy when something triggers symptoms. And when your symptoms are out of control, an anti-inflammatory, such as the oral steroid prednisolone, might be necessary. The problem is that prednisolone can cause mood swings as a side effect, adding fuel to the anxiety fire.

The good news is that prednisolone is only a short-term treatment. When a course of oral steroids ends, a person should continue with a long-term maintenance therapy like inhaled steroids, which do not have an impact on mood and anxiety.

Sometimes a long-term asthma medication doesn't work well, and wheezing and chest tightness occurs all too often. Then, a vicious cycle can begin, where anxiety worsens asthma, and asthma worsens anxiety.

The solution is to talk to your doctor about your symptoms, triggers, and stress. Also, discuss other treatment options that can help get your asthma under control again.

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Reviewed on September 11, 2017

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