Reduce the impact of anxiety and stress on your asthma 

Whether you have to juggle family and work or you’ve recently received bad news, dealing with the challenges of everyday life can take its toll. But if you’re living with asthma, the stress and anxiety this causes can be a trigger for your symptoms.^1–3 Here, we talk about how anxiety and stress might affect your asthma and what you can do about it.

While stress and anxiety differ, they often come hand in hand. These feelings are a normal reaction to life’s pressures and they aren’t always a bad thing. In small doses they can drive us to face a challenge and do well. Just think of those butterflies in your tummy that motivate you to prepare well before a job interview or study hard for an important exam.

Stress and anxiety: what’s the difference?^4,5

Stress Our body’s physical response to a challenge – our heart pumps faster, palms sweat and adrenalin is released in preparation to respond.

Anxiety A feeling of fear or worry that is often triggered in response to stress. But it can also be experienced by someone unable to identify any specific stress in their life. 

But stress and anxiety can become too much to deal with and may begin to interfere with daily life.⁶ If these feelings have prolonged, your first port-of-call should be your GP. It may also help to know that you’re not alone. In the UK, around three million people experience anxiety⁷ and in the past week one in six people worldwide will have experienced a common mental health problem such as anxiety.⁸

If you’re living with asthma, you may have noticed that anxiety and stress make your symptoms worse.^1–3,9 Coping with asthma can also be another cause of stress or anxiety.¹⁰ So there’s a danger this can become a cycle, with negative emotions around asthma leading to more symptoms. That’s why managing stress and anxiety is important for keeping control of your asthma.

How stress and anxiety affect asthma

When you’re feeling stressed you may be more likely to react to your usual asthma triggers such as pets, pollen or colds and flu.¹ Or you may be more likely to drink or smoke, which can both increase the risk of asthma symptoms.^1,11,12 Stress can also lead to anxiety, thereby making the problem¹ even worse.

Both stress and anxiety cause physical changes such as your heart beating fast and your breathing becoming shallower and faster.¹ This can lead to the symptoms of asthma such as coughing, breathlessness and a tight chest.¹

It can be difficult to know whether what you’re feeling is anxiety or asthma symptoms. And if you mistake your anxiety for asthma, you might take more medicine than you need, which can make anxiety worse.⁵

According to Viv Marsh, independent Specialist Asthma Nurse and Educator, “Taking more medicine than you need can lead to side effects, which can sometimes worsen anxiety or even make your heart beat faster. Over the longer term stress and anxiety have been linked to more severe symptoms and worse asthma control.¹² It is important to learn to cope and reduce the impact of anxiety on long term health. If a patient is uncertain about their symptoms, they should talk to their doctor or nurse about it.”

Remember that your doctor is not only able to support you with your asthma symptoms but also with how they affect your mental health. If you’re feeling anxious, try keeping a diary to identify how this affects your asthma. You can use the notes you’ve made to discuss any symptoms with your doctor and work out the best way of dealing with each situation.

Panic attack or asthma attack?

Some people may experience panic attacks in which anxiety is extreme and happens suddenly. The symptoms of a panic attack and early stages of an asthma attack can be similar – you may feel breathless, tense and have a racing heart⁵ – that’s why it can be difficult to know which it is.

Panic attacks can happen in particular situations and environments such as crowded buses or during a stressful encounter. But some people find that panic appears to be unrelated to what’s going on around them.

If you are able to identify a source of your panic, it’s important not to avoid these situations – after all you won’t always be able to avoid getting that bus. Remember, although panic attacks are scary they don’t last long and you can help reduce panic by breathing slowly and calmly.

It’s important to recognise whether you’re feeling panic or asthma symptoms so you know how to handle the situation and take your medication when you need it. Coughing and wheezing are signs you’re having an asthma attack while dizziness and feeling faint are more likely to be signs of a panic attack.⁵

Top tips for dealing with stress and anxiety if you have asthma

Dealing with these complex emotions is rarely simple, but Viv Marsh has some ideas that may help.

- Try keeping a diary to work out any connections between feelings of stress or anxiety and your asthma symptoms.^1,5 This can help you think of ways to reduce anxiety where you can plan for events that you know you’ll find stressful.

- Get on top of your asthma control by taking your medication as prescribed.  

- Breathing exercises can help you to relax and could also help reduce asthma symptoms. Ask your doctor or nurse about any progammes available in your area to learn breathing techniques.^1,5

- Think about how organisations such as Asthma UK or local support groups could help you – speaking with people in similar circumstances may help you feel more confident about dealing with your asthma, particularly when you’re stressed or anxious.

- Talk to a professional if you need to. Don’t underestimate the impact an asthma attack can have on you. You may find them scary and traumatic so it’s important to discuss these feelings with an expert. You should have a review with your asthma doctor or nurse at their practice within two days of an attack occurring.¹⁴

Staying in control^1,5

To avoid the negative cycle between asthma and stress or anxiety, it helps to first have good control of your asthma. Stress or anxiety may lead to you not prioritising the management of your asthma¹³… which in turn can lead to more stress and anxiety. So it’s really important to stay on track with treatment or the good habits that are helping you manage your asthma.

Remember that you don’t have to put up with anxiety and stress. Keeping on top of these feelings will help you control your asthma, but you may need some extra support along the way. It’s important to seek the advice of your doctor if you’re struggling to cope.

Visit the Asthma UK website for more information and guidance on how to manage stress and anxiety if you have asthma, including breathing exercises and how to optimise your asthma action plan.

To check if your asthma is causing you stress and anxiety, take the Asthma Control Test here.

^{NP-GBL-ASU-WCNT-190002. Date of preparation: February 2020}