You start to panic because you are short of breath. If you’re out in public, you’re likely to also become embarrassed by your situation. And next, your asthma control disappears. It’s a vicious cycle: fear of an asthma attack can actually make the experience of an actual asthma attack even worse, which creates more fear and worry about when the next attack might occur.
But the good news is that you can get a handle on this escalating cycle by learning how to cope, relax, and be prepared, all at the same time.
An Asthma Attack and Stress: What’s Going On?
The problem starts in your brain, and spirals from there. “The interesting mind-body part of asthma is that the anxiety parts of our brain are very finely attuned to breathing problems, meaning that if people’s carbon dioxide levels go up or their oxygen levels go down, the brain very quickly tweaks the fight or flight response,†explains Wayne Katon, MD, vice chair of the department of psychiatry and behavioral sciences at the University of Washington Medical School in Seattle. Dr. Katon and colleagues have published widely about depression, anxiety, and panic disorder in asthmatics.
Once people have had a traumatic asthma attack experience, Katon says, they are likely to think, “Oh no, this is going to be bad again,†which can lead to a panicked, hyperventilation response. And that increased rate of breathing just feeds into the panic/asthma spiral. Katon calls these thoughts “catastrophic†because they assume the worst will happen — and in a way, because your mind can affect your body’s response during an asthma attack, the thoughts do become self-fulfilling. “The asthma might provoke these catastrophic cognitive self-statements, which can bring on fear and anxiety that can [then] worsen the attack,†explains Katon.
To complicate matters, Katon’s research suggests that people with asthma are nearly twice as likely as their peers to suffer from depression and/or anxiety, making it harder to unravel whether asthma attacks cause anxiety, or the reverse.
How to Develop Emotional Asthma Control
Knowing you are prepared to handle an asthma attack is one way to counter these catastrophic thoughts, says Katon, who recommends that your asthma management plans include:
-Extra rescue inhalers. Keep them with you wherever you are, and in several places at home, at work, or in school. “Have extras around so you are not ever caught without it†Katon says.
-Emergency numbers and cell phone. Keep your doctor’s number and a cell phone close at hand at all times. Remember that if your asthma does spiral completely out of control, you should call 9-1-1 directly rather than calling your family or doctor first.
-Daily corticosteroid use. If you use a daily, inhaled corticosteroid for asthma control, be sure to take your medication consistently.
-Prep work. Be prepared for ups and downs, There will be seasons when your allergies and asthma triggers are worse. This is a good time to plan several doctor visits in advance, Katon says.
Focusing on how you can improve your asthma control helps you prioritize positive thoughts over negative ones, Katon notes.
Now the Hard Part: Learning to Relax
Even though learning to relax may seem like an impossible task, Katon says people are successful at gaining asthma control, despite stress and anxiety, using techniques learned in:
Yoga
Deep breathing
Meditation
When to Get Help for Asthma Control
If your depression, anxiety, or panic disorder is preventing you from participating in daily activities, even when you usually have good asthma control, you should seek help from a mental health care professional. Katon recommends going to someone who specializes in cognitive behavioral therapy — a style of therapy that can help you concentrate on your strengths and exchange positive thoughts for the negative ones that may be keeping you in a panic and asthma attack cycle.
So, if fear of your next asthma attack is causing you to give up on good asthma control, take heart. With preparation and some relaxation training, you can conquer the intimidating dread of having an asthma attack.
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