How to Tell If It's Asthma or Anxiety

At my last job, I managed multiple webinars every month. After each webinar, I would carefully comb through the comments and suggestions to make sure the webinar topics were meeting the needs of people across the United States.

One of the most common questions asked was, "How do you know if the symptoms someone is having are caused by anxiety or asthma?"

This question usually came from school nurses who wanted to make sure they were treating students correctly. I remember when my kids were in public schools and the overwhelmed school nurse would treat one kid for asthma, another for diabetes, and then another for a seizure.

Sometimes, kids at school can overact when they are in a stressful situation. I know this all too well, as my kids seemed to turn into different people in their teenage years.

So how does a school nurse (or anyone else for that matter) know if a student is having an asthma attack or having an anxiety/panic attack?

Should the nurse treat them for an asthma attack? Or was the student having an anxiety attack? How can they tell which is which?

This is like asking which came first – the chicken or the egg?

Comparing anxiety and asthma

Anxiety can trigger an asthma attack (in fact, any strong emotion can trigger an asthma attack.) And anxiety can also make an asthma attack worse.¹

When I have a sudden asthma attack (you probably know the kind – where you are coughing so hard you almost throw up.) I have a hard time breathing because I'm having an asthma attack, and I panic/am anxious because I am having a hard time breathing – which makes my breathing worse, which makes me more anxious...

And around and around and around I go.

The American Lung Association (ALA) has a graphic that explains “Asthma vs. Panic” (or anxiety).¹ Some symptoms of asthma and anxiety can seem the same. Let's look at the symptoms for both.

Symptoms of an asthma attack

Common symptoms of an asthma attack include:¹

• Coughing
• Wheezing
• Shortness of breath
• Chest tightness or pain
• Mucus production

Symptoms of anxiety

Common symptoms of anxiety include:¹

• Shortness of breath
• Chest pain
• Sweating
• Pounding heart
• Trembling/shaking
• Nausea and or upset stomach
• Dizziness or lightheaded

As you can see from the lists, there are a few symptoms that are the same, like shortness of breath or chest pain.

But the ALA says:

“Coughing, wheezing, or mucus production does not normally happen during panic attacks but often occur during an asthma attack.”

So that's the difference!

What do you do if you are having an asthma attack and also anxiety?

I have had asthma all my life, but there are still sudden and severe asthma attacks that really scare me. So I use my albuterol inhaler or have a breathing treatment with my nebulizer.

But then I also belly breathe (it's like a short version of yoga breathing).

I breathe in slowly through my nose and exhale slowly through my mouth. That noisy exhale helps me HEAR that I am still breathing okay. It reminds me that I will be okay – I just need to wait for the albuterol to kick in.

I hope this explains the difference between asthma and anxiety.

Keep breathing, fellow asthma peeps!