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Anxiety and Depression

Anxiety or depression often co-exist with asthma. These mental health problems do not cause asthma, but they do make asthma harder to control.1 Treating asthma requires effort every day. You have to know which medications to take and remember to take them daily. You may clean or do other things regularly to avoid exposure to triggers. You have to pay attention to your symptoms and know how to treat them if they get worse. If you are feeling overwhelmed, stressed, or depressed, this can be a lot to manage.

Both anxiety and asthma cause symptoms like shortness of breath and chest tightness. Panic attacks can feel like asthma attacks. It may be difficult for you to know what is happening and what treatment to use. Anxiety is related to hyperventilation. Hyperventilation is not an asthma symptom, but it can make people with asthma feel like their symptoms are not well controlled.2

What are the symptoms of anxiety and depression?

Symptoms of an anxiety disorder are:3

  • Feelings of panic and fear that overwhelm you.
  • Obsessive thoughts that are difficult to control.
  • Painful, intrusive memories.
  • Nightmares.

Physical symptoms of anxiety include a sick feeling in your stomach, having butterflies, feeling your heart pound, having chest pain, sweating, being easily startled, or feeling tense.3

Typical depression symptoms include:4

  • Depressed mood.
  • Loss of interest in activities you once enjoyed.
  • Difficulty concentrating.
  • Feeling worthless or guilty.
  • Suicidal thoughts.

Some people with depression have physical symptoms, such as stomach or back pain, changes in appetite, constipation, fatigue, headache, difficulty sleeping, or excessive sleepiness.4

How do anxiety and depression affect asthma?

Having depression or anxiety leads to worse asthma outcomes.5 People with these co-existing conditions have more asthma symptoms and asthma attacks. They go to the emergency department more often.

Your asthma symptoms may feel more intense if you have depression or anxiety.6 For example, the feeling of breathlessness may be more distressing when you are already anxious. Of course, anxiety is a normal response to feeling unable to breath deeply enough.6 In fact, some anxiety can be useful. It might motivate you to avoid triggers, take your medication, and see your health care provider.

However, for many people, anxiety and depression get in the way of managing asthma. Feeling depressed or overwhelmed can make it difficult to work with health care providers. It can be harder to remember to take medications or pay attention to your symptoms.1

How common are comorbid asthma and anxiety or depression?

People with severe or difficult-to-control asthma are prone to anxiety and depression.6 More than 18% of veterans had co-existing asthma and depression in one study.7 In another study of people with mild asthma, 11% were currently depressed and 14% had a history of depression.8

Estimates of anxiety in people with asthma range widely, from 16% to 52%.6 Results from the National Health Interview Survey show that 7.5% of people with asthma have serious psychological distress. In comparison, only 3% of the total population has serious distress.6

How are anxiety and depression treated?

Anxiety and depression are medical conditions. They are treated with medication and counseling.9,10 Medications help to normalize chemicals in your brain.9 With counseling, you can learn how to cope with anxiety. You will learn ways to help you to feel in control.10 Counseling may focus on your relationships, thoughts, and beliefs. It may also focus on the effects of your behavior and healthy alternative behaviors.9

What effect does treating anxiety and depression have on asthma?

No one knows with certainty if treating a mental health condition can improve asthma.6 There has not been enough good research. A small study showed that asthma improved after people learned how to control panic.11 Two small studies showed that reducing depression symptoms also reduced asthma symptoms.12,13

Written by: Sarah O'Brien | Last Reviewed: May 2016.
    National Heart, Lung, and Blood Institute. Expert panel report 3 (EPR-3): Guidelines for the diagnosis and management of asthma - Full Report 2007. Accessed 11/12/14 at:
  1. Meuret AE, Ritz T. Hyperventilation in panic disorder and asthma: empirical evidence and clinical strategies. Int J Psychophysiol. 2010;78:68-79.
  2. American Psychiatric Association. Anxiety disorders. Accessed 2/10/15 at:
  3. Maurer DM. Screening for depression. Am Fam Physician. 2012;85:139-144.
  4. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention 2014. Accessed 11/12/14 at:
  5. Thomas M, Bruton A, Moffat M, Cleland J. Asthma and psychological dysfunction. Prim Care Respir J. 2011;20:250-256.
  6. Sumino K, O'Brian K, Bartle B, et al. Coexisting chronic conditions associated with mortality and morbidity in adult patients with asthma. J Asthma. 2014;51:306-314.
  7. Trojan TD, Khan DA, Defina LF, et al. Asthma and depression: the Cooper Center Longitudinal Study. Ann Allergy Asthma Immunol. 2014;112:432-436.
  8. Depression. Accessed 2/10/15 at:
  9. Generalize Anxiety Disorder. Accessed 2/10/15 at:
  10. Lehrer PM, Karavidas MK, Lu SE, et al. Psychological treatment of comorbid asthma and panic disorder: a pilot study. J Anxiety Disord. 2008;22:671-683.
  11. Brown ES, Howard C, Khan DA, Carmody TJ. Escitalopram for severe asthma and major depressive disorder: a randomized, double-blind, placebo-controlled proof-of-concept study. Psychosomatics. 2012;53:75-80.
  12. Brown ES, Vigil L, Khan DA, et al. A randomized trial of citalopram versus placebo in outpatients with asthma and major depressive disorder: a proof of concept study. Biol Psychiatry. 2005;58:865-870.