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Strong Emotions, Stress, and Depression

Some people with asthma report that hard laughing or crying causes asthma symptoms. In fact, health care providers trying to diagnose asthma may ask whether emotions cause trouble breathing.1 Unfortunately, asthma triggered by strong emotions or stressful events has not been well studied. One reason is that it is hard create an experiment that causes strong emotions, because everyone reacts to things differently.

Much more is known the effect of chronic stress and depression on asthma. People with asthma are more likely to have depression than people with healthy lungs.2 For a number of reasons, depression and stress can make asthma harder to control.

Emotions and stressful events

In one experiment, researchers measured lung function while people looked at pictures.3 They found that people who looked at pictures of catastrophes, injuries, and disgusting things had a harder time breathing. Later, this group of people rated their mood three times per day for three weeks and measured their lung function with a peak flow meter. This study was very small, but it showed that negative emotions can cause lung function to decrease.3 These results were true for people with and without asthma, but lung function went down more in people with asthma.

In some studies, having recently had a serious life event was linked to asthma attacks in children and hospital admission for adults.4,5 However, not all studies have found this link. A large study in Europe showed that job strain did not increase the risk of severe asthma attacks.6

One theory is that mood plays a role in how people perceive their symptoms.7 Interestingly, after a negative experience, everyone–with and without asthma–reports having more respiratory symptoms.

Ongoing stress and depression

Depression and anxiety are more common in people who have asthma.8 Having a mental health condition and asthma together can lead to:8

  • Worse control of asthma symptoms
  • More asthma attacks
  • More visits to the emergency department

Panic attacks may feel like asthma attacks, and it can sometimes be difficult to tell them apart.

Chronic stress and hardship are also linked to worse outcomes in asthma.1 Children who are always stressed have more asthma attacks.1 In adults, more stress often means more symptoms, missing more doses of medication, and worse quality of life.9

The reasons that stress makes asthma worse are not entirely clear. Stress causes your body to produce stress hormones. Having high levels of stress hormones over time could make airways more sensitive to allergens, infections, and pollutants.10 Your body may not respond as well to asthma medications when it is under stress.10

Ongoing stress and hardship may make it difficult to manage asthma. When you are juggling a lot, it can be hard to afford medication, pick-up refills, get to appointments, and remember to take your medication (or give it to children).1 You might be so busy with other concerns, that you do not notice when your symptoms get worse.

How common is stress-induced asthma?

Among people who had serious psychological distress in the past year, the risk of asthma is 50% to 70% higher than people without distress.11 Among people diagnosed with depression in the past year, the risk of asthma is also about 70% higher. The highest levels of stress are seen in inner-city residents, Puerto Ricans, and African Americans/blacks.9 Asthma rates in these groups are disproportionately high.12

What can I do to reduce stress and manage my emotions?

  • Identify the things that cause you stress, such as money or relationships, and try to find people who can help with these areas13
  • Avoid situations that cause you stress and that trigger stress-induced asthma symptoms
  • Try relaxation and breathing techniques8
  • Exercise13
  • Get enough sleep13
  • Eat a healthy, balanced diet13
  • See a mental health provider about anxiety and depression8
Written by: Sarah O'Brien | Last Reviewed: May 2016.
  1. 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:
  2. Zielinski TA, Brown ES, Nejtek VA, Khan DA, Moore JJ, Rush AJ. Depression in asthma: Prevalence and clinical implications. Prim Care Companion J Clin Psychiatry. 2000;2:153-158.
  3. von Leupoldt A, Ehnes F, Dahme B. Emotions and respiratory function in asthma: a comparison of findings in everyday life and laboratory. Br J Health Psychol. 2006;11(Pt 2):185-198.
  4. Sandberg S, Paton JY, Ahola S, et al. The role of acute and chronic stress in asthma attacks in children. Lancet. 2000;356:982-987.
  5. Wainwright NW, Surtees PG, Wareham NJ, Harrison BD. Psychosocial factors and incident asthma hospital admissions in the EPIC-Norfolk cohort study. Allergy. 2007;62:554-560.
  6. Heikkilä K, Madsen IE, Nyberg ST, et al; IPD-Work Consortium. Job strain and the risk of severe asthma exacerbations: a meta-analysis of individual-participant data from 100 000 European men and women. Allergy. 2014;69:775-783.
  7. von Leupoldt A, Dahme B. The impact of emotions on symptom perception in patients with asthma and healthy controls. Psychophysiology. 2013;50:1-4.
  8. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention 2014. Accessed 11/12/14 at:
  9. Yonas MA, Lange NE, Celedón JC. Psychosocial stress and asthma morbidity. Curr Opin Allergy Clin Immunol. 2012;12:202-210.
  10. Rosenberg SL, Miller GE, Brehm JM, Celedón JC. Stress and asthma: novel insights on genetic, epigenetic, and immunologic mechanisms. J Allergy Clin Immunol. 2014;134:1009-1015.
  11. Arias D, Becerra BJ, Becerra MB. Racial and ethnic differences in asthma and mental health among US adults: Results from the National Survey on Drug Use and Health. J Asthma. 2015 Jan 13:1-23.
  12. President’s Task Force on Environmental Health Risks and Safety Risks to Children. Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities. May 2012. Accessed 12/9/14 at:
  13. Cleveland Clinic. Stress and asthma. Accessed 1/19/15 at: