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-related 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. Try to find people who can help with these areas.13 Avoid situations that cause you stress.
  • Try relaxation and breathing techniques.8
  • Exercise.13
  • Get enough sleep.13
  • Eat a healthy, balanced diet.13
  • See a mental health provider about anxiety and depression.8
Written by: Sarah O'Brien | Last Reviewed: May 2016.
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