Emotional and Social Effects

The psychological impact that asthma has on any individual person is determined by many factors, such as:

• asthma severity
• limitation of activities due to asthma
• social and family support available
• age at which asthma symptoms started
• level of asthma-related skills and knowledge
• overall personality and coping style

Each person's asthma experience is unique, but there are some feelings that many people with asthma experience at one time or another.

Fear and Anxiety - Difficulty breathing, leading to the sensation of "air hunger", can of course be terribly upsetting. It is common for people with asthma to experience fear that they are going to die during an asthma episode. The fear of dying then can become more general and continue when the person is not having active symptoms. Asthma episodes are for most people somewhat unpredictable, and unpredictable events are known to be more stressful than events that can be anticipated and prepared for. Feeling that another asthma episode could start at any time may cause a person to feel anxious constantly.

Hypervigilance - To be vigilant is to be watchful, so hypervigilance is being too watchful. A person with asthma can sometimes get so focused on when another asthma episode might occur as to be alarmed by even small and normal bodily changes (for example, heart rate increasing with activity).

Loss of Control - Asthma (especially asthma that is not effectively controlled) can lead a person to feel out of control in life. If you feel as if your efforts don't do any good anyway, it may make you stop even trying to take care of yourself. People who feel out of control in one area may also try to make themselves feel more secure by exerting extra control in other areas (such as the workplace, or relationships with family and friends).

Denial - Having asthma can involve a lot of anxiety and fear. Denial is one natural mechanism that humans have to deal with an excess of anxiety and fear. We seem to "forget" the thing that is causing us to feel anxious so that we can keep functioning and not be paralyzed by our emotions. Unfortunately, denial can also prevent a person with asthma from doing the things he needs to do to stay healthy and prevent serious asthma episodes.

Anger - As with other diseases, the basic truth is that asthma isn't fair. It places demands on the people affected by it. It causes discomfort and worry. It can limit a person's activities. And nobody deserves it. Most people with asthma will feel angry at some point about having the disease. This may be a part of a person's reaction to the initial diagnosis of asthma, or may crop up much later. If you don't have a chance to acknowledge and talk about feeling angry, the unresolved emotion can sometimes make it difficult for you to take the best possible care of yourself.

Guilt - Even if you understand that asthma is not something you caused, and that you can't make it go away, you can still sometimes have irrational feelings of guilt. Children may be especially prone to blame themselves for the disruption their asthma causes on their families. Frequent reassurances that asthma is nobody's fault can help.

Embarrassment - It can, for most of us, be uncomfortable at times to feel different from those around us. Aspects of having asthma such as using an inhaler or avoiding triggers, as well as the asthma symptoms themselves, can make a person feel conspicuous and set apart from others. These feelings can be particularly difficult for children and adolescents. The desire to fit in with a peer group or not to appear different can sometimes lead people with asthma to neglect important parts of their own asthma care.

Confusion - Especially in the period following the initial asthma diagnosis, a person can feel overwhelmed by all of the information there is to take in. Asthma is a complex disease, with many aspects to understand and, often, many steps to take (such as taking medicines, watching for symptoms, taking peak-flow measurements, keeping a daily record, deciding when to seek urgent care, and so on). If the feelings of confusion are too severe, a person may give up on trying to understand asthma and the steps to take to stay well.

There is, of course, no one right way to go about dealing with the emotions that asthma can cause. There are some strategies, though, that many people find particularly useful.

Acknowledge and accept the feelings you're having. Pretending you don't feel a certain emotion doesn't make it go away. It just makes it more difficult for you to address the feeling and its underlying cause.

Take an active role in taking care of yourself. Learn about the disease and what you can do to stay as healthy as possible. Ask questions when you see your health care provider, and make it clear you want to participate in your own care. Make the changes you know you need to make. Not only will your asthma get better, but you will feel more in control of what happens to you.

Learn and practice relaxation exercises or meditation. These have been shown not only to reduce asthma-related stress and anxiety but also, in some cases, actually to reduce the physical symptoms of asthma.

Find yourself a health care provider you feel comfortable with. A health care provider who is patient and understanding, and who has the time to explain things and answer questions, can be of significant help. Talk with your health care provider about the emotions that asthma causes for you. They are an important part of how you experience the disease. Also, pay attention to your own preferences. Even if other people swear by Dr. X, you may find you actually communicate better with Dr. Y.

It is important, too, to note that psychological factors do not cause asthma. Half a century ago, psychoanalytic theories of the origin of asthma were popular, but these have fallen out of favor as we have learned more about the biology of asthma and its genetic and environmental elements. Emotions can, however, be asthma triggers. Some people find they are more susceptible to asthma episodes when they are under a lot of stress. Emotional responses like laughing and crying can also sometimes trigger an attack.

For more about children and psychological effects of asthma, go to Children and Asthma.