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Asthma and Depression

People with asthma have twice the risk of developing mood and anxiety disorders.
WebMD Feature

Asthma, a chronic disease of the airways, affects more than 22 million people in the U.S.

Most people with asthma have symptoms such as cough and wheezing. But did you know that people with asthma have twice the risk of developing mood and anxiety disorders, including depression?

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Depression, with its feelings of sadness and helplessness, is the most commonly diagnosed mental health disorder. In the U.S., depression is widespread among men (12.7%) and women (21.3%).

Many people with chronic illnesses such as heart disease and diabetes suffer with depression. Yet with poorly managed asthma, the inability to breathe is stressful. This emotional stress can add to depressive feelings and can worsen asthma symptoms.

Understanding the Link Between Asthma and Depression

University of Wisconsin brain imaging and behavior researcher Melissa A. Rosenkranz, PhD, explains that the exact causes of depression in asthma are unknown, but inflammation may hold answers.

Asthma is a chronic inflammatory disease. Rosenkranz tells WebMD that when the presence of inflammation in the body is communicated to the brain, neural (brain) changes take place.

The neural changes can modify behaviors that resemble those seen in depression, says Rosenkranz. Symptoms may include depressed mood, lethargy, decreased appetite, and decreased interest in social interaction.  

Rosenkranz’s study, published in the journal Neuroimage, analyzes clues that may link depression and asthma. Her findings show that as depressive symptoms improve, so does the asthma.  In fact, a reduction in depressive symptoms is linked to a decreased use of asthma medications.

Poorly managed asthma keeps people from being active.  When inactivity combines with difficulty breathing, it triggers a downward spiral that includes:

•         Social isolation

•         Increased feelings of depression

•         Poor asthma management

•         Worsening of asthma symptoms

Depression with asthma is also a side effect of steroid use. This includes anti-inflammatory inhalers and oral steroids commonly used to treat asthma.

Findings show that other nonsteroid asthma drugs may cause irritability, depression, and even suicidal ideation or completion.

Treating Asthma and Boosting Mood

If you or a loved one has asthma, there are nine proactive steps you can take to optimize breathing and protect your mental health:

1.     See your asthma doctor regularly. Your doctor will perform breathing tests to see if your asthma has worsened or if you need further treatment.

2.     If your asthma is poorly controlled, talk to your doctor about changing medications and/or dosages.

3.     Asthma symptoms can correspond with emotional upset. Talk to your doctor about depressive symptoms or other mood disorders.

4.     Be sure to use your asthma inhalers correctly. Medications should spray into the lungs and not hit the roof of your mouth.

5.     Ask about the side effects of asthma medications.  Steroids can cause mood swings for some people. Your doctor can help you cope with emotional side effects.

6.     Take antidepressants according to your doctor’s instructions. Talk to your doctor if the drug is not working. Your doctor may prescribe another antidepressant to find the one that works best.

7.     Schedule more time for physical activity.  Exercise is beneficial to the body. Also, the chemicals produced during exercise may help boost your mood.

8.     Make plans to increase your social network. Being with supportive friends may boost your mood. A strong social network can also increase your compliance to taking asthma medications.

9.     Talk to a counselor to learn positive coping strategies. Cognitive behavioral therapy (CBT) can help you learn to replace negative thoughts with positive statements.

Reviewed on July 14, 2009
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