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Stress and Asthma

When stress levels go up, asthma symptoms can go into overdrive. What’s the link, and how can asthma and anxiety be managed?
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When stress levels start to creep upward -- whether it's over bills, work, or your kids -- jam-packed calendar -- asthma symptoms can kick into overdrive. As the wheezing and coughing gets worse, your health becomes one more reason to worry. Asthma and anxiety make for a vicious circle, and one that can spiral downward quickly.

"Asthma is triggered by many things, and one of them is stress," says Pramod Kelkar, MD, a fellow with the American Academy of Asthma Allergy and Immunology (AAAAI).

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"So look at the big picture: just as you manage exposure to triggers like cigarette smoke and pet dander to keep symptoms from getting worse, stress -- as a trigger -- needs to be managed as well."

Stress and Asthma: What's the Connection?

"Stress can affect the cardiovascular, gastrointestinal, musculoskeletal, immune, and central nervous systems," says Paul Rosch, MD, president of the American Stress Institute. "In fact, it's difficult to think of any disorder in which stress has not been shown to have an aggravating role.

Asthma is no exception.

Stress can create strong physiologic reactions that lead to airway constriction and changes in the immune system, which can worsen asthma symptoms.

"The mechanism between asthma and anxiety is many-fold," says Kelkar, a physician at Allergy and Asthma Care in Maple Grove, Minn. "Uncontrolled emotions can work the nerves and cause constriction of muscles, like the smooth muscles of the airways in the lungs. They tighten up and constrict, which can worsen wheezing, coughing, and chest tightness in people with asthma."

Although stress and anxiety start in your mind, asthma is a physical disease of the lungs.

"It is important to note that asthma is not a psychosomatic disease," Kelkar tells WebMD. "It's not in your head. Stress can trigger symptoms if you already have the disease, but if you don't have it, stress does not all of a sudden cause a person to develop the disease of asthma."

The Brain's Impact on Asthma and Stress

The brain-body link between asthma and anxiety is starting to be better understood. Led by researchers from the University of Wisconsin, a group of scientists found that certain areas of the brain cause worsening asthma symptoms when a person is under stress.

Researchers exposed a group of people with mild asthma to triggers that caused both inflammation and muscle constriction. When symptoms flared, the participants were asked to read words that were either emotionally charged, such as "lonesome"; neutral, such as "curtains"; or asthma-related, such as "wheezing."

They found that the words linked with asthma increased inflammation and activity in parts of the brain that control emotions.

The results, published in the Proceedings of the National Academy of Science, show a possible link between emotions and asthma. Although it's only preliminary research, it does start to connect the dots. Until researchers find a clear link between anxiety and asthma, keep symptoms in check by managing stress and treating asthma with appropriate medication.

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