Living with asthma can be stressful, and stress can make asthma worse. Practicing stress-reduction techniques and taking steps to manage asthma can help break the cycle.
Asthma is a chronic respiratory condition that involves shortness of breath, wheezing, and coughing. It’s caused by inflammation and narrowing of the airways, and it can range in severity from mild to life threatening.
If you live with asthma, you’re not alone. More than 25 million people in the United States are also living with this noncommunicable respiratory condition, according to the
Many things can trigger asthma and cause your symptoms to worsen. Common triggers include:
- respiratory infections
- pet dander
- extreme weather conditions
Strong emotions and stress can also be major asthma triggers, according to the American Lung Association.
According to a 2020 study, long-term stress in early life is associated with an increased risk of developing asthma. And both acute and chronic stress may exacerbate symptoms in those already living with the condition.
Life can be stressful — and asthma can add to that stress. So, how do you manage stress when you have asthma, especially if it’s a known trigger for you?
Asthma is often unpredictable. You can never fully know when or where you might experience respiratory symptoms, or what specific symptoms you might have.
Tamara Hubbard, a licensed professional counselor and allied health member of the American College of Allergy, Asthma & Immunology (ACAAI), explains that both physical and mental stress are part of the package.
Apprehension about symptoms can lead to social avoidance, feelings of embarrassment, and fear of stigmatization on top of your physical discomfort.
Dr. Sandeep Gupta, a pulmonologist with Memorial Hermann in Houston, Texas, adds that chronic asthma brings chronic stress.
“Missed work days and expenses for medical care can have significant financial implications,” he says.
Stress may also affect your ability to follow your asthma treatment plan. Gupta notes that not sticking to treatment plans can make your health decline further.
You may also experience stress due to having avoid triggers, such as certain foods or environmental allergens. If your asthma is severe, there’s the added pressure of always needing to be prepared for a respiratory emergency.
Forgot to bring your inhaler with you? Talk about a huge jump in stress and apprehension.
Types of stress
Stress isn’t inherently bad. It’s your body’s response to challenges. How long it sticks around and why it’s there, however, matters.
Stress can be broadly divided into two types:
- Eustress is stress that’s a positive force in your life, driving you to grow or achieve goals.
- Distress is stress that negatively affects you physically, psychologically, or both.
Stress can be short-term (acute) or long-term (chronic). Acute stress helps give you a physiological boost to overcome obstacles. Those changes in your body aren’t meant to stick around forever, though, and if stress becomes chronic, they can start to compromise your health.
When you’re stressed, you’ve probably noticed some changes in your body, such as elevated heart rate, flushed skin, nausea, or — you guessed it — rapid breathing.
These are all part of your body’s natural reaction to something it perceives as a threat. But they’re also factors that can complicate asthma.
“Rapid breathing leads to incomplete exhalation and leads to air trapping and worsening asthma symptoms,” says Gupta. “Stress may change inflammatory response to allergens and decrease sensitivity and response to bronchodilators.”
Dr. Purvi Parikh, an allergist and immunologist in New York City, adds that stress makes every chronic condition worse, and asthma is no exception.
“[It puts] the body into an inflammatory state, raising cortisol, and decreasing immunity,” she explains.
Signs and symptoms of stress
- sleep disturbances
- gastrointestinal upset
- sexual dysfunction
- problems concentrating
- mood changes
- skin conditions
- muscle pain
- appetite changes
- weight fluctuation
- frequent illness
- flushed skin
- increased heart rate and respiration
- high blood pressure
- sensation of chest tightness
Stress — the kind that keeps you in a negative state — doesn’t just affect you physically.
Stress can affect how you manage your asthma, says Hubbard. You may be less likely to follow your treatment routines or to pay attention to changes in your asthma symptoms, which can translate to more frequent hospital visits.
Gupta adds that stress can also lead to mood disorders such as anxiety and depression, which may make you even less likely to follow through with daily medications or treatments.
At the heart of it all, stress can make asthma more difficult to control, says Hubbard, and can lead to medication overuse.
“Stress-induced asthma symptoms can present the same as other asthma symptoms,” says Hubbard.
If you notice wheezing, coughing, or shortness of breath during high-stress times, it’s a good indication that stress is a trigger.
Stress can be insidious and challenging to recognize at first. But identifying your stressors is the first step toward managing them.
Parikh recommends paying attention to the things in life that cause you anxiety, tension, anger, or feel draining. These can be early warning signs that you’re dealing with a stressor.
Even positive experiences, such as having a baby, can create a situation of stress, Hubbard says. In order to identify stress in your life, she suggests an introspective approach of:
- Observing: What are you feeling? Where are you feeling it in your body?
- Exploring the effects: How does it affect your functioning? How does it affect important areas of your life?
It’s not always possible to avoid all sources of stress in your life, but you may be able to change how you respond to them.
For example, the American Psychological Association recommends asking yourself if you can change the situation that’s stressing you out, perhaps by letting go of some responsibility or asking for help.
Stress is a part of life, but it doesn’t have to be all-consuming. While you may not be able to avoid stress completely, you can take steps to reduce or manage it.
One of the simplest ways to manage stress in the moment is to remember it won’t last forever, says Gupta. However, both short-term and long-term stress can benefit from immediate coping strategies, such as:
- deep breathing
- body-awareness techniques
Body awareness: The 5-4-3-2-1 method
Hubbard recommends the 5-4-3-2-1 method for distress in the moment.
This is a mindfulness technique in which you use your five senses to help ground yourself in the present moment.
Take several deep breaths, then look around and notice:
- 5 things you can see
- 4 things you can touch
- 3 things you can hear
- 2 things you can smell
- 1 thing you can taste
There are also many strategies that can help you manage long-term or chronic stress.
Meditation is a mind-body practice that can help you clear your mind, focus on the present moment, and reduce stress.
If you’re new to meditating, you may want to start by taking a few minutes to sit in a quiet, comfortable place and focus on taking deep breaths. If your mind starts to wander, simply acknowledge your thoughts and then bring your focus back to your breathing.
Practicing relaxation techniques
Progressive muscle relaxation, guided imagery, and deep breathing exercises are some of the relaxation techniques that can help ease the physical and emotional symptoms of stress.
Keeping a journal or diary of your thoughts and feelings can help
To get started, set aside a few minutes each day to write in a notebook, journal, or your laptop. Don’t set any rules about what to write or not to write — just let your thoughts flow freely.
Making time for things you enjoy
It’s important to make time for activities that make you feel good. You might read a good book, watch a movie that makes you laugh, or spend time with friends and family.
Exercise helps boost levels of endorphins, your brain’s “feel-good” chemicals. Regular physical activity can help reduce stress, boost your mood, and improve your sleep.
If you have exercise-induced asthma, talk with your doctor about how to safely start an exercise routine.
Getting quality sleep
Lack of sleep can contribute to stress. Aim to get at least
If you find your asthma symptoms interfere with your sleep, you may want to consider using dust mite-proof mattress and pillow covers, washing your bedding regularly, keeping pets off your bed, and using a humidifier.
Eating a balanced diet
Aim instead to eat a variety of nutrient-dense foods, such as whole grains, fruits, and vegetables.
Being dehydrated may cause stress and
Having a support system and someone to talk with can be helpful when you feel stressed or overwhelmed. Joining an asthma support group may also help you connect with others who understand what you’re going through.
You can find support groups through the American Lung Association.
Working with a mental health professional
If you feel overwhelmed and self-help strategies aren’t enough, you may consider speaking with a therapist or other mental health professional. They can help you identify your stressors and find ways to manage them.
Talking with your doctor
If your asthma symptoms are causing you stress, speak with your doctor. They may be able to adjust your treatment plan or recommend other strategies that may help.
Hubbard’s deep breathing tips
Deep breathing exercises can help reduce stress. They’re also especially important to do if you have asthma because they can help make your lungs more efficient.
Try these breathing exercises:
- Place one hand on your chest, and one hand on your belly.
- Inhale slowly, expanding your belly fully while aiming to keep your chest as still as possible.
- Exhale slowly, contracting the abdominal muscles as you let that breath out.
- Inhale for 4 seconds.
- Hold that breath for 7 seconds.
- Exhale for 8 seconds.
Being prepared is one of the best ways to make managing asthma less stressful. Parikh and Gupta recommend:
- always carrying an additional rescue inhaler
- visiting your doctor regularly
- developing an asthma action plan for emergency situations
- practicing good hygiene to prevent respiratory infections
- avoiding triggers whenever possible
- taking medications as prescribed
- keeping track of symptoms to help identify patterns and changes
It’s never too soon to speak with someone about stress. A mental health professional can help you uncover stressors in your life, understand how they’re affecting you, and learn new ways to cope.
If stress has significantly affected your work, home, or social life, it may be time to take this step. You can ask your doctor to refer you to a therapist or other mental health professional.
Managing asthma can be stressful, and stress can make asthma worse, but you don’t have to feel trapped in an endless cycle of asthma and stress.
“Knowing how to effectively manage stress and being willing to make lifestyle changes that allow you to do so can lead to more effectively-managed asthma and an increased quality of life,” says Hubbard.