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Asthma and Anxiety Disorders

Does anyone have both? I have health anxiety, so it doesn’t help my cause. I believe my asthma was flaring up this morning and for some reason, it sent me into freak out mode. I did my rescue (Pro Air) and I’ve been doing my maintenance inhaler (Symbicort) twice a day. I’ve actually noticed a sort of uptick in my anxiety since I started doing my Symbicort. Is it possible for the medicine to do that? I’m coming off the anxiety attack now, still a bit shaky but feeling better than I was. Am I the only one who has an anxiety disorder and asthma? I’ve read that there is some correlation but it doesn’t make me feel any better about it! I have anxiety meds but I don’t like to take them (I guess I’m overly paranoid about developing a dependency!)

I don’t even know how severe my asthma actually is. My doctor said she could hear some wheezing and gave me my meds. I don’t have an allergist nearby who takes my insurance, so I’ve been relying on my PCP to help me. She’s been great and I’d like to ask her if she could tell me how severe it is without making it seem like I’m questioning her. Does that make sense? 

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  • K8sMom2002

    Hugs, Hufflinpuff! Anxiety can be a trigger for asthma, so figuring out how it impacts your asthma is definitely important.

    One way doctors decide how "severe" asthma is to use guidelines. AAFA has a great that helped me talk to my doc.

    It stinks that you don't have an allergist in your insurance network close by … but since you have a great working relationship with your PCP, how about looking for one a bit further? 

    And since you don't like to manage your anxiety with meds (totally understandable — I'm a minimalist myself!), could you reach out to your PCP about a referral to a therapist who has experience with chronic health conditions and uses cognitive behavior therapy? That can help you "re-train your brain" to not always go to the worst case scenario. I know I have used a lot of CBT techniques to help me avoid imagining the worst!

    We've had to do that with our DD … our allergist and other specialists are about three hours away, but we have a great working relationship with her primary care physician, and for day-to-day stuff, we can either work with our primary care physician or we can reach out by phone or email to her specialists. I wasn't sure how it would work when we first went down this path, but it's the best of both worlds.

  • Shea

    Hi Hufflinpuff! I have never been diagnosed with an anxiety disorder but I have had anxiety attacks in the past (years ago) and so I know how crazy they can be! I now have a chronic disease where asthma is one of the symptoms, and I know that when I have very stressful events, my anxiety goes up AND my asthma flares up– and neither one is good for the other like you say. Part of it is that most inhalers do increase heart rate and anxiety can increase as a result, but doesnt necessarily HAVE to. I have noticed that when I am in a safe calm place, like my bedroom, and use my daily inhalers (mine are flovent and combivent) then my anxiety doesnt spike. I usually will sit/lay for about 10 minutes and go over my day's pland in my head. If I do that then I typically will not need my rescue inhaler– which to me when I am anxious in the middle of the day and my breathing starts acting up anf I am busy and about and then need my rescue inhaler– that is when my heart will really race and anxiety will go up, and THAT is what I try to avoid. Sometimes throughout the day when I notice I am holding my body tighter and feeling stressed I will take a step back– sometimes even excuse myself to the restroom, and just try a few relaxing breaths and calm my mind. That helps me. I do not like xanax (zonks me out, afraid of dependence, tends to spike high relaxation and high anxiety cycles) so if my anxiety even did get big again I would probably request clonopin (take low dose regularly for a certain amt of time to sort of jump start a moderate level of anxiety cycle, and then wean off an monitor it from there). Everyones situation is unique and it is definitely necessary to have a healthcare provider to chat about your options with. For me, asthma trumps anxiety as far as the risk-benefit ratio, so I take my asthma meds even if they do cause anxiety to go up a little, because asthma can be deadly and breathing is so important. But– I do other things to help my anxiety levels too. I hope sharing my experience is helpful to you, sry if it is a novel!!!

  • Brenda Silvia-Torma

    I have both as well and have wondered about the same thing…thank you for starting this conversation!!  I'll let you know if I figure anything out along the way. 

  • HufflinPuff

    Thanks everyone. I think that the worst part for me is wondering "do I need my inhaler?" I have some issues in my thoracic spine (text neck because smart phones), and it causes my back to hurt in an area that's relatively even with my chest. I feel that back pain in my chest, and that always freaks me out. That's where the anxiety starts, and then I start to notice other things, which make me more anxious. I hate that cycle. I feel like I'm probably not as bad as I think, but for some reason, trying to tell myself that doesn't work. I can point out rational reasons for things to other people, but I just can't do it myself!

  • LK
    HufflinPuff posted:

     I feel like I'm probably not as bad as I think, but for some reason, trying to tell myself that doesn't work. I can point out rational reasons for things to other people, but I just can't do it myself!

    HufflinPuff, I hear you on that!!  It is so much easier to see the reality when I am not the one in (possible) dire straits.  I also hear you on the uncertainty of knowing when to use my rescue inhaler.  It has taken me a long time to learn if I should go ahead and use it or wait a little while to see if I need it.  There are still times when I am not sure if I should use it or not.

    When I was first diagnosed I was told that over using my rescue inhaler would make my cough-variant asthma worse so I didn't use it even when I probably should have.  So naturally I decided to use it only when I was in deep distress.  Not a good idea. 

    There are times when I think I may need it and I am finally getting to the point of using it then instead of waiting, coughing more, chest tightening more and then really needing it.   

    So for me, I had to use it sometimes when perhaps I didn't need it and sometimes when I did need it, but it is an ongoing process of trial and error to find the right balance for me.

    Hope some of this makes sense and is helpful for you!!

  • K8sMom2002

    Hufflinpuffin, more hugs … I so know that feeling — it was very familiar to me when I was first diagnosed. Could you talk to your PCP — it sounds like you have a good relationship — and ask your doc to help you come up with an emergency action plan?

    AAFA has a that your doc can use to help you figure out when to use your inhaler. It's based on the idea of "asthma zones." Here's a "know your asthma zones" chart. That helped me to talk with my doc. And with my DD's and my asthma, I needed to get specific about scenarios. I'd say, "Okay, this is what happened… Should I have used my inhaler? If so, when?"

  • Shea

    The asthma zones above are good tools to refer to I think, and also good to bring to doctors appointments to refer to so that you have a plan you feel comfortable with.

    The longer I have had asthma, the more comfortable I have gotten recognizing signs of attacks, recognizing triggers, and knowing my limits, also knowing what to do to calm my asthma. I always have my inhalers with me. Today, I had just finished getting groceries and a thunderstorm was looming. I noticed it was tougher for me to breathe and I had a wheeze on the exhale. Before I drove home I used my inhalers (flovent and combivent). I am precribed to take them 2x a day and it was near the time I do my evening dose. If it had been earlier I would have just used my rescue inhaler (albuterol). My flovent is an inhaler that I use 2x a day every day no matter what… It is a controller med and wont work properly if I took it "as needed". My combivent is also prescribed to me as 2x a day. My rescue inhaler is "as needed", but if I find myself needing it more than once a day then I will call my doctor. That is just an example of my plan– everyone kind of has a unique plan so dont follow mine ver batim or anything, but I think its a good idea to talk with your doc and set up which meds are daily, which ones are as needed and when to call the doctor, and what to do in energency. Some people on here do refer to peak flow measurements as good indicators of their asthma and you can refer to it before and after using your inhaler as a biofeedback tool. That is another thing you could ask your doctor about. 

  • LK

    Shea,  You always know how to write detailed information so it makes sense and is well understood.  Thank you for saying it so succinctly.

  • Brenda Silvia-Torma

    Before walking out the door yesterday to pick up my DD from camp, my husband texted me to say the air quality was bad…which led me to realize that I needed to take two puffs and wait 10 minutes before walking outside. When I got home (after gassing up the car and picking up DD), I didn't feel the heaviness. If I hadn't taken the ProAir, I might have wondered if it was anxiety or asthma and then would have had to play "catch up" on feeling better. 

    I felt really good knowing that I prevented a problem with my asthma!!! 

  • LK

    Exactly, Melissa - 

    Melissa G posted:

    Way to go Dh and Brenda! Glad the pro-air helped you!

      Good job, Brenda and your DH!!!

  • K8sMom2002

    SO glad, Brenda! and

    Shea, I'm with Lisa … you put it exactly right! That's why it's so helpful to talk with doctors about what to do when, because none of us were made with cookie cutters!

    Anxiety can make things very hard to sort out … this morning, my DD was completely freaked out by a place on her leg, especially after her friends had scared her with tales of horrid staph infections and spider bites. But a wonderful friend texted me encouragement this AM and reminded me to remind DD: Don't FOBFO — don't freak out before finding out.  

    It's perfect to help me remember! And wouldn't you know, after being reassured by the doc that her leg WOULDN'T fall off and that antibiotics would fix it right up, the pain seemed less intense when she got home. Phew! 

  • LK
    K8sMom2002 posted:

    : Don't FOBFO — don't freak out before finding out.  

    Cynthia,  I love this acronym!  Thank you for sharing it!  I can always count on you to have the perfect way to look at a situation!

  • K8sMom2002

    I shall forward your compliment on to my friend — she's a treasure, the most positive person I know. 

    It helps me to have lots of little memory aids to help me get through things — like BRAND for talking with docs and OHIO for reminding me not to procrastinate or toss things down, and now this lovely abbreviation — I know I will use it often. And drive my DH and DD crazy with it.

  • HufflinPuff

    Hi Melissa!

    Thank you so much for thinking of me! I’m definitely feeling better these days. I had a spirometry test done and they said my asthma is “intermittent”, so it made me feel better to know that it’s not as severe I was afraid it was. My doc said to keep up with the Symbicort and Zyrtec in the morning and then the Fluticasone at night, and if it’s a bad air quality day, take my rescue about ten minutes before I go out. It’s been very helpful!!

  • Melissa G

    That is fantastic news!! Very glad to hear it! Have you had any problems with the weather changes?

  • HufflinPuff

    A few! It seems that this is the worst time of the year for a lot of people, I’m definitely no exception!

  • Melissa G

    This year has been really bad! Have you seen our ? Some areas are definitely worse off than others.