In our recent episode with Tony Hale, we talked a lot about asthma. But what exactly is asthma? Well, asthma is a chronic inflammatory condition that affects the airways. Individuals with asthma often experience chest tightness, shortness of breath, and coughing fits. During an asthma attack, an individual may experience constriction of the airways and bronchi of the lungs. In acute cases, this can even lead to death by asphyxiation (Mims, 2015; Yang et al, 2017). While the condition may appear to be completely physical in nature, it is strongly interrelated with and influenced by one’s mental health.
Research suggests that individuals with chronic conditions (asthma included) are at a significantly increased risk of developing anxiety and depression (Dudeney et al., 2017; National Institute of Mental Health, 2021). In fact, an estimated 22.7% of people with asthma have a comorbid anxiety disorder, and several large studies were even able to show that the average asthmatic scores significantly higher on depression scales than their non-asthmatic counterparts (Del Giacco et al., 2016; Dudeney et al., 2017; Zielinski et al., 2000). The long-standing question is why?
There are several likely reasons as to why asthma is so commonly coupled with mental health conditions. First off, asthma, like other chronic conditions, can interfere with an individual's ability to engage in activities that they enjoy. Often exercise and physical activities can exacerbate asthma symptoms, making it difficult to stay in the moment and focus on the task at hand (Detweiler-Bedell et al., 2008). Secondly, asthma attacks are an incredibly traumatic experience. Losing your ability to breathe and needing to be rushed to the hospital is a scary situation that can easily lead to the development of anxious tendencies (Arcaya et al., 2014). Third, asthma causes chronic levels of inflammation, which has been shown to play a role in the pathogenesis of anxiety and depressive disorders (Eisenberger & Moieni, 2020; Yuan et al., 2019).
As you can see, the experience of an asthmatic person is more complex than you may have guessed. The interplay between physical and mental illness can easily be seen, further strengthening the argument behind the mind-body connection.
Sources:
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Mims, J. W. (2015). Asthma: definitions and pathophysiology. International Forum of Allergy & Rhinology, 5(S1), S2–S6. https://doi.org/10.1002/alr.21609
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Yang, I. V., Lozupone, C. A., & Schwartz, D. A. (2017). The environment, epigenome, and asthma. Journal of Allergy and Clinical Immunology, 140(1), 14–23. https://doi.org/10.1016/j.jaci.2017.05.011
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Chronic Illness and Mental Health: Recognizing and Treating Depression. (2021). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health
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Dudeney, J., Sharpe, L., Jaffe, A., Jones, E. B., & Hunt, C. (2017). Anxiety in youth with asthma: A meta-analysis. Pediatric Pulmonology, 52(9), 1121–1129. https://doi.org/10.1002/ppul.23689
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Del Giacco, S. R., Cappai, A., Gambula, L., Cabras, S., Perra, S., Manconi, P. E., Carpiniello, B., & Pinna, F. (2016). The asthma-anxiety connection. Respiratory Medicine, 120, 44–53. https://doi.org/10.1016/j.rmed.2016.09.014
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Zielinski, T. A., Brown, S., Nejtek, V. A., Kahn, D. A., Moore, J. J., & Rush, A. J. (2000). Depression in Asthma: Prevalence and Clinical Implications. The Primary Care Companion to the Journal of Clinical Psychiatry, 02(05), 153–158. https://doi.org/10.4088/pcc.v02n0501
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Detweiler-Bedell, J. B., Friedman, M. A., Leventhal, H., Miller, I. W., & Leventhal, E. A. (2008). Integrating co-morbid depression and chronic physical disease management: Identifying and resolving failures in self-regulation. Clinical Psychology Review, 28(8), 1426–1446. https://doi.org/10.1016/j.cpr.2008.09.002
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Arcaya, M. C., Lowe, S. R., Rhodes, J. E., Waters, M. C., & Subramanian, S. V. (2014). Association of PTSD Symptoms With Asthma Attacks Among Hurricane Katrina Survivors. Journal of Traumatic Stress, 27(6), 725–729. https://doi.org/10.1002/jts.21976
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Eisenberger, N. I., & Moieni, M. (2020). Inflammation affects social experience: implications for mental health. World Psychiatry, 19(1), 109–110. https://doi.org/10.1002/wps.20724
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Yuan, N., Chen, Y., Xia, Y., Dai, J., & Liu, C. (2019). Inflammation-related biomarkers in major psychiatric disorders: a cross-disorder assessment of reproducibility and specificity in 43 meta-analyses. Translational Psychiatry, 9(1). https://doi.org/10.1038/s41398-019-0570-y
