The Relationship Between Asthma and Anxiety and Treatment Strategies

Asthma is a common respiratory system disease that occurs as a result of chronic inflammation of the airways and is characterized by symptoms such as shortness of breath, coughing, and wheezing. However, asthma is not limited only to physical symptoms; the psycho-social dimension of the disease also has a significant impact. While dealing with emotional reactions resulting from asthma, asthma patients also encounter various difficulties in their social, economic, and personal lives.

In particular, difficulty maintaining daily life activities, work and school absenteeism, avoiding crowded environments, social isolation, and economic difficulties are frequently observed problems. The shortness of breath and symptoms caused by asthma can affect patients' social relationships and make it difficult for them to maintain a normal life. Therefore, asthma patients may experience various psychological distresses depending on their illness. Among these, emotional responses such as anxiety, fear, depression, anger, hopelessness, guilt, and shame are common. As the severity of the disease increases, the frequency and severity of these emotional responses may also increase. Patients tend to experience anxiety particularly when they feel shortness of breath, which plays a role in aggravating asthma symptoms.

Research examining the relationship between asthma and anxiety in depth, especially among youth, has revealed that youth with asthma have higher levels of anxiety disorders and symptoms compared to those without asthma. In a study conducted in this context, clinically diagnosed anxiety was found in 22.7% of youth with asthma. This finding indicates that youth with asthma are more likely to develop anxiety. Understanding this relationship between asthma and anxiety is of great importance in terms of developing treatment plans and managing the disease more effectively. Three different types of anxiety are observed in people living with asthma:

Symptom-Related Anxiety: This is associated with the emergence or worsening of asthma symptoms. For example, experiencing difficulty breathing or hearing a wheeze during an asthma attack can cause intense anxiety and fear in the patient. In this case, the patient may experience a panic attack along with increased asthma symptoms, develop fears and anxious expectations regarding the onset of symptoms, and restrict daily life activities. At this point, when asthma symptoms decrease, anxiety may also decrease.

Treatment-Related Anxiety: This is associated with the use of medications or devices (e.g., inhalers) used in asthma treatment. Some patients may be afraid of using inhalers and, therefore, may start using their medications irregularly. Treatment-related anxiety can occur during medication use or following negative experiences related to the treatment. Treatment-related anxiety also plays a triggering role in symptom-related anxiety by creating difficulties regarding treatment adherence and keeping asthma under control.

Trigger-Related Anxiety: This is associated with exposure to specific triggers or other factors that can increase asthma symptoms. For instance, exposure to allergens or stressful situations can trigger asthma symptoms and lead to feelings of anxiety in the patient. Considering the aspects of anxiety regarding asthma triggers that affect social life, it can be observed that patients experience restrictions in their social relationships and have a predisposition to become isolated.

Specialists implement various therapy methods to identify anxiety symptoms in asthma patients and offer appropriate treatment options. These include methods such as cognitive behavioral therapy, breathing and stabilization exercises, group therapy or support groups, and family therapy. These therapy methods can help young asthma patients understand, manage, and reduce their anxiety symptoms.

Cognitive Behavioral Therapy (CBT): Focuses on changing patients' thought patterns and behaviors. It can be effective in reducing anxiety symptoms in young asthma patients. CBT can help patients understand the relationship between asthma symptoms and anxiety and change negative thought patterns.

Breathing and Stabilization Exercises: For those who have difficulty regulating their breathing during an asthma attack, teaching breathing and stabilization exercises as well as relaxation techniques can be beneficial. These techniques can help reduce anxiety symptoms, return the heart rhythm to normal levels, make the person feel in control, and help bring both the asthma attack and the anxiety caused by asthma under control.

Group Therapy or Support Groups: Organizing support groups or group therapy for young asthma patients allows patients to share their experiences and support one another. These groups can help youth understand and manage their anxiety symptoms.

Family Therapy: Therapy sessions conducted with the families of youth with asthma can strengthen intra-family communication and ensure that family members support the young asthma patient. Family therapy can help youth cope with their asthma symptoms and reduce their anxiety levels.

In conclusion, specialists should adopt a multidisciplinary approach, using psychotherapy and medical treatment together to support both the physical and mental health of asthma patients. Healthcare professionals should eliminate information gaps and guide patients on coping strategies by providing direct education. In addition, a psychiatric evaluation should be performed, and psychiatric support should be provided if necessary. Ultimately, it is crucial to understand the psycho-social needs of asthma patients and integrate these needs into treatment plans. This can increase patients' quality of life, improve treatment adherence, and help bring the disease under control. For this reason, attention must be paid not only to physical symptoms but also to psycho-social factors in asthma treatment.