Vol. 14 •Issue 3 • Page 8
First Thoughts
Taking the Stress Out of Asthma
Stress is an unavoidable part of today’s hectic lifestyles, but for people with asthma, it can be a deadly force. Researchers are unsure of exactly how stress affects biological responses linked to asthma, but it’s a potential asthma trigger for some patients. When they’re overexposed to stress and anxiety, it can cause bronchial constriction that aggravates their symptoms. Patients may experience extreme shortness of breath and begin to panic, which sends the situation into a full-blown asthma attack.
Some data have suggested that 20 percent to 30 percent of people’s asthma is intensified by negative emotion, according to this issue’s cover story on stress and asthma. Thoughts like, “I could have died from my asthma,” escalate anxiety for the next exacerbation.
Unlike asthma triggers such as dust and pet dander that can be whisked away with a good cleaning, stress is insidious. Patients may not realize an asthma episode that appears out of the blue actually may be linked to a recent stressful situation. They also may be reluctant to bring up their financial burdens, relationship troubles and deadline pressures at their next checkup.
It’s up to physicians to ask patients about their worries and concerns, just as they would address any other potential barrier to asthma management. Once patients understand the relationship between stress and asthma, they can practice ways of coping.
Physicians can guide each patient’s individualized approach to stress management and recommend deep breathing techniques, biofeedback, yoga, journal writing, family therapy and social support.
Researchers have found that integrating a stress management component with a traditional asthma education program led to high patient satisfaction and decreases in hospitalization and urgent care visits.1
Despite the growing body of evidence that psychological interventions can complement traditional medical asthma management, many physicians are unprepared to counsel patients on the connection between their minds and bodies. They feel more comfortable adjusting patients’ medication dosages than adjusting patients’ stress levels.
At the very least, these physicians can encourage patients to take daily peak flow readings, maintain an asthma diary, and know their asthma action plans. Conscientious asthma monitoring will empower patients so they feel in control of their asthma, instead of their asthma controlling their lives.
REFERENCE
1. Lucas DO, Zimmer LO, Paul JE, et al. Two-year results from the asthma self-management program: long-term impact on health care services, costs, functional status and productivity. J Asthma. 2001;38(4):321-30.
Sharlene George,
Editor
