Emotional burden

Limitations to desired activities affected the emotional wellbeing of many people we interviewed. Research has shown that limitations in function affect 70 to 100% of people with severe asthma. People we talked to described the feelings associated with physical inability—feeling disabled, less of a person, isolated, and removed little by little from life’s enjoyments. However not everyone saw severe asthma in such negative terms.

Ann just wanted to be able to do things normally.

Wayne is sad that severe asthma does not have an easy fix.

Marg tries to help others and understand her own situation.

Michael found the diagnosis almost a relief and he doesn’t get emotional about having severe asthma.

Although Michael does not perceive his severe asthma as life-threatening, it certainly can be, and a proportion of people we interviewed spoke about their fear of living with a life-threatening condition and the emotional toll that takes, as well as feelings associated with reduction in physical abilities.

Shannon is scared just living her life

People with asthma may have mental health issues. Studies have shown that anxiety, depression and panic disorders are more common among people with asthma than in the general population. Depression and anxiety disorders are more common among people with severe asthma and may be either a result of, or a factor in the development of a person’s asthma. [Amelink et al 2014 ]

Jemma feels depressed and angry about having severe asthma.

Ed knows he needs to keep the anxiety in check.

Medications used in asthma can also affect a person’s mental state. Large doses of prednisone or prednisolone can cause changes in mood and behaviour, but these adverse effects appear to stabilise over time. See Managing Medication.

Karen found steroids hyped her up.

Diana felt invincible on steroids.

Steroids affected Monique‘s memory.

Psychological factors may trigger asthma symptoms and affect patients’ asthma symptom perception, and also may influence a person’s adherence to their treatment routine. High levels of asthma-related fear and panic can make asthma symptoms worse. Anxiety and hyperventilation attacks can also be mistaken for asthma. Some people in our study talked about being able to recognise the differences between panic, fear and asthma symptoms.  Rachel says she can tell the difference becausepanic attack affects your head and everything”.

The uncertainty of the future was an issue for several participants. Some people brought up the subject of death and dying. The realisation that, despite doing everything possible to manage their condition, it might not be enough was quite common in their thoughts.

Clive finds it hard to plan.

Kim accepts that there’s no magic bullet for her.

Tony sees how fragile life is.

Link

Amelink M, Hashimoto S, Spinhoven P, Pasma HR, Sterk PJ, Bel EH, ten Brinke A.

Anxiety, depression and personality traits in severe, prednisone-dependent asthma

Respir Med. 2014 Mar;108(3):438-44. doi: 10.1016/j.rmed.2013.12.012. Epub 2014 Jan 2.