Anxiety and Asthma

In this article, I am going to summarize and discuss the issues raised about anxiety and asthma by a subscriber of my free newsletter.

Issue: This person has challenges with anxiety and asthma and panic attacks. Of course asthma itself can make it more difficult to breathe, which adds to one’s anxiety.

My reply:

Many persons with anxiety and breathing and this is why I use the term “anxiety breathing”. Fortunately I was quickly able to pinpoint a study that looked at Cognitive Behavioral Therapy with asthma sufferers. One such study conducted by the Department of Clinical Psychology, NIMHANS, Bangalore looked at efficacy of Cognitive Behavioral Therapy, as an adjunct to standard pharmacotherapy in bronchial asthma.

They found that there was a significant decrease in asthma symptoms, anxiety and depression; and significant increase in quality of life in the experimental group. Researchers concluded that Cognitive Behavioral Therapy helps in improving the management of asthma.

While of course this is good news for asthma sufferers, and  anxiety and asthma sufferers.  However, it’s also good news for anxiety and panic attack sufferers in general. The reason is that a common issue sufferers will report is feeling anxious about their breathing even though they have no inherent problems. In other words feeling like they are not getting enough air or even just becoming more conscious of their breathing. Some people have indicated that they have even stuck their head out of a window in order to make themselves feel better.

So I’ll look at some of the specific thoughts that might be plaguing the above referenced subscriber who has asthma, but this process can also help anyone who suffers from anxiety and panic attacks.

To begin, why don’t you click here (the page will open in a new window) and try to determine which are present.

(Note: Below I will sometimes use the term “we.” This is not to suggest that you have asthma, but rather to simplify the overall scenario and make it most relevant.)

Likely present are:

1) jumping to conclusions, and
2) magnification, and
3) emotional reasoning, and
4) disqualifying the positive

You might be asking why:

Well it’s certainly understandable how someone who’s having difficulty breathing could become anxious, and it would be reasonable to assume that the emotion behind this anxiety may involve a fear of harm or fear of dying (if they are unable to breathe).

Moreover, anytime we have a “what if” thought we are really entertaining, at least in our mind, the actual scenario that is feared.


1) Jumping to conclusions is present because at some level we are likely predicting that this will happen because, as mentioned, we are imagining the actual scenario happening – at least on some level – or beginning to happen (i.e. passing out, dying) even though that’s not likely the case.

2) Magnification is present because we are thinking worst case scenario is likely and thereby “catastrophizing.” Catastrophizing is defined as “Focusing on the worst possible outcome, however unlikely, or thinking that a situation is unbearable or impossible when it is really just uncomfortable.”

3) Emotional reasoning is present because we feel bad, obviously, and conclude that things are bad, dire in this instance.

4) I also mentioned disqualifying the positive because we are likely overlooking all the many times we had an asthma attack and in the end, really suffered no harm and obviously did not die.

An alternative thought is that just because one has asthma does not mean one will pass out or die.

Another alternative thought to state is that there are various options an asthma sufferer can discuss with his/her doctor and/or health care professional to help with asthma.

Here’s an illustrative example that a psychologist shared with me some time ago. The scenario could involve a person who is learning to swim. The person notices he/she has ventured into the “deep end” and gets frightened. This leads to panic and immediately begins the person gasps for air which quickly draws water into their lungs. I say this not to scare you but to impart to you what a helpful psychologist once explained to me. He said that asthma sufferers have the same experience when they begin to fear an asthma attack. They gasp for air which exacerbates the asthma attack. Of course the same would be true for someone who more generally anxious about breathing.

In sum: the above discussion about anxiety and asthma followed by the illustrative example about breathing can be helpful. It can be a further help to use the Cognitive Behavioral Therapy on your anxiety about breathing.

You can’t expect to work through one instance as we’ve done with the above the topic of anxiety and asthma and completely eliminate your panic attacks in one go.  However, this is a good start and applying these suggestions to your OWN thoughts can make you feel better quickly.  And, over time, as you continue to tackle your own thoughts, you will become very good at recognizing distortions and generating new and more valid viewpoints which will allow you to make a shift which can have a dramatic effect on your panic attacks and anxiety.

Department of Clinical Psychology, NIMHANS, Bangalore April 30, 2009 from