Managing Asthma-Related Depression
When you think of chronic medical conditions, what illnesses do you picture? Multiple sclerosis, dementia, osteoporosis and COPD are typical responses. The public generally perceives these diseases as serious and long-term. Additionally, the treatment seems intensive and somewhat risky while success is never assured. These qualities all fit the criteria for a chronic medical condition.
What about asthma? Outside observers might consider asthma to be a condition confined to childhood triggered only by allergens floating around the air. The common conception is that people “grow out” of asthma by adulthood so the notion that asthma is chronic could be difficult to accept. People with the diagnosis know differently, though.
Asthma fits into the category of chronic medical conditions for the same reasons the others do. Asthma is problematic, dangerous, long-lasting and treatment has its limitations. Because asthma is chronic, it carries the same burden as other illnesses in terms of pervasive stress and the menace of mental illness.
Asthma/Depression VS. Depression/Asthma
A very real risk for people with asthma, like people with other chronic medical conditions, is depression. There is much debate regarding which comes first: the asthma or the depression. The answer is that asthma can make depression worse and that depression can make asthma worse. You also know that having both is much worse than having either alone. Because of this, understanding the interaction between asthma and depression is an important step to improving your well-being.
Asthma Worsens Depression:
- Asthma can trigger depression due to the restricting nature of the disease. With asthma, you need to know and avoid your triggers. What if your triggers are all of the things you enjoy? Do you like going for walks? Asthma will flare if the pollen is high. Do you like eating out at restaurants with your friends? Sorry. The mix of scents will trigger high symptoms. People with asthma can often feel trapped inside their comfort zone while opportunities for fun pass by them. The more severe your symptoms, the more restricted your behaviors become. This allows depression to surge, as it would make anyone feel more isolated and pessimistic.
- Asthma can trigger depression due to its treatment. There is a growing base of research linking steroids like prednisone to depression with long-term use. If your asthma is prednisone-dependent there are greater risks involved. You may be saying that people with prednisone-dependent asthma have severe symptoms and severe symptoms lead to worse symptoms of depression. Opponents to this thought say that it is not the treatment it is only the asthma. This makes sense, but there have been studies comparing people with severe, prednisone-dependent asthma to severe, nonprednisone-dependent asthma. The studies found that group dependent on the steroid had three times higher reports of depression than the nondependent group. No one can say that prednisone causes depression, but there is a link with long-term use.
Depression worsens asthma:
- Depression makes asthma worse through poorer recognition of symptoms. Being able to address problems before they gather momentum is crucial for any illness. Depression works to move focus from areas that are controllable to areas that are not. Rather than monitor your symptoms, depression encourages you to dwell on the time that you were mistreated by your boss or makes you feel guilty about the time that you lied to your friend. When you become consumed by the world inside your mind, you miss out on current world around you.
- Depression makes asthma worse through poorer treatment follow-through. Behaviorally, depression limits your energy and interest in doing things, especially the activities that are most beneficial for you. People with depression often miss doctor’s appointments, follow-up testing and other essential pieces of care. Additionally, you may find it challenging to complete your at-home care with depression because you only feel comfortable zoned-out on the couch. The final component is that depression constantly wants you feeling more depressed. If depression can convince you that your treatment is not working and that there is no reason to follow-through than asthma will get worse. Subsequently, depression will get even bigger, stronger and more pervasive. Depression wins as you lose.