Depression is the most common mood disorder. It used to affect almost 20% of Americans each and every year. The current numbers are higher due to a significant increase in cases during the COVID pandemic.
Individuals with asthma and other chronic conditions are at even higher risk to develop depressive symptoms or full-blown depression. Furthermore, depression tends to worsen the symptoms of preexisting conditions.
For example, people who had a heart attack and also have depression are more likely to die compared with someone who had a heart attack but doesn’t have depression.
Someone who has depression and diabetes has 8 times the rate of depression relapse of a person who has depression, but no diabetes.
What happens when a person has asthma? Could asthma trigger depression? How does depression affect the symptoms and progression of asthma? Let’s review the connection between asthma and depression in this article.
The link between asthma and depression
Several studies found that asthma is associated with an increased risk of depression and that depression leads to more severe symptoms of asthma. More severe symptoms of asthma translate into a greater number of emergency room visits, more frequent appointments to the treating doctors, more aggressive treatment to control the asthma symptoms, and of course higher levels of stress experienced by the person with asthma, who also has to battle depression. Overall, someone with asthma is twice more likely to have depression or anxiety compared with someone without asthma. More stress and depression triggers more asthma attacks or worsen the symptoms, creating a vicious cycle. On the other hand, treating depression with antidepressants helps improve lung function.
Asthma drugs and depression. Asthma drugs- particularly oral tablets prednisone can cause depression, mood swings, aggression, sleeping problems including nightmares, and headaches. Montelukast, other asthma drugs, have been less prescribed in recent years because its use seems to trigger depressive episodes in adults and various psychological abnormalities in children. However, these drugs are still prescribed when the overall benefits outweigh the risks.
Why chronic illnesses lead to depression
One of the most common complications of chronic conditions in general, and asthma in particular is depression. Those who have a genetic susceptibility or other major stressors in their life will be more likely to develop depression.
A chronic illness causes significant changes in a person’s life. The symptoms interfere with day-to-day life, and for some, it may be impossible to pursue hobbies and activities enjoyed in the past. Chronic illnesses can affect one’s self-confidence and ability to have a normal social life. Asthma in particular causes difficulty breathing, a symptom that further increases stress and anxiety. Depression does not only cause low mood, but also fatigue, changes in appetite, sleep, and more.
Know the difference between grief, depressed mood, and true clinical depression
Living with a chronic condition like asthma is a serious challenge and it is normal to experience a period of grief and sadness when receiving the diagnosis from the doctor. How can you tell the difference between grief, depressed mood, and full-blown depression?
Grief is self-limited, the mood changes are experienced in waves, and the intensity improves over time. Although a person may feel hopeless at times, the self-image is normal, he is able to express anger or irritability and responds in a positive way to reassurance and support from others.
When someone feels “blue” or sad in response to a difficult trigger, it is considered a normal reaction, as well. It is a common reaction, as the person needs to adjust to the circumstances. The trigger can be an asthma attack which brings stress and anxiety, some challenges at work, or an argument with a partner. However, once the trigger is gone, the emotional hurt and sadness fade, and everything goes back to normal.
The true, clinical depression that requires treatment is different. In clinical depression, the mood and feelings are static, experienced daily, for a few couples of weeks or more. These symptoms interfere with day-to-day life like work and relationships. All aspects of life can be affected, as everything seems less enjoyable, less interesting, or less important. The self-image is affected, making a person feel unworthy and hopeless. Anger is not expressed but rather turned inward, making that person want to isolate, although some people feel angry and irritable rather than depressed. Support and reassurance from others don’t help. The appetite can either increase or decrease, leading to weight gain or loss respectively. Some people feel more fatigue and sleep more, while others may have insomnia associated with depression.
Clinical depression requires treatment. As noted above, asthma symptoms can also improve when the coexisting depression is treated, so both conditions will be under control. Daily sessions of mindfulness meditation or deep breathing (even 10 minutes can make a difference!), regular exercise, yoga, or tai chi are great additions to standard medication and psychotherapy.