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Respiratory Disorders (Expert Forum)
Asthma and anxiety?
Answered by
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Asthma and anxiety?
by ClareS, Mar 06, 2004 12:00AM
I have been having tight chest and breathing problems for about four months.
My GP said it was a virus and then when it did not go away said it was probably anxiety and prescibed beta blockers which I took for two weeks but did not make any difference. I have no other anxiety symptoms such as a racing heart.
Unsatisfied with my GP I saw a private chest physician who gave me a spirometry test which he says is abnormal and inidcates obstructive airways disease. I had a chest xray which showed too much air in my lungs. My peak flow is about 400. The physician diagnosed asthma and prescribed me ventolin (which I have had before and does not help me) and flixotide as a preventer. (I have taken becotide before for three weeks but no difference) I have been on this medication a week now but if anything feel worse not better. I am 28, female, non smoker, excercise regularly, vegetarian
My questions:
Could the abnormal spirometry tests indicate any other condition?
Could my abnormal spirometry tests be a result of anxiety?
If I do not respond to ventolin, does this mean that I do not have asthma, or may there be another drug/inhaler that may help?
If these inhalers I have been prescribed are unsuitable for my condition could they actually do me more harm than good?
Could I have anxiety and asthma at the same time?
Is it safe to take anti-anxiety meds such as Buspar at the same time as inhalers for asthma?
Many many thanks
My GP said it was a virus and then when it did not go away said it was probably anxiety and prescibed beta blockers which I took for two weeks but did not make any difference. I have no other anxiety symptoms such as a racing heart.
Unsatisfied with my GP I saw a private chest physician who gave me a spirometry test which he says is abnormal and inidcates obstructive airways disease. I had a chest xray which showed too much air in my lungs. My peak flow is about 400. The physician diagnosed asthma and prescribed me ventolin (which I have had before and does not help me) and flixotide as a preventer. (I have taken becotide before for three weeks but no difference) I have been on this medication a week now but if anything feel worse not better. I am 28, female, non smoker, excercise regularly, vegetarian
My questions:
Could the abnormal spirometry tests indicate any other condition?
Could my abnormal spirometry tests be a result of anxiety?
If I do not respond to ventolin, does this mean that I do not have asthma, or may there be another drug/inhaler that may help?
If these inhalers I have been prescribed are unsuitable for my condition could they actually do me more harm than good?
Could I have anxiety and asthma at the same time?
Is it safe to take anti-anxiety meds such as Buspar at the same time as inhalers for asthma?
Many many thanks
Doctor's Answer
by National Jewish, Mar 16, 2004 12:00AM
, Mar 16, 2004 12:00AM
The chest physician should reevaluate you.
The obstructive airways disease indicated by your abnormal spirometry test could be cystic fibrosis, reactive airways disease (RAD) or hypersensitivity pneumonitis. However it’s most likely to be asthma.
Viral infections like a cold can cause inflammation of the airways of the lungs. This inflammation can cause a tight chest and breathing problems. After the cold is gone, it is possible for the inflammation to linger. This inflammation can last for several weeks. Sometimes this inflammation may linger for 3 to 6 months. Eventually the inflammation will go away, and then the tight chest and breathing problems will stop. This is called RAD and behaves a lot like asthma. This inflammation often clears more quickly when it is treated with an asthma controller medicine, such as an inhaled steroid. It is important that an inhaled steroid be used every day to decrease inflammation in the airways of your lungs. If there is a lot of inflammation in your airways, it may take longer than 3 weeks to see a difference.
When this continues, it is generally considered to be asthma. Testing can be helpful to show if your symptoms are due to asthma or RAD or anxiety. Generally testing starts with a simple breathing test, the spirometry that you have done. This test provides detailed information about how your lungs are working. It will show if there is obstruction in your airways.
To really test for asthma it is best to repeat this test after using a rescue inhaler, an inhaled bronchodilator like the Ventolin® Inhalation Aerosol (albuterol sulfate). This measures how much the bronchodilator helps your lungs by reversing the problem. When there is a 20% increase the test is positive for asthma.
There is a complex asthma test that is the gold standard for diagnosing asthma. This is called a methacholine challenge. You will blow into a spirometer before and after each increasing dose of an inhaled medicine. This test is positive for asthma if the result after the inhaled medicine is 20% lower than it was before the inhaled medicine.
A lung problem such as asthma can cause a tight chest. A tight chest can be the only symptom of asthma. There are a variety of things that can make asthma worse. These things are called triggers. Exercise and respiratory infections are common triggers of asthma. Also some people start to have problems with asthma only after having a respiratory infection. Once you have asthma, you will always have asthma. It does vary from person to person. For some people the symptoms will come and go. For others the symptoms are constant. There is no cure at this time, but it can be controlled with medicine.
It is possible that your abnormal spirometry tests could be a result of anxiety. However this is unlikely since the test is effort dependent.
Failure to respond to Ventolin® Inhalation Aerosol (albuterol sulfate) does not mean that you do not have asthma. You could have asthma and need a controller medicine to help with the inflammation in your airways.
If the inhalers you have been prescribed are unsuitable for your condition they would not do you more harm than good.
You could have anxiety and asthma at the same time. It is also possible to have vocal cord dysfunction (VCD) along with anxiety and asthma. This is a condition that can mimic asthma. However, VCD is not helped by asthma medicines. While inhaling the vocal cords should open to let air into the lungs. With VCD the vocal cords close together during inhalation. This makes it difficult for air to get into the lungs. A lot of the same things that trigger asthma can trigger VCD including exercise and respiratory infections. Sometimes the trigger is not known.
Testing for VCD needs to be done while you are having symptoms. Spirometry may be normal, but the “breathing in” or inspiratory part, also called an inspiratory flow volume loop, will show little airflow while you are inhaling. A laryngoscopy is a procedure done by a specialized doctor using a camera at the end of a flexible tube to see how your vocal cords open and close.
VCD is treated by a speech therapist that will instruct you in open throat breathing techniques. Counseling can help you identify and deal positively with chronic stress, which may be an underlying factor in VCD. Please read our Vocal Cord Dysfunction MedFact at http://www.nationaljewish.org/medfacts/vocal.html for more information.
It is safe to take anti-anxiety medicines such as BuSpar® (buspirone) at the same time as inhalers for asthma.
The obstructive airways disease indicated by your abnormal spirometry test could be cystic fibrosis, reactive airways disease (RAD) or hypersensitivity pneumonitis. However it’s most likely to be asthma.
Viral infections like a cold can cause inflammation of the airways of the lungs. This inflammation can cause a tight chest and breathing problems. After the cold is gone, it is possible for the inflammation to linger. This inflammation can last for several weeks. Sometimes this inflammation may linger for 3 to 6 months. Eventually the inflammation will go away, and then the tight chest and breathing problems will stop. This is called RAD and behaves a lot like asthma. This inflammation often clears more quickly when it is treated with an asthma controller medicine, such as an inhaled steroid. It is important that an inhaled steroid be used every day to decrease inflammation in the airways of your lungs. If there is a lot of inflammation in your airways, it may take longer than 3 weeks to see a difference.
When this continues, it is generally considered to be asthma. Testing can be helpful to show if your symptoms are due to asthma or RAD or anxiety. Generally testing starts with a simple breathing test, the spirometry that you have done. This test provides detailed information about how your lungs are working. It will show if there is obstruction in your airways.
To really test for asthma it is best to repeat this test after using a rescue inhaler, an inhaled bronchodilator like the Ventolin® Inhalation Aerosol (albuterol sulfate). This measures how much the bronchodilator helps your lungs by reversing the problem. When there is a 20% increase the test is positive for asthma.
There is a complex asthma test that is the gold standard for diagnosing asthma. This is called a methacholine challenge. You will blow into a spirometer before and after each increasing dose of an inhaled medicine. This test is positive for asthma if the result after the inhaled medicine is 20% lower than it was before the inhaled medicine.
A lung problem such as asthma can cause a tight chest. A tight chest can be the only symptom of asthma. There are a variety of things that can make asthma worse. These things are called triggers. Exercise and respiratory infections are common triggers of asthma. Also some people start to have problems with asthma only after having a respiratory infection. Once you have asthma, you will always have asthma. It does vary from person to person. For some people the symptoms will come and go. For others the symptoms are constant. There is no cure at this time, but it can be controlled with medicine.
It is possible that your abnormal spirometry tests could be a result of anxiety. However this is unlikely since the test is effort dependent.
Failure to respond to Ventolin® Inhalation Aerosol (albuterol sulfate) does not mean that you do not have asthma. You could have asthma and need a controller medicine to help with the inflammation in your airways.
If the inhalers you have been prescribed are unsuitable for your condition they would not do you more harm than good.
You could have anxiety and asthma at the same time. It is also possible to have vocal cord dysfunction (VCD) along with anxiety and asthma. This is a condition that can mimic asthma. However, VCD is not helped by asthma medicines. While inhaling the vocal cords should open to let air into the lungs. With VCD the vocal cords close together during inhalation. This makes it difficult for air to get into the lungs. A lot of the same things that trigger asthma can trigger VCD including exercise and respiratory infections. Sometimes the trigger is not known.
Testing for VCD needs to be done while you are having symptoms. Spirometry may be normal, but the “breathing in” or inspiratory part, also called an inspiratory flow volume loop, will show little airflow while you are inhaling. A laryngoscopy is a procedure done by a specialized doctor using a camera at the end of a flexible tube to see how your vocal cords open and close.
VCD is treated by a speech therapist that will instruct you in open throat breathing techniques. Counseling can help you identify and deal positively with chronic stress, which may be an underlying factor in VCD. Please read our Vocal Cord Dysfunction MedFact at http://www.nationaljewish.org/medfacts/vocal.html for more information.
It is safe to take anti-anxiety medicines such as BuSpar® (buspirone) at the same time as inhalers for asthma.
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Whilst I am not a doctor I have suffered similar symptoms to yourself and done alot of patient research.
It has become very clear to me recently that I have suffered anxiety for quite some time...I recently had an emotional bout, which sort of crystallized the problem for me !
However, physical anxiety has manifested itself for many years as muscle tension in my chest, back and now lungs.
(I also get upper gastric IBS/ stomach bloating).
It appears the tension is now effecting my lungs to such an extent that I get asthma-like symptoms: mucus, tightness, bronchial sensitivity, etc... In fact a couple of years ago, when it first started, I had hyperventilation attacks and still regularly feel respiratory distress. This is often related to stressful periods.
Ventolin does not work and I have generally optimistic but mixed feelings about Becotide, which I have been taking recently. Buspar has provided me some relief from anxiety and perhaps somewhat reduced my concern about my breathing, although has really only taken the 'edge' off the problem.
I must note that my peak flow is relatively good, but still my symptoms are reminiscent of asthma. I have an appointment and shall be visiting a lung specialist in the near future and guess I may have a spirometry test myself.
I imagine my problem is caused by anxiety/ muscle tension in my lungs, but would not know whether I am officially asthmatic (?) It is exacerbated by stomach bloating which makes the breathing condition seem worse. It is definitely alot worse when my anxiety levels are high !
I guess you may be able to draw some parallels which may (or may not) give you some comfort !
Good luck...
COMMON TRAITS OF INDOOR AIR POLLUTION
Affected Household Members initials: ____ ____ ____ ____ ____
Dust on furniture / Visible in air
House odors
Allergies
Asthma
Sinus problems
Headaches
Sleeplessness / Light sleeper
Snoring
Sore throats / Colds / Flu
Itchy/ Watery eyes
Coughing / Throat clearing
Lack of Concentration
Depression / Irritability
Fatigue / Naps
Mold / Mildew in basement & bathrooms
Pet dander and odors
Smoking
Wood / Coal heater
Static Electricity
As you fill this in and realize how much is affected by your indoor air; maybe you'd want to try an ionizing/ozone air purifier like I have. It's removed all respiratory ills in our family with 8 children 19 down to two.