Anxiety and Asthma in Children

Somewhat surprisingly, anxiety disorders are the most commonly diagnosed psychiatric condition in children and adolescents. As many as 20% of young people experience some degree of anxiety. Panic attacks, which are sudden, acute episodes of fear and anxiety, are just one manifestation of an underlying anxiety disorder. In children with respiratory diseases like asthma, anxiety becomes an even more serious concern. The fear of not being able to catch one’s breath naturally feeds into a growing, ever-present sense of unease. In a vicious cycle, this latent unease can then trigger frequent and severe bouts of asthma. Pharmaceuticals can serve a dual purpose in relieving these frightening symptoms; they offer immediate relief of acute attacks as well as long-term management of both conditions.

As a first step in managing the anxiety and fear surrounding a breathing problem, a low-dose prescription for a standard anti-anxiety medication like Xanax (alprazolam) may be necessary. However, this is not a long-term solution for counteracting anxiety disorders. Xanax and other drugs in its class have a high potential for dependence and abuse. Furthermore, these medications only address the symptoms of the anxiety and not the cause. For these reasons, a combination of talk therapy, antidepressant medications, and an emergency inhaler are generally recognized as the most effective treatment program for anxiety-related breathing problems in younger patients. In the long-term, antidepressants offer more targeted treatment of anxiety without the side effects or grave potential for abuse.

Doctors have yet to fully unravel the complex relationship between anxiety and asthma in children and adolescents. It’s a sort of chicken and egg problem, to borrow a simplistic metaphor. Asthma attacks initiate anxiety, which in turn leads to more frequent and more severe asthma attacks. One disorder feeds into and reinforces the other in a cycle that must be broken if the child is to experience a better quality of life. For the immediate easing of anxiety symptoms—racing heartbeat, sweating, intense fear, feelings of doom—medications like Xanax and Valium have shown themselves to be very effective. As previously noted, though, a real solution to the issue involves treating the problem rather than the symptoms. For many young patients, this means a gradual cessation of anti-anxiety drugs while psychotherapy and antidepressants take effect.

Troup, K., & Roberson, A. (2011). A 10-year old with anxiety and history of asthma. Pediatric Nursing, 37(3), 133-135.

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