One of the most frustrating things an asthmatic might be told is “it’s all in your head.” Nothing is more demeaning than being told your asthma isn’t real or is in your head. How many of us have been in the midst of a pretty bad asthma flare up and are struggling to catch your breath and someone leans in and tells you to “just calm down and breathe.” While they more than likely mean well, it’s probably the last thing you want to hear. People who don’t have asthma or have never had breathing troubles are unable to truly put themselves completely in our shoes. There are also people out there who are just plain rude and we will save that discussion for another article at another time.
The anxiety connection
Asthma is a disease of the airways caused by inflammation which leads to constriction, making it harder to breathe. Anxiety can definitely cause asthma symptoms to be worse, but try not being able to breathe and remain completely calm! It’s impossible! Anxiety itself doesn’t cause asthma if that makes sense, but it can definitely make asthma that is already there much worse. It’s such a delicate balance. What helps me when my asthma is flaring is to practice pursed lip breathing or holding my hand on my belly and doing some belly breathing. It gives me something to focus on so I am not as anxious.
Your asthma diagnosis
You have been given an asthma diagnosis by a doctor. That in of itself is proof that it’s not all in your head. There are instances when a doctor might question an asthma diagnosis, especially if you don’t present like a “typical asthmatic” with the classic symptoms of wheezing and coughing. It doesn’t necessarily mean you don’t have asthma. However, there are other diseases that can mimic asthma but are not actually asthma. If a doctor (especially a new one to you) questions your asthma diagnosis don’t immediately go on the defensive and assume they think it’s all in your head. It’s the doctor’s job to give the best possible care and rule out (or in) any and all other possibilities for your breathing troubles. They might ask to have you have more recent lung function testing done or even a methacholine challenge to confirm the diagnosis. As always, keep an open dialogue with your medical team. Ask questions and ask them to explain their reasoning for questioning your asthma. Seven years ago I started with a new pulmonologist and he questioned my asthma diagnosis. I was upset at first, but once he explained his reasoning, it made more sense. He had me do a methacholine challenge test which cemented my asthma diagnosis for good. I am one of the asthmatics who do not present typically in that I never wheeze. My lungs just get super tight, making me very short of breath.
When it comes to dealing with naysayers, use it as an opportunity to provide some education on what asthma is and isn’t. Open that dialogue to hopefully help others understand what it is like living with asthma, and that it’s NOT all in your head.