I’ve already indicated that, in my experience, with my own asthma and my daughters, doctors are slow to pick up on asthma symptoms if the patient does not really complain about them. But don’t let anyone talk you out of your symptoms or suggest that they are “all in your head”! Even an educated adult can have a confused reaction to the “sense of suffocation that comes with breathlessness, as did one young friend of mine who mistakenly attributed her feeling of panic in the dirty, particle-laden air of a New York City subway to psychological causes. She was starting a new job and, understandably, felt somewhat tense and nervous, but her breathing problems seemed “out-of-line” to her, inconsistent with her usual sensible self. After months of worry and seeing several doctors, the diagnosis of asthma really came as a relief, and helped her dismiss her fear of a more amorphous, less explicable problem.
Asthma is definitely not a psychological disease; it is a physical condition of the respiratory system. It is a myth and a great disservice to all persons diagnosed with asthma to view asthma as a disease of the mind, or of a somehow disturbed frame of mind. Asthma triggers are exposures that precipitate or worsen a person’s asthma. In some people with asthma, strong emotions can function as a trigger. Conversely, flares of asthma symptomatology, especially if severe, can lead to strong emotional responses.
During an exacerbation of asthma, breathing is compromised and extremely uncomfortable. It is very frightening not to be able to breathe normally and effortlessly, and instead experience a sensation of suffocation. Let’s say that a young child, for example, develops an exacerbation and becomes increasingly symptomatic in the middle of the night. As symptoms of wheezing and breathlessness progress, the child’s parents become more and more worried, and start to panic a little; they yell at the child to “relax and take it easy.” They argue about whether to proceed to the emergency room, or to call the pediatrician after hours.
You can certainly imagine that the child is likely to become upset, too, and may start crying and acting “emotionally.” The child’s asthma is not a “psychological disease,” but his response to the exacerbation, as well as to the reaction of the adults around him, might be wrongly attributed to an emotional problem.