Abstract

THE DUAL BURDEN OF ASTHMA AND ANXIETY: FROM SHARED MECHANISMS TO COMPREHENSIVE CARE

Ahamed Bilaal*, Satish S. and A. R. Shabaraya

Abstract

Asthma is a prevalent chronic respiratory disease affecting over 300 million people globally, characterized by episodic or persistent symptoms and airflow limitation due to bronchoconstriction, airway wall thickening, and increased production of mucus. This disease often coexists with anxiety, which significantly affects patient outcomes. Anxiety, identified as the strongest predictor of dyspnea in asthma, exacerbates the perception of symptoms, impairs cognitive function, and reduces coping mechanisms. This review explores the association between asthma and anxiety, including biological and psychological mechanisms such as inflammatory pathways, neuroimmune interactions, genetic factors, and autonomic dysregulation. Elevated inflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP) indicate a common inflammatory mechanism that contributes to the comorbidity. Epidemiological studies highlights a bidirectional relationship, with each condition increasing the risk of developing the other. This relationship is evident across all age groups, with higher prevalence among women and younger adults. The presence of anxiety in asthma patients leads to poorer asthma control, more frequent exacerbations, and overuse of healthcare services, significantly burdening both patients and healthcare systems. Effective management strategies, including cognitive-behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), pharmacological treatments, and breathing techniques, have shown promise in reducing the impact of anxiety on asthma. Additionally, integrated pharmacotherapy, telemedicine, physical exercise programs, and peer support are valuable tools in addressing the complex relationship between anxiety and asthma. By addressing both conditions simultaneously, patients can achieve better asthma control and an improved quality of life.

Keywords: Anxiety, Asthma, Cognitive-behavioral therapy, Inflammatory markers.