“Ask Kwynn” Advice: Anxiety-Induced Asthma?

Dear Kwynn,

I am a high school Phys. Ed. teacher in Middle Tennessee, and I have recently been having a hard time working with one of my students who suffers from asthma. I understand that asthma is a serious condition and that PE and asthma don’t sound like they go hand in hand. However, at this time, my student, Emma, is not participating in any PE activities with her classmates. I don’t want her to feel excluded, and I also don’t want her to miss out on important physical activity, but every time I try to get her to participate in an activity, even a modified one, she starts displaying asthma-like symptoms, sometimes even full-blown asthma attacks. I understand that the idea of participating in PE when you have asthma can be scary, but can this fear affect her so much that it actually causes her to have an asthma attack? I don’t want her to think I don’t believe her or that I’m not taking her asthma seriously, but I really think some of it might be caused by nerves. How do I approach this?

Thanks,
Derek H.

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Hi, Derek.

Thank you for reaching out. I’m glad you’re trying to get Emma involved in physical activity and that you want to her to feel included in normal activities despite her limitations from asthma. According to the Mayo Clinic, asthma is a chronic condition that affects the lungs, causing “airways to narrow and swell and produce extra mucus, making breathing difficult and triggering coughing, wheezing and shortness of breath.”

Asthma affects people differently and can be divided into three main categories:

  • Exercise-induced asthma, which may be worse when the air is cold and dry
  • Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
  • Allergy-induced asthma, triggered by airborne substances such as pollen, mold spores, cockroach waste or particles of skin and dried saliva shed by pets (pet dander)

 

Has Emma or her parents disclosed what causes her asthma? It’s possible that hers may be exercise-induced, which would definitely make her nervous about participating in your PE activities.

The following list includes common asthma triggers:

  • Airborne substances, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste
  • Respiratory infections, such as the common cold
  • Physical activity (exercise-induced asthma)
  • Cold air
  • Air pollutants and irritants, such as smoke
  • Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
  • Strong emotions and stress
  • Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
  • Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat

 

If you look at the list above, strong emotions and stress are listed as an asthma trigger, so it is possible that Emma’s intense fear of participating in PE could be creating asthma-like episodes or sending her into full-blown attacks. Researchers and physicians are working to reduce anxiety-induced asthma through techniques like breathing retraining or cognitive behavioral therapy.

It may be a good idea to sit down with Emma, her parents and, if possible, her doctor, to create a plan for Emma so she can participate in PE in some modified capacity (if her doctor determines she is safe to do so). It’s important that Emma has a say in these activities and that she feels safe and supported throughout the activity. The plan could start off with Emma walking one lap around the school gym with a friend at a slow pace. Once she feels comfortable or is not experiencing anxiety symptoms, she can build onto that activity. Emma’s anxiety likely won’t change overnight, but with the right support and practice, she may one day be your star PE pupil.

All the best,
Kwynn


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About Kwynn

Kwynn is currently pursuing a PhD in Social Work at the University of Utah. She comes from a public health background, having earned both a Master of Public Health degree with a focus on community health and a Graduate Certificate in Lifestyle Health.

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