Asthma or Anxiety

Chest and lungs
1

Hi there, I reckon I have suffered with anxiety for over 2 years now and the last few months have for progressively worse to the point my doctor wants to put me on antidepressants although I'm not depressed, the 2 are different issues!

I have found at times that out the blue I start wheezing when inhaling and it's really scary as I automatically think I'm going to stop breathing (hence the anxiety) I have had a chest X-ray, lung function test and ECG and all were normal in fact the spiriometery test was above average. I am really curious and any info regarding this would be really appreciated... Can anxiety really cause wheezing or have the doctors misdiagnosed and I may possibly have asthma?! 🤔

2

Hi Lisa,

Just a quick note of how much I understand what you're going through. I've been sick for 16 years and because they can't find the biological basis for it the doctors that see me in the hospital try to say it's a psych thing. Never mind the two doctors who've seen me all these years say differently. So, yeah, I get it.

So, as for you my dear, there is something that comes to mind regarding your symptoms that you might want to have considered. It's call vocal chord dysfunction (VCD) I can be caused by anxiety, anxiety definitely makes it worse. People may often be thought to have asthma but upon all the testing (PFT's and the like) its all negative. Then they find out they have a VERY treatable thing called VCD! You can see a speech therapist who can help you relearn talking and breathing techniques and teach you interventions to mitigate they symptoms and get you back to being focused on living rather than whether or not you're going to stop breathing or not. Whew! What a relief it would be! Huh?

So, the thing is, a lot of the anxylitics are actually addictive. Things like klonopin, xanax, and I think even ativan, can be physically addictive, as well as psychologically addictive. Addiction can run on both sides of the gamet. The body may become physically dependent on a drug, but the mind can also become dependent. So there can be a double whammy. That said, frequently, various classes of antidepressants are often used to very successfully treat mild anxiety. (It doesn't take much anxiety to make one feel that one can't breath!) The beauty of the antidepressants is that they aren't addictive! Ones like the class called tricyclic antidepressants are particularly useful in this area. There may well be some newer classes that I'm not aware of. But the tricyclics are oldies but goodies, as the saying goes.

So in short, the antidepressants might be a good interim treatment to help you get through until you can figure out what's really going on!

Just remember, you can always get a second opinion, but you have to be careful about that. Because if you look long and hard enough, you'll eventually find a doctor to treat you the way you WANT to be treated, rather than the way you NEED to be treated!

I hope this helps. From what little I can gather, it sounds to me like you're doctors actually on the right tract!

Hope you feel better soon!

3

Yes, as the previous poster has mentioned VCD (Vocal Cord Dysfunction) can easily be exacerbated and even caused by anxiety. In all likelihood, your doctor probably isn't about to prescribe you anything from the Benzodiazepine class of drugs Clonazepam (Klonapin), Alprazolam (Xanax), Lorazepam (Ativan) to manage your anxiety long term. Because they do cause a dependence when used long term... benzodiazepines are frowned upon nowadays, they are best used infrequently as tolerance and dependence develops very quickly.

If I had to guess, you'll probably be given an SSRI or SNRI like Fluoxetine (Prozac) or Venlafaxine (Effexor) one of the best imo. Antidepressants can and do work for anxiety.. sometimes in conjunction with a very short initial course of something like Diazepam (Valium) as the antidepressant can take a week or two to kick in. The biggest problem with antidepressants IMHO is weight gain and after a prolonged course need to be tapered otherwise you can get rebound symptoms.

​One common symptom with VCD is that the tightness and wheezing happens when you breathe in. In asthma it's the opposite, you feel tighter when you breathe out. Having said that in a severe asthma attack you feel very tight breathing in and out. To complicate matters a good proportion of asthmatics have VCD as well. While it sounds like you do have VCD.... have you had a saline challenge test to help rule out asthma. Though the fact you have above average spirometry and normal lung function tends to rule it out. In lung function testing asthma presents in a unique way (even if you don't feel tight at the time), the lines marking exhaling tend to be scalloped rather than nice and linear.

​I tend to agree, I think your doctor is following the right path. I've got both severe asthma and VCD. I've seen a speech pathologist and the exercises help retrain the muscles around your throat so to speak and treating anxiety also helps with that. But VCD is a very different thing to asthma, from what you’ve said, I’d be inclined to say that it’s more likely to be VCD.

Psychotherapy along with medicine can help you manage your anxiety and can help you get to the bottom of what causes you difficulty, giving youthe ability to work through it and get off any medications.

4

Hi neo and Shelley

Thank you both for your comments. Never heard of that before by reading about it seems to fit the bill!! To the point where I think I just don't know how to breathe properly and could do with lessons on how to! Sounds silly but that's exactly how I feel. I've been telling myself for months I don't know how to breathe properly and just put it down to anxiety. I feel like it even when I'm not anxious but then as the vicious circle goes I get anxious because I think I can't breathe 🙀 I am waiting for appointment to come through to see healthy minds to help deal with the anxiety and wonder whether they may be able to refer me to someone who deals with breathing techniques? I feel as though it's taking over my life and has really got me down. Felt like it's all in my head 😢 My only concern is doctor gave me citrolpram along with diazepam as you also suggested but so scared to take them. I really don't want to stay in them as doctor suggested about 12-18 months! I know they can potentially make anxiety worse too initially... I'm also dealing with breast pain with all of this which doesn't help. I am 46 so not sure whether there's a mixed bag of peri menopause too just to add to it! 🙄

5

Every morning I wake up with a dry nasal passage and chest. I will dry cough and it feels like my chest is tight. This causes some anxiety for me. Recently I had a case of bronchitis and pneumonia and ever since it cleared up I wake up with this every morning. I will cough off and on for about an hour or so and then I am fine. Sometimes the shower will bring up yellow and green mucas but the rest of the day it's clear. I am worried that maybe I have developed Asthma. I had a panic attack while I was sick and went to the ER. The oxygen test that they give you on your finger was fine. I was around a 99. They did an X-ray suspecting pneumonia at that time but it was clear. I did get it about 3 weeks later though. I am smoker and need to quit. I went to my doctor and he said I have allergies and I am stressed out. I am taking Zyrtec at night now but still wake up to this slight heaviness and cough shortly afterwards. Any thoughts on whether it could be Asthma or allergies like the doc said?

6

My dr seems to think antidepressants cure everything he of course is a head dr.  Anyway before you take any medication that messes with your brain read up on the side effects.  Also most dr etc seem to think they work no better than a placebo a difference of .5.  They may benefit people with severe depression, but they say they still don't now what the drugs really do.