Why your Shortness of Breath gets Worse When you are Down?

March 17, 2023
Mental Health
Stephen Keenan
4 mins read

If you are suffering from asthma or COPD, you may have noticed that your shortness of breath gets worse when you are feeling low, or when you are down and depressed. It is quite natural to feel that way. Let’s dive into the research that supports the link.

What the Experts Say

It was commonly thought that feeling intense emotions does contribute as a triggering factor for the symptoms of asthma and other chronic lung illnesses. Research has now shown it to be true. When you are experiencing psychological or emotional stress such as depression, there are respiratory changes that may lead to exacerbations if you have asthma or COPD. [1]One study suggests that emotional distress early in life can affect the nervous system and the release of certain hormones in your blood. [2] It indicated that this chain of events leads to glucocorticoid (GC) resistance.

💡 Glucocorticoids are produced by important glands in your body. They play a pivotal role in the metabolism (processing) of glucose, protein, and fat metabolism in the body.

This can result in inflammation and certain shifts in your immune system. It means that if you have depression and asthma side by side, the GC resistance and accompanying inflammation can make your shortness of breath worse by exacerbating your asthma.

Another study looked into patients who were displaying signs of depression and who had asthma. They noticed that having received treatment for their depression (a course of antidepressants in this case) they reported feeling less depressed, but also reported improvements in asthma symptoms. [3]

Finally, another study looked at the link between depression and decreased lung function. [4] They found that not only did asthma and COPD patients’ lung function decrease with depression but so did those in the general population. Despite not concluding the reason for this, they cited a few possibilities:

“For example, decreased lung function may be related to symptoms such as dyspnea which can lead to feelings of hopelessness, reduced physical activity, social isolation, and a sedentary lifestyle.”

💬 a fancy way of saying that a decrease in lung function, and the breathlessness that follows, can lead to feelings of hopelessness, reduced physical activity, social isolation, and a sedentary lifestyle 🧐

“A previous study found that the relationships between depression and lung function appear to be partly mediated by proinflammatory cytokines such as interleukin-6 and C-reactive protein”

💬 a scientific way of saying a group of molecules that are produced by your body that stimulate inflammation might be the link that causes depression to affect lung function 🧐

What you can do to help

To conclude, yes, intense emotions and depression can worsen your breathing problems if you already have asthma or COPD. The good news is that there are actions that you can take to minimize it such as counselling, CBT, or meditation. Talk to your doctor about the options available to you. Lastly, if you might be in a stressful situation or one where you know you might be emotionally affected,  ensure you keep your inhaler with you - you’ll thank yourself later.


[1] Mai Leander, Erik Lampa, Anna Rask-Andersen, Karl Franklin, Thorarinn Gislason, Anna Oudin, Cecilie Svanes, Kjell Torén, Christer Janson, Impact of anxiety and depression on respiratory symptoms, Respiratory Medicine, Volume 108 (11) 2014, Pages 1594-1600, ISSN 0954-6111,https://doi.org/10.1016/j.rmed.2014.09.007.

[2] Van Lieshout, R. J., & Macqueen, G. (2008). Psychological factors in asthma. Allergy, asthma, and clinical immunology: official journal of the Canadian Society of Allergy and Clinical Immunology Volume 4 (1), 12–28. https://doi.org/10.1186/1710-1492-4-1-12

[3] Brown ES, Vigil L, Khan DA, Liggin JD, Carmody TJ, Rush AJ. A randomized trial of citalopram versus placebo in outpatients with asthma and major depressive disorder: a proof of concept study. Biol Psychiatry, 2005; Volume 58(11) 2005, Pages 865-870 https://doi.org/10.1016/j.biopsych.2005.04.030

[4] Park Y, Jung JY, Kim YS, Chung KS, Song JH, Kim SY, Kim EY, Kang YA, Park MS, Chang J, Leem AY. Relationship between depression and lung function in the general population in Korea: a retrospective cross-sectional study. Int J Chron Obstruct Pulmon Dis. Volume 13 2018, Pages 2207-2213 https://doi.org/10.2147/COPD.S169025

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