In children with bronchial asthma, parents usually serve as the care partner. It is extremely important that all members of the child's family be aware of the nature of this disease as well as of the treatment needed. Conflicts can be avoided through proper education directed by the child's physician. This education should also be directed to teachers and friends who are involved in the child's daily activities.

Children may have problems accepting that they have an illness that may cause restrictions on their activities. They may suffer embarrassment at school or play when they suffer attacks. The physician and parent must reinforce a positive attitude in the child regarding asthma to avoid loss of self esteem and development of poor self-image. Emphasis should be made on maintaining as close to normal as possible activities at home and school, including exercise. This should be understood by teachers as well as parents. The school nurse or physician should be made aware of the child's illness and should have on record the child's physician's name and a list of the child's medications.

Asthma Camps

Support groups for children and parents are available that take the form of ";asthma camps"; or year round activities. The physician should be able to direct or advise parents in contacting these groups.

Stress and Asthma

Asthma has often been associated with anxiety and stress to such an extent that many individuals have erroneously attributed the disease to a psychological disorder. A recent study has documented that anxiety occurs no more frequently in patients with bronchial asthma than in the general population. The same appears true for depression.

Anxiety and Depression

In the more severe asthmatic the level of anxiety increases, usually due to feelings of breathlessness and chest tightness experienced more frequently by patients with moderate to severe asthma. Patients who have suffered severe attacks and may have had emergency care or hospitalization may also suffer increased anxiety. Depression may also develop in a setting of chronic bronchial asthma as with any other chronic illness.

Although anxiety and depression may occur in patients with bronchial asthma, there is no evidence that they cause the disease. It is likely, however, that they are aggravating factors in the course of this illness. Therefore, every effort should be made to reduce your stress and to treat anxiety and depression. This is accomplished best by psychological counseling. Relaxation techniques and biofeedback have also been helpful in reducing stress in patients with bronchial asthma. As a rule, tranquilizers should be avoided, since they may affect your respiratory drive and decrease your awareness of shortness of breath. Some antidepressants may also have adverse effects on the respiratory system. Before any medication is prescribed for anxiety and /or depression, there must be close consultation between the primary physician and the consulting psychiatrist.

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