I wake up in the middle of the night, and rummage around. I jump out – I’m going to drown. I can’t find it and I feel like I am falling faster now, tumbling down into nothingness and I just need to keep my head up…
and breathe. My inhaler! Okay, got it.
A few gulps of the medicine’s vapours and I’m good. I still hold the inhaler in my mouth for a while though, a doctor told me it helps to ensure the medicine gets absorbed and I hold onto this half-remembered fact and cradle myself back to shore, to air, to normalcy.
I have an inhaler next to my bed. One in my bag. And one in my dresser. A couple more are strewn around my house – but some are also for my brother and some may be expired so I could buy another, I rationalise.
Asthma - A Childhood Friend and Foe
Asthma is common, and according to the World Health Organisation, just India has around 15-20 million asthmatics. I keep multiple inhalers around to cover all my bases, just in case.
It wasn’t so bad earlier. I have a mild form of asthma, which was highly manageable – I would tuck away an inhaler in my school bag just to be safe though, but I rarely needed to use it. IF I did, I always had time to excuse myself and scuttle away to a lone corner or a loo for privacy.
It was never something I was ashamed of though, it had little consequence and I honestly had greater things on my mind like what’s going on in One Tree Hill or what homework I had, in that order.
But stumbling into adulthood meant various complex things, one of them being increased anxiety.
Again, highly manageable, and it’s always brushed away (even in my head) as just the jitters and I do usually ease into stability pretty soon.
Plus, doesn’t everyone freak out and get a giant pit in their stomach regularly – a couple times a day? It’s a millennial thing right, we’re all nervous, we all lie somewhere between wanting to be coddled and being fiercely independent.
Again, highly manageable, normal, everyday stress.
Mix asthma and anxiety, though, and we take things up a notch.
Anxiety Amps up the Asthma
What should be solved easily by one puff of my Asthalin inhaler, when combined with general anxiety becomes an often tizzy free-fall till I calm down. Again, this is happening inside, this lasts for one minute and is pretty manageable. Mostly.
When I feel an asthmatic attack coming, I now tense up, especially when my inhaler is not in sight. I rummage through my bag more frantically than I need to. I should be able to breathe easy again by modulating my breath but at that moment I need my inhaler, I need relief and don’t want to think and do pranayam, not now.
I keep thinking – I need to find my inhaler or I’ll be worse. The anxiety builds up. I need something to hold on to or I will drown.
It gets worse. My asthma amplifies and I now need three puffs. WebMD backs this up, and Dr Peter Gergen from the National Institute of Allergy and Infectious Diseases says “During periods of stress and anxiety, asthma attacks occur more frequently, and asthma control is more difficult,” he says.
Stress-induced asthma attacks have a name – anxiety asthma. It’s not very creative but it does underline that the co-relation is not all in your head.
There is scientific, medical proof that stress or anxiety exacerbates asthma. This makes logical sense too, since stress does manifest itself physically – a higher heart rate, dizziness, digestive issues and chest pain among others reports Medical News Today.
So if there is a pre-existing respiratory condition, it would follow that stress or anxiety would make this worse.
They’re really very common, mild conditions, but together they may be making things not so ‘highly manageable.’
Not All Doom and Gloom
Remember that piece of advice I ignored earlier? To breathe? That’s the one the experts keep coming back to.
To nip the nasty cycle of anxiety asthma in the bud is tough, and takes a lot of unlearning. I am still a work in progress, but I’ve learnt to identify stressers as a step one. Most often what stresses us out is out of our control, but I try to re-train my body’s natural instincts – I remind myself to breathe and be still for a moment.
It may sound silly or pointless, but I know that while I’m in the middle of an asthmatic attack I need reminding to breathe deeply and take it slow (generally good life advice also).
One of the benefits of grounding myself like this is knowing that while I do feel helpless and strained during the attack, I can actually regain control of the situation. Another way that works for me is making a plan; this could sound counter-intuitive to some, but for me, knowing the next steps means taking control back.
Now, I will still need my inhaler but by controlling the stress, the urgency of the situation is diluted.
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