It often seems that everywhere we turn, we find more obligations: a Friday night e-mail from the boss, an early morning soccer game, laundry piling up—the list goes on and on. But for those of us with asthma, there is an additional stressor: staying on top of an illness that can unexpectedly take away our ability to breathe. We have medications to take, inhalers to remember, and doctors appointments to go to on top of everything else.
How do we manage all of this stress while trying to stay balanced and enjoy life? We have talked about how social support—strong, nurturing relationships with family and friends—can limit the effects of stress on asthma, but the way we cope with stress and our symptoms also plays a huge role in well-being.
Coping styles are grouped into active and passive. Those with active coping styles identify their stressors and develop strategies for addressing them head-on. When stressors can be controlled, they take action. When stressors cannot be controlled, they reach out for support. People with passive coping styles do not take action to address stressors. Instead, they try to pretend there isn’t a problem or withdraw from the situation by doing things like watching TV, killing time on the computer, and using alcohol or drugs.
The funny thing about those of us with asthma is that we’re all fine. No, I’m not having trouble breathing today. No, that’s not the sound of me wheezing. That cough? Must be something in the air. Now if you’ll excuse me, I need to sneak into the bathroom and secretly take my inhaler. And there is no way I’m calling the doctor because my inhaler isn’t helping—I’ll be fine in a few minutes.
It turns out that denial is a passive coping strategy. And passive coping strategies are associated with poor quality of life for people with asthma.
Coping and Quality of Life in Asthma
Hesselink and colleagues studied the relationship between coping style and quality of life in 220 asthma patients. They found that using avoidant coping styles (like the denial described above) was associated with a significantly lower quality of life and level of functioning than using active coping styles. So, the more actively you cope with stressors, the better your quality of life will be and the less your asthma symptoms will affect your well-being.
There are three potential ways avoidant coping may affect asthma. First, as the authors of the study point out, asthma tends to have periods of full or partial remission. This may lead people to feel their asthma is not as severe as it actually is, leading them to minimize or even deny their asthma. This could lead people to take their control medications less consistently, forget to take their rescue inhaler with them, or not be careful about avoiding triggers.
Second, people who generally cope with stressors by avoiding them instead of addressing them may generally be more stressed. Their stressors can grow in severity when not dealt with, and for many with asthma stress is a potent trigger. People may also resort to unhealthy behaviors, like internet addiction, drugs, and alcohol, to try to ignore them.
Third, the authors of the study found that feeling unable to address stressors is associated with lower quality of life in people with asthma. When people feel like they cannot meet the demands of a situation, they may not feel able to do what is necessary to resolve a stressor. Because they feel like they cannot fix the problem, they may resort to passive coping strategies.
What Can You Do?
Since active coping strategies are related to better quality of life and less impact of asthma symptoms, it may be beneficial to work on active coping. These resources may help:
Hesselink, A. E., Pennix, B. W. J. H., Schlosser, M. A. G, Wijnhoven, H. A. H., van der Windt, D. A. W. M, Kriegsman, D. M. W., & van Eijk, J. T. M. (2004). The role of coping resources and coping style in quality of life of patients with asthma or COPD. Quality of Life Research, 13(2), 509-518.
Van De Ven, M., Engels, R., Sawyer, S., Otten, R., Van Den Eijnden, J. (2007). The role of coping strategies in quality of life of adolescents with asthma. Quality of Life Research, 16, 625-634.