context: Stress is a common asthma trigger. An asthma trigger is anything that brings on asthma symptoms. When you have stress and asthma, you might feel short of breath, anxious, and even panicked. Stress may cause your asthma symptoms to worsen and cause you to feel frightened. When stress levels start to creep upward -- whether it's over bills, work, or your kids' jam-packed calendar -- asthma symptoms can kick into overdrive. As the wheezing and coughing gets worse, your health becomes one more reason to worry. Asthma, stress, and anxiety make for a vicious circle, and one that can spiral downward quickly. With persistent asthma, you have symptoms more than twice a week. Treating persistent asthma requires long-term maintenance therapy, such as an inhaled steroid, plus rescue therapy when something triggers symptoms. And when your symptoms are out of control (in the red zone, a severe asthma attack), prednisone for asthma might be necessary for a few days. The problem is that prednisone often causes mood swings as a side effect, adding fuel to your anxiety. Remember, prednisone is a short-term treatment for most people with asthma. After you finish taking the "burst" of oral steroids, your mood will return to normal. Inhaled steroids don't cause permanent mood changes. If your long-term asthma medication doesn't work well, and wheezing and chest tightness occur too often, a vicious circle can begin where anxiety worsens asthma, and asthma worsens anxiety. That's when you need to talk to your doctor about your symptoms, triggers, and stress. Also discuss other asthma treatment options that can get asthma under control again, so you can prevent symptoms of asthma. Stress is part of daily life -- with or without asthma. That's why it's important to find effective ways to manage stress if you do have the disorder. Learning to relax before you feel stressed can help you prevent shortness of breath and avoid an asthma attack. Change Your Thoughts. Learn to change thought patterns that produce stress. What you think, how you think, what you expect, and what you tell yourself often determine how you feel and how well you manage rising stress levels. Reduce Your Stressors. Identify the major stressors in your life such as money problems, relationship problems, grief, too many deadlines, and lack of support. If you can't resolve these stressors alone, get professional help. Avoid Stressful Situations. Try to avoid situations that trigger stress for you. Practice effective time-management skills, such as delegating when appropriate, setting priorities, pacing yourself, and taking time out for yourself. Exercise Daily. Get some exercise. Exercising with asthma is an excellent way to burn off the accumulated effects of stress and also keep your body healthy. Get Plenty of Sleep. With asthma or any chronic illness, you need plenty of sleep. If you are not sleeping well or suffer with nighttime asthma, you will have less energy and fewer resources for coping with stress. Developing good sleep habits is very important. Here are seven sleep tips: Do not go to bed until you are tired. Develop specific bedtime rituals and stick to them. If you have trouble sleeping, do not watch TV, read, or eat in bed. Do not engage in exercise or strenuous activity in the hours before bedtime. Avoid caffeine. Go to bed and get up at the same time every day, including on weekends. Eat a Healthy Diet. Junk food and refined sugars low in nutritional value and high in calories can leave you feeling out of energy and sluggish. Limiting sugar, caffeine, and alcohol can promote health and reduce stress. Delegate Responsibility. Stress often results from having too many responsibilities. You can free up time and decrease stress by delegating responsibilities. Take a team approach and involve everyone in sharing the load. Try applying these eight guidelines at home or modifying them to fit your situation at work: Make a list of the types of tasks involved in the job. Take time to train someone to do the job or specific tasks. Assign responsibility to a specific person. Rotate unpleasant duties. Give clear, specific instructions with deadlines. Be appreciative; let people know you are pleased by a job well done. Allow others to do a job their own way. Give up being a perfectionist. Seek Support. Life is tough sometimes and support from friends and family members is important. In fact, social support is the single most important cushion/shield against stress. Here are some tips you can offer to family or friends when they ask how they can help. Family and friends can do the following: Help you remain as active and independent as possible. Provide emotional support. Help with household chores and with grocery shopping and other errands as necessary. Learn what they can about your condition and prescribed treatment by attending doctors' appointments with you. Provide encouragement and help you follow your prescribed asthma treatment plan. Practice Relaxation Exercises. Relaxation exercises combine deep breathing, releasing of muscle tension, and clearing of negative thoughts. If you practice these exercises regularly, you can use relaxation exercises when needed to lessen the negative effects of stress. Relaxation exercises include diaphragmatic and pursed lip breathing, imagery, repetitive phrases (repeating a phrase that triggers a physical relaxation, such as "relax and let go"), and progressive muscle relaxation. Many podcasts and books that teach these exercises are available. A 2-minute Relaxation Exercise. Concentrate your thoughts on yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. ( Stop any movements that cause pain.) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel more relaxed. Mind Relaxation Exercises. Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word "one," a short word such as "peaceful," or a short phrase such as " I feel quiet" or " I'm safe." Continue for 10 minutes. If your mind wanders, gently remind yourself to think about your breathing and your chosen word or phrase. Let your breathing become slow and steady. Deep Breathing Relaxation. Imagine a spot just below your navel. Breathe into that spot and fill your abdomen with air. Let the air fill you from the abdomen up, and then let it out, similar to deflating a balloon. With every long, slow breath out, you should feel more relaxed.