Asthma (Teenagers)

What is asthma?

Most people associate asthma with sudden fits of coughing and wheezing, but the disease is actually present 24 hours a day. If your teenager has asthma, the tubes that carry air to her lungs are inflamed and may be swollen and clogged with mucus. This state may not impair her breathing, but it does set the stage for asthma attacks. Her inflamed airway is extra sensitive, and something as seemingly harmless as dust, cold air, or exercise can cause the muscles lining the airway to suddenly squeeze tight, leaving little room for air to pass.

How can I tell if my teenager has asthma?

Asthma's symptoms can mimic those of pneumonia, bronchitis, allergies, or even a cold, so it's not always clear. Wheezing and coughing (particularly at night) are the most common symptoms of an asthma attack, but other signs -- tightness in the chest or shortness of breath -- are also indications of asthma.

If your teen's symptoms keep him from sleeping through the night or if they interfere with his normal activities, he could have asthma. You should have a doctor examine your child to determine whether or not he has it, and if he does how severely the disease affects his lungs. Keep in mind that many teens with asthma also have allergies; if your teen suffers from hay fever or other allergic reactions, take any sign of asthma seriously. Also, since colds and other respiratory infections often lead to attacks, you should suspect asthma if your teen keeps coughing long after an illness has faded.

What can I do to prevent attacks?

Try protecting your teenager from the allergies and irritants that commonly trigger attacks. No family members should ever smoke in the house, and urge your teen never to smoke; she should also avoid breathing secondhand smoke. Vacuum your floors regularly, clear her room of major dust traps such as potted plants, rugs, and carpet, and get bedding made of non-allergenic materials. If she's allergic to your pets, ask your allergist for advice. Meanwhile, keep them outside or at least out of her room. (Washing your pet regularly is also effective.) If she suffers asthma attacks only in spring and fall, try limiting her exposure to pollen -- the likely culprit in seasonal allergies -- by keeping the windows closed and installing filters in your air conditioner. When she goes out in cold weather, remind her to breathe through her nose and suggest that she cover her mouth with a scarf.

Physicians have long speculated that strong emotions can trigger an asthma attack, and a study from the University at Buffalo in New York backs up that theory. The research found that young people have nearly twice the incidence of depression compared to peers without asthma and that being depressed can increase their asthma symptoms. In addition, another study found that kids faced with threats such as street violence were twice as likely to show symptoms of asthma as other children. For these reasons, some psychologists recommend suggesting your child have an appointment for counseling if she seems depressed or under a lot of stress.

Can my teenager still exercise and play sports?

Absolutely. Many top Olympic and professional athletes have asthma, and there's no reason the condition should keep your teen from her favorite sports. If she's prone to attacks during exercise, she may need to use her inhaler right before working out. Swimming is an excellent form of exercise for anyone with asthma because the warm, humid air around a heated pool makes breathing easier. Sports that require constant motion, such as soccer, may be particularly challenging, but your teen can almost certainly find a way to stay in the game. She should always have her inhaler close by, though, in case she needs it.

How is asthma treated?

Doctors use two types of medications: one that reduces inflammation (a "controller") and one that opens the airways (a "reliever").

Corticosteroids and similar drugs -- which are either inhaled, injected, or taken as pills -- can ease the inflammation in your teenager's airways and make her less likely to have attacks. Bronchodilators, which are spray drugs usually taken using an inhaler, can make breathing easier by relaxing the muscles that squeeze the airway during an asthma attack. If your child is still struggling to breathe after using the inhaler more than twice, call 911 or get her to an emergency room immediately.

An asthma journal and a peak-flow meter -- an instrument that gauges how well your child is breathing -- can also be important parts of the treatment plan. By using the peak flow meter regularly to measure the force of her breath and by tracking the number and severity of her attacks in a journal, your teenager can give her doctor information that lets him evaluate how well the treatments are working. Recording what she was doing or feeling just prior to an asthma attack also helps her identify triggers to avoid. Based on this knowledge, the doctor might change your teenager's medications to give her better control over the illness.

How can I encourage my teen to take her medicine?

Even if your teenager has been dealing with asthma since grade school, she may suddenly have trouble sticking to her treatment. Indeed, one study found that while both children and teens under-used long-term control medication across the board, teens were 20 percent more likely to show signs of inadequate control of their asthma than younger children. Fearful of being teased or ridiculed, many teens try to keep their condition a secret, which often means going without their inhalers or pills.

When left untreated like this, the disease can get worse, leading to permanent lung damage or even a life-threatening attack. Tell your teen that the medications can help her lead a normal life filled with sports and socializing -- if she doesn't try to keep her asthma to herself. Instead, she should tell all her friends and teachers about the condition so they'll be supportive and less likely to panic during an attack.

The good news is that by taking an active role in managing asthma, your teen can lead a full life.

Further Resources

The American Lung Association, (800) 586-4812 or http://www.lungusa.org , has more tips to help both you and your teenager cope.

The Asthma and Allergy Foundation of America, (800) 727-8462, offers referrals to books, pamphlets, videos, and local support groups.

References

Science News, Stress and Depression Worsen Childhood Asthma, Researchers Show. https://www.sciencedaily.com/releases/2009/07/0907...

Miller BD, Wood BL. Influence of specific emotional states on autonomic reactivity and pulmonary function in asthmatic children. : J Am Acad Child Adolesc Psychiatry; 36(5):669-77. http://www.ncbi.nlm.nih.gov/pubmed/9136502

Lozano P et al. Asthma Medication Use and Disease Burden in Children in a Primary Care Population. Archives of Pediatric and Adolescent Medicine. 157(1):81-8. http://www.ncbi.nlm.nih.gov/pubmed/12517200

Wood BL, Lim J, Miller BD et al. Family and emotional climate, depression, emotional triggering of asthma, and disease severity in pediatric asthma: examining the pathways of effect. Journal of Pediatric Psychology;32(5):542-51. http://jpepsy.oxfordjournals.org/content/32/5/542....