People with very severe forms of asthma, who rely on prednisone, are more than three times more likely to be depressed than people with asthma who don’t use prednisone and those with mild to moderate asthma. According to a new study from researchers in The Netherlands, prednisone-dependent asthma patients ‘deserve’ screening for depression and anxiety to both remove the suffering and perhaps improve their physical health through the treatment they would receive for mental health conditions. Often, depression can go unnoticed and can develop into a more severe condition. The connection between depression and asthma is well established. As well as being a chronic illness in itself, there are now strong reports of depression levels being high as well. Prednisone is a steroid anti-inflammatory medication which is used to treat asthma attacks in people with severe asthmatic symptoms. Prior studies have found that steroid use can be connected to depression and other mood disorders, and the links go in both directions with depression and the severity of asthma symptoms. This study took place with 187 participants to examine the depression risk among asthma patients. Among the participants, 67 had severe prednisone-dependent asthma and 47 had severe asthma but were not dependent on prednisone. Another 73 patients had mild to moderate asthma – the people in the three groups were similar but the prednisone-dependent group were, on average, older and had greater limitations to their breathing.
All of the patients were asked questions about depression and anxiety, as well as questions regarding their personality traits which could well be a factor in their risk of mood disorders. Researchers discovered that people with severe prednisone-dependent asthma were 3.4 times more likely to be depressed than those with severe, but no prednisone-dependent, asthma. They were also 3.5 times more likely to be depressed than patients with mild to moderate asthma. There were no significant differences in the personality traits of the patients, but there was a 2.5x higher chance of the prednisone-dependent participants developing anxiety than those with mild to moderate symptoms – however, there was no significant difference in those with severe non-prednisone dependent asthma. The increased risk of the depression may well be due to the stress of the treatment, according to researchers, rather than the severity of the illness itself. This could be similar to other chronic illnesses, such as diabetes, which require a complex daily regimen to be treated. Having to maintain the treatment every day reminds you of the illness itself, and that can lead to untreated but long-term depression. The more depressed you are, the less likely you will be able to take care of the responsibility of maintaining your medication. Researchers involved in the study believe that GPs need to be more proactive in screening asthma suffers for depression, anxiety and related disorders, to check early on whether symptoms are present. If you’re concerned about your health or think that you may be suffering with depression, either as an illness itself or as a side effect of your medication, you should speak to your GP as soon as possible so that they can assign you help or medication to treat the condition. The researchers of the study also placed importance on friends, family and caregivers to express their concerns if they believe that they know of someone who is suffering with untreated depression, as often people are either anxious about coming forward with their symptoms or don’t spot them in the same way that people living around them may well do.