Expert: Marc Rubin, RPh Asthma Educator - 10/29/2010

Question
I've been suffering from asthma since my 20th birthday, believed to have
started from exposure to black mold.  I've since been on two nasal sprays,
asmanex twist inhalers and a albuteral sulfate emergency inhaler.  However,
when I take my medicine, it has a habit of putting me on edge.  So much so
that if I take it daily, then it starts to cause major anger issues, massive dips
into depression, suicidal thoughts and has more than once caused me to put
my fist into a wall.

A friend of mine's mother had issues after she became asthmatic as well, and
doing some research, we both came to the conclusion it might be a psychosis
from the steroids.  As I have no health insurance anymore, and no doctor I
can speak to, I wanted to know if there is an alternative to these medicines,
such as a steroid-free one that might help with these issues?

Answer
Hi Bryan,

Realistically, you and your friends mother are not having steroid psychosis. The psychosis you refer to is from "anabolic" steroids, not corticosteroids which are involved in the inflammation process. Anabolic steroid, such as testosterone, are taken by athletes and weightlifters to increase muscle mass by building tissue. The fact that the word "steroid" appears in both groups is due to part of their chemical structure, not their actions or side effects. In fact, the inhalation steroids are the "Gold Standard" of asthma therapy, and the basis of treatment for patients with continuous asthma symptoms. If psychosis was an issue, this would certainly not be the case, especially with 8 million asthmatics in this country.

A greater likelihood is the fact that neither of you have been provided educational materials from your physicians to allow you to understand what is taking place in your body, and therefore, take control of the condition, rather than be controlled by it. That lack of control leads to anxiety, frustration and anger, all of which can take you to a dark view of life.

I also have the feeling that you have not only not been educated on what exactly asthma is, but the role the meds play in restoring healthier lung function. In addition, you do not mention whether the black mold is in your home, or if has been eradicated.

To learn about asthma, I can provide you with education, or you may wish to start by going to a number of professional websites that provide patient education:

http://www.aaaai.org
http://www.acaai.org
http://www.lungusa.org

This is a good place to start.

In addition, contact your local health department regarding your need to receive health care. They should be able to assist you in this.

Feel free to get back to me after you've done some educational homework.

Sincerely,

Marc