Manage your severe asthma

Follow this advice to lower your risk of asthma attacks

Health advice > Severe asthma > Managing severe asthma

We’ve created this plan with the help of healthcare professionals and people with severe asthma, to help you manage your symptoms as well as possible.

Having severe asthma is different for everyone. It can vary over time and there are good and bad days. “We know it can sometimes make you feel out of control,” says Asthma + Lung UK’s in-house GP Dr Andy Whittamore.

 “But it’s important to remember there are things you can do that can make a difference,” says Dr Andy. “In fact, it’s vital you look after yourself. Even if you still have symptoms, managing your asthma well can mean you reduce them as much as possible and lower your risk of having a potentially life-threatening asthma attack.”

1. Manage your severe asthma symptoms

“You might sometimes feel there’s no point taking these steps as you’re still putting up with symptoms,” says Dr Andy. “But remember it’s likely your symptoms will be worse if you don’t do the things you need to do to manage your asthma.”

  • Get and use a written asthma action plan
  • Go for regular asthma reviews, at your GP or Specialist clinic
  • Check your inhaler technique at every appointment
  • Know your personal triggers
  • Take your medicines exactly as prescribed
  • Tell your healthcare team about any changes in your symptoms

2. Team up with your healthcare professionals

“To make sure you’re on the right level of treatment for you, see yourself as part of a team, along with your healthcare professional,” says Dr Whittamore. This will help them put the best treatment plan in place for you. As well as taking the simple steps above, you can:

  • Keep a diary of symptoms to show your GP or asthma nurse
  • Film yourself having symptoms if they are hard to describe
  • Tell your healthcare team every time you have had an asthma attack
  • Always talk to your GP or asthma nurse if you have any concerns about your treatment

“Don’t be embarrassed to tell them if you’re having trouble taking your medicine as agreed – you’re not alone, and we would rather you told us so we can help you get the best from your medicines without having to increase doses or change to stronger medicines,” says Dr Whittamore.

Studies show that nearly half of the people with severe asthma who take steroid tablets don’t take them properly. Many people with severe asthma don’t use their inhalers as agreed with their healthcare professional. 

If you know you are having problems with your medicines, tell your GP or asthma nurse. If your treatment isn’t working well, let them know so they can look at how to make it better for you.  Telling them honestly what is happening with your medicines might mean you need a different treatment that is better for you.

3. Keep fit and healthy

When you have severe asthma, looking after your health helps you deal with severe asthma.  It can also lower the risk of getting other conditions. “It’s especially important that you try to avoid gaining weight, quit smoking and deal with stress and low mood,” says Dr Andy Whittamore.

Eat well

It can be difficult to keep your weight down, especially if you are on long term steroids.  These increase your appetite, but if you eat healthy food with lower calories you are less likely to put on weight. Staying active will also help you keep at or work towards a healthy weight.  A healthy diet and staying active is good for the heart and lungs even if you have severe asthma.  Speak to your GP or asthma nurse about healthy eating and increasing your activity levels in a way that’s realistic for you.

Healthy diet and severe asthma

Staying active with severe asthma

If you smoke, quit

Smoking puts you at risk of asthma attacks and can stop your asthma medicines working so well. Over time, smoking raises your risk of getting other lung diseases such as COPD.

People with asthma who smoke should quit.  They should avoid being around secondhand smoke, too.  If you’re finding it hard to stop smoking, speak to your GP, who can offer support.

COPD at the Asthma + Lung UK

Get help for depression and anxiety

People with severe asthma are more likely to feel depressed or anxious.  This is common for people with long-term conditions that need a lot of patience and energy to manage.  But low mood can make it more difficult to manage your severe asthma, so talk to your GP or asthma nurse about getting help dealing with depression and anxiety.

Mental Health and severe asthma


NHS Every Mind Matters

4. Deal with bad days

“Following a list of things you need to do to look after your asthma may seem a big challenge, especially if you have days when you feel down or unwell,” says Dr Andy Whittamore. Here are some ideas for making the more difficult times feel a bit easier:

Have a daily routine

Speak to your healthcare team about ways you can get into a good routine with your medicine, so it’s almost effortless. “It’s a good idea to link taking your medicine with something else you do every day, like brushing your teeth or having a cup of tea when you get home from work,” says Dr Whittamore.

If you’re finding it hard to take your medicine as agreed with your healthcare professionals, talk to your GP about ways that could help, especially when you’re out of your usual routine. And think about other ways you could make life easier. Such as making and freezing healthy meals on days you have more energy. You can defrost and heat them on days you can’t cook.

Remember why staying healthy is good for you

Write a list of all the things that you can do when you look after yourself. Stick a copy on the fridge or keep it on your phone so you can look at it at any time

Give yourself good advice

When it feels too much effort to do things like eating well, exercising and taking your medicine, imagine a friend coming to you and asking for advice on the same problem. What tips would you give them? Could they help you?

Gain confidence from past success

Think about other times you’ve overcome a challenge – whether it was with your severe asthma or something else. What was it? How did you feel at the time? What helped you cope and deal with the difficulties then? Perhaps it was asking others for support or making sure you got plenty of rest. Could you try the same things now to support yourself?

5. Worry less 

It’s natural to have concerns about a serious long-term condition like severe asthma. Here are some of the most common ones that people with severe asthma have shared with us:

‘I’ll always feel like this”

“Asthma can change over time for all sorts of reasons,” says Dr Andy Whittamore. “For example, stress can make it worse, and changing hormone levels in women during pregnancy or menopause can sometimes trigger symptoms. So even if you are putting up with lots of symptoms at the moment, that doesn’t mean they’ll never improve.”

Getting your treatment right can take time, too – your healthcare professional may still be trying to get the best possible combination of medicines for you.

“I’m worried that my severe asthma will get worse in the future” 

Unfortunately, sometimes people with severe asthma can find over time their symptoms get worse. But sometimes symptoms can get worse because medicines are not being taken exactly as agreed with the healthcare team. It could be down to inhaler technique or concerns about steroid tablets. If your severe asthma is getting worse, let your healthcare professional know. It is important to take your medicines exactly as prescribed and talk to your GP or asthma nurse about any worries you have. 

“I’m worried there will never be any treatment that works” 

If you are thinking this, remember scientists are working on new treatments for severe asthma all the time. In recent years, new treatments for severe asthma have become available that are having a lot of success. There are people with severe asthma whose lives are now a lot better because of them. These medicines called biologic therapies (also known as monoclonal antibodies or mAbs.. Not everyone with severe asthma can be offered a biologic therapy at the moment.  But new drugs are being developed and will be available in the future.

6. Get support

“There is evidence to show that people with good support networks can manage a long-term health condition better,” says Dr Andy Whittamore. “Having support – both practical and emotional – is a vital part of managing severe asthma.” 

A support network is made up of different kinds of people. It can mean your family and friends but also work colleagues, your neighbours and your local pharmacy. It is also your healthcare team, your GP and asthma nurse. 

You can build support networks. It can mean finding ways of meeting new people and getting involved in activities, even if there will be times you can’t do them because of your severe asthma. 

Asthma + Lung UK Community Forum

Breathe Easy Support Groups - Asthma + Lung UK

Severe asthma may mean you have to change your working life, or even stop working, leaving you with money worries. Severe asthma can be considered a disability, so make sure you find out about the benefits you may be entitled to. 

“Having severe asthma should not control my life and I won’t let it. I’m a very positive person and I try to remind myself there are always people who are worse off. I’m in a fortunate position as I have excellent medical care and an understanding GP. I know I’m good at managing my condition and I take it very seriously as I have to. I can’t afford to be complacent.”

 – Celena

Benefits and severe asthma

Work and money and severe asthma

Don’t forget, you can always call our friendly asthma nurses on 0300 222 5800 or message them via WhatsApp on 07378 606 728 (Monday-Friday, 9am-5pm) for support and advice.


Last updated March 2020

Next review due March 2022

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