Have you ever felt discouraged after being told a symptom is psychogenic? In reality, our body functions as an intricately interconnected system. Coughing rooted in the seven emotions, as described in the Donguibogam—a habit cough prompted by psychological factors—is recognized in modern medicine under categories such as chronic refractory cough, habit cough, and psychogenic cough.
The brain exerts a strong influence over physical reactions. Under sustained stress, the hypothalamic-pituitary-adrenal axis becomes overly active, continuously releasing stress hormones such as cortisol. These hormones can prompt systemic inflammatory responses and heighten bronchial sensitivity, making the cough reflex easily triggered by minor stimuli. Chronic stress also disrupts autonomic nervous system balance, suppressing parasympathetic nerve function and overstimulating sympathetic nerves. In this state, bronchial smooth muscle tightens and dries out, allowing coughs to arise more readily, much like the throat dryness experienced when nervous.
The gut-brain axis also influences coughing. When digestive health declines, gut dysbiosis develops, allowing pro-inflammatory cytokines to travel through the blood flow to the brain and contribute to systemic inflammation. This inflammatory state increases the sensitivity of the respiratory system mucosa, including the airway, and lowers the cough threshold. As a result, minor irritants that would normally cause no reaction can trigger a cough.
Over time, chronic cough can sensitize the cough center in the brain, turning into a learned behavior. While the coughing may begin from an initial physical stimulus, it can eventually emerge in response to specific contexts, such as stress, anxiety, or social tension, becoming habitual. This process can involve the brain's reward system, where temporary physical relief or social attention acts as a subconscious reinforcement, repeating the cycle.
Modern medicine addresses habit cough through integrated approaches, combining cough reflex suppressants with cognitive behavioral therapy, mindfulness meditation, and stress regulation techniques. The mind-body connection highlighted centuries ago in the Donguibogam is now supported by findings in neurology and endocrinology. If a cough persists without a clear physical cause, it may be a meaningful signal from the brain and nervous system, and paying attention to that internal state is a practical step forward.
