With symptoms like shortness of breath and difficulty breathing, it’s easy to understand why anxiety is common in chronic obstructive pulmonary disease (COPD) patients. Anxiety can bring up feelings of nervousness and fear, and even physical symptoms which can impact day-to-day life. Identifying, understanding and managing anxiety is important for people living with COPD. Especially since this connection between anxiety and COPD is associated with more severe COPD symptoms, increased use of healthcare, more hospitalizations and need for treatment.
“One of the most basic elements our bodies need to survive is oxygen, which we obtain through breath. COPD impacts one’s ability to breathe deeply, and this alone can result in anxiety, not to mention the psychological stress that can arise from living with chronic illness,” says Caryn Blanton, MSW, LCSW, a licensed clinical social worker at Rush University Medical Center.
The American Lung Association’s Airways Clinical Research Centers (ACRC) recently published research findings on the effectiveness of questionnaires evaluating anxiety in COPD patients in the Annals of the American Thoracic Society. The study found that symptoms of anxiety among patients with COPD were common and significantly higher based on the results from each of the three screening questionnaires compared to the prevalence of anxiety disorder as determined by the “gold standard” screening questionnaire. The results show there is a need for improved anxiety measures for patients with COPD—for both early identification and treatment.
“Recognizing these symptoms and learning how to manage them, can greatly increase one’s quality of life,” Blanton said.
To better understand the impact of anxiety on people living with COPD, we got more information from Blanton, who is part of an interdisciplinary team that assists patients in identifying and addressing psychosocial needs impacting a patients’ ability to be successful in reaching their healthcare goals.
Q: Why is anxiety especially common in COPD patients?
A: When our breath becomes shallow, our brains can sometimes perceive there to be a stressful situation at hand, even when there isn’t. This can cause a stress response in the body, often referred to as anxiety. It is important to understand that this is a normal function of the brain and finding ways to cope with anxiety due to shortness of breath can make your day-to-day activities easier. Some ways to do this would be to engage in psychotherapy (mindfulness-based where available), talk with spiritual leaders, attend support groups or lean on friends and family; connection with others can be very healing, and it can also be a welcome distraction from how we’re feeling inside.
If you feel that you are experiencing symptoms of anxiety, talk with your healthcare provider as they will be able to provide some additional guidance and make recommendations for connection to additional support.
Q: Why is it important to recognize and address anxiety while living with COPD?
A: Facing the complex emotions that arise with a diagnosis of COPD can sometimes leave us feeling anxious. In addition to this kind of anxiety that we might expect living with a chronic illness, people living with COPD often experience shortness of breath. Whether we realize it or not, breathing not only brings oxygen into the lungs, but it also taps into something called the autonomic nervous system, which is what regulates many of the automatic processes that occur within the body. Intentionally trying to lengthen the breath can help your body feel safe and calm, thereby decreasing your symptoms of anxiety. One way to do this is to pay attention to your natural breath and count the seconds it takes to breathe in and out at a normal pace. For you, it might be only one count on each side, and that’s OK. Gradually try to increase the length of time you exhale first, then begin to increase your inhale, and try to deepen your breath by breathing deep into your belly. To start, focus on keeping your exhale either even with, or a little longer than your inhale to get the most calming benefit. This is called belly breathing and helps to relax the body and mind. Finding a way to manage your anxiety can help improve your quality of life.
Q: An important part of living with COPD is creating a support system. How are support groups helpful?
A: Coping with your emotions is an important part of caring for yourself or your loved one who is living with COPD. Support groups, like the Better Breathers Clubs, are wonderful because not only do they decrease isolation, which can lead to depression, but they make you feel a part of a community who really understands what you’re going through. Support groups can create feelings of hopefulness and provide an opportunity for you to learn new coping skills. There is often a sharing of resources and ideas that you would not have access to in a typical social setting.
Altogether, this can make a great impact on one’s mental health. It can feel uncomfortable at first, but if you stick with it, you can reap all of the benefits groups have to offer.
Q: What tips would you give to someone living with COPD?
A: Find ways to continue to engage in things that bring you joy. If you love going for brisk walks but now find them to be frustrating, find ways to take slower, shorter walks or walk places where you know there are benches for resting along the way. Maybe bring a buddy who can help you pace yourself. For some, using a rollator (rolling walker with a seat) could be a nice option for more frequent breaks.
Practice mindfulness, deeper breathing, and perhaps engage in more accessible or restorative forms of yoga, including chair yoga. Engage with your support system. Be patient with yourself. A new diagnosis requires some adjustment. If you begin to experience symptoms of depression or anxiety, know you are not alone and there is help available to you
Talk to Your Doctor
Anxiety (and depression) can be very serious. If you experience symptoms of depression and anxiety, talk to your doctor right away. Your doctor can connect you to healthcare professionals (such as counselors or therapists) who can help you work through your emotions and can help determine if medication might be right for you.
Get more information on COPD and coping with emotions. Also, join our free, online Inspire community, “Living with COPD,” where you can learn and share with others living with or caring for someone with COPD. Call the Lung HelpLine (1-800-LUNGUSA) to talk one-on-one with a medical professional who can offer tips and connect you to resources.
Caryn Blanton is a licensed clinical social worker at Rush University Medical Center