Chronic obstructive pulmonary disease, commonly only referred to as COPD, is a term used to refer to a group of progressive lung diseases. The most common of these are chronic bronchitis and emphysema. Many people with the chronic obstructive pulmonary disease tend to have both these conditions. Many people with the chronic obstructive pulmonary disease also tend to have anxiety for a wide variety of reasons. When you have trouble breathing, it is common for your brain to set off an alarm to warn you that something is wrong. This is usually the cause of anxiety or panic. It has been found that anxiety treatments like cognitive behavioral therapy can help people with chronic obstructive pulmonary disease deal with their breathing difficulties. Read on to learn all about using anxiety treatments to help people with COPD breathe easier.
What is Chronic Obstructive Pulmonary Disease (COPD)?
Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease that includes chronic bronchitis and emphysema. Many people with the chronic obstructive pulmonary disease have both these conditions. While emphysema slowly damages the air sacs in the lungs, which interfere with outward airflow, bronchitis causes inflammation and narrowing of the bronchial tubes, which leads to a build-up of mucus.(1, 2, 3, 4) It is estimated that nearly 30 million people in the United States have chronic obstructive pulmonary disease, and what’s more, nearly half of them are unaware that they have the condition.(5, 6)
If left untreated, COPD can cause a faster progression of the disease, worsening of respiratory infections, and even heart problems.
COPD and Anxiety
Chronic obstructive pulmonary disease obstructs the airflow to the lungs, and this can cause anxiety in many patients, which makes breathing more challenging. It can be thought of like a spiral effect. The stress and anxiety cause the breathing to get more difficult, which in turn causes more stress and anxiety. This gets worse again, thus creating cycles of shortness of breath. However, treating the anxiety may lead to a decrease in the suffering of COPD patients, along with a reduction in costs for treatment and hospitalization.
However, a new research study has now found that using cognitive behavior therapy can help reduce the discomfort of COPD patients.(7)
What Does the Study Show About Anxiety Treatment in COPD Patients?
The research team screened COPD patients for anxiety in a study carried out by the Newcastle-upon-Tyne NHS Foundation Trust Hospital in England. Out of 1500 patients in the study, 59 percent were found to have anxiety symptoms. Some of the patients with both anxiety and COPD symptoms were treated with cognitive-behavioral sessions by nurses who specialized in respiratory issues. Others were just administered self-help literature on how to manage anxiety.
The research team found that the patients who were treated with cognitive-behavioral therapy experienced significant improvement in their anxiety as compared to the other participants in the study. The group receiving the therapy had a dramatic reduction in hospital admissions as well.
The behavioral therapy worked by helping the patients work on different ways of coping with and managing their anxiety in order to prevent it from getting out of control.
Coping with Anxiety
Most people with COPD and anxiety often do not understand the link between breathlessness, feeling frightened, and anxiety. They simply assume that the shortness of breath is due to COPD. When you feel terrified, you struggle to breathe, which in turn makes breathing worse. However, there are some things you can do to control these fears, thus helping tone down your anxiety.
It is easier to master such coping mechanisms if you have a little help from a mental health professional, especially if that professional has expertise in dealing with lung conditions like COPD and anxiety. In such a case, they would be better able to tell you whether there is a real breathing problem or if it is being caused by anxiety.
For example, if your lungs are working at 80 percent and you experience a lot of anxiety, then the professional will be able to guide you in the right direction so that you understand the underlying cause of your symptoms. This is also one of the reasons why the research team relied on cognitive behavioral therapy from respiratory nurses instead of using psychologists for the study.(8, 9)
People who do not have the chronic obstructive pulmonary disease are sometimes prescribed anti-anxiety medications like alprazolam (brand name Xanax) or diazepam (brand name Valium). However, these drugs are known to cause a reduced rate of breathing in some people, which can make COPD worse in people with the condition, and also interact with other medications you are taking for this condition. Over time, though, these medications can lead to dependence and addiction problems as well.
Your doctor may prescribe a non-addictive anti-anxiety medication that does not interfere with breathing, such as buspirone (brand name BuSpar). There are also some antidepressants that help lower anxiety, including citalopram (brand name Celexa), sertraline (brand name Zoloft), and paroxetine (brand name Paxil). Your doctor will be able to advise you which medication will be the best for your individual condition. It is also important to remember that all medications do carry the potential for side effects, including headaches, increased anxiety, intestinal upset, or nausea, especially when you first start taking these medications. You can ask your doctor to start you on a low dose and work your way up on the dosage. This gives your body the time needed to adjust to the new medication.(10,11,12)
Cognitive-behavioral therapy has become a common therapy technique today for people with COPD and anxiety. It helps decrease anxiety symptoms through relaxation techniques and breathing exercises.
At the same time, group counseling and support groups can also help you learn how to cope better with anxiety and COPD. Being with and interacting with others who are dealing with the same health issues as yourself will help you feel less alone.
People with lung disease COPD often experience trouble breathing, which leads to anxiety. Cognitive-behavioral therapy, a therapy technique that helps patients develop strategies for coping with anxiety and similar conditions, can help reduce that anxiety and also decrease the chances of COPD patients ending up in the hospital. This is especially true in cases where behavioral therap6y is carried out by nurses who specialize in dealing with lung conditions, such as the case demonstrated in the research study discussed above.
- Barnes, P.J., Shapiro, S.D. and Pauwels, R.A., 2003. Chronic obstructive pulmonary disease: molecular and cellularmechanisms. European Respiratory Journal, 22(4), pp.672-688.
- Agusti, A.G.N., Noguera, A., Sauleda, J., Sala, E., Pons, J. and Busquets, X., 2003. Systemic effects of chronic obstructive pulmonary disease. European Respiratory Journal, 21(2), pp.347-360.
- Salvi, S.S. and Barnes, P.J., 2009. Chronic obstructive pulmonary disease in non-smokers. The lancet, 374(9691), pp.733-743.
- Anthonisen, N.R., Wright, E.C., Hodgkin, J.E. and IPPB Trial Group, 1986. Prognosis in chronic obstructive pulmonary disease. American Review of Respiratory Disease, 133(1), pp.14-20.
- Copdfoundation.org. 2021. How Common is COPD in the United States? | COPD Foundation. [online] Available at: <https://www.copdfoundation.org/What-is-COPD/Understanding-COPD/Statistics.aspx> [Accessed 13 December 2021].
- Rycroft, C.E., Heyes, A., Lanza, L. and Becker, K., 2012. Epidemiology of chronic obstructive pulmonary disease: a literature review. International journal of chronic obstructive pulmonary disease, 7, p.457.
- Heslop-Marshall, K., Baker, C., Carrick-Sen, D., Newton, J., Echevarria, C., Stenton, C., Jambon, M., Gray, J., Pearce, K., Burns, G. and De Soyza, A., 2018. Randomised controlled trial of cognitive behavioural therapy in COPD. ERJ Open Research, 4(4).
- Coventry, P.A. and Gellatly, J.L., 2008. Improving outcomes for COPD patients with mild‐to‐moderate anxiety and depression: A systematic review of cognitive behavioural therapy. British journal of health psychology, 13(3), pp.381-400.
- Ma, R.C., Yin, Y.Y., Wang, Y.Q., Liu, X. and Xie, J., 2020. Effectiveness of cognitive behavioural therapy for chronic obstructive pulmonary disease patients: A systematic review and meta‐analysis. Complementary therapies in clinical practice, 38, p.101071.
- Yohannes, A.M. and Alexopoulos, G.S., 2014. Depression and anxiety in patients with COPD. European Respiratory Review, 23(133), pp.345-349.
- Mikkelsen, R.L., Middelboe, T., Pisinger, C. and Stage, K.B., 2004. Anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). A review. Nordic journal of psychiatry, 58(1), pp.65-70.
- Usmani, Z.A., Carson, K.V., Cheng, J.N., Esterman, A.J. and Smith, B.J., 2011. Pharmacological interventions for the treatment of anxiety disorders in chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (11).
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