Many people who have COPD struggle with anxiety. This is because when you're having trouble breathing, your brain sets off an alarm to warn you that something is wrong, causing sensations of anxiety or panic to occur. Anxious feelings may also arise when you think about having a progressive lung disease. You may worry about experiencing an episode of difficult breathing or about what the future holds and how you will care for yourself as your disease worsens. To make matters worse, certain medications used to treat COPD can trigger feelings of anxiety, too.
The Breathlessness-Anxiety Cycle
Anxiety and COPD often create a vicious cycle. Feelings of breathlessness can provoke panic, which can make you feel more anxious—which can make it even harder to breathe. When people get caught up in this “breathlessness-anxiety-breathlessness cycle,” they may have a hard time distinguishing the symptoms of anxiety from the symptoms of COPD— so they go to the doctor or the hospital more often than they need to go. Others end up avoiding enjoyable social and leisure activities that can cause breathlessness, such as walking the dog or gardening.
Having some degree of anxiety when you have a chronic disease can be a good thing. It can prod you to pay attention to your symptoms and follow your treatment plan. It can also warn you when you need to seek medical attention. But too much anxiety can severely impact the quality of your life.
Coping With Anxiety
How to cope with your anxiety? People without COPD are often prescribed anti-anxiety medications, such as Valium or Xanax. But these medications used over time may cause problems with dependence. They can cause a decreased rate of breathing, which can worsen COPD, and also may cause interactions with other medications you use.
Your doctor can help you to determine what medication will work best for you. Some people with COPD find relief with a non-addictive anti-anxiety medication called Buspirone, which doesn't interfere with breathing. Others are helped by certain antidepressants that also reduce anxiety, such as Sertraline (Zoloft) or Citalopram (Celexa).
Even if you are prescribed medication, its effectiveness will be increased by other means of reducing anxiety. Ask your physician about referral to a pulmonary rehabilitation program, where you will receive education about COPD and get help with coping strategies to deal with your anxiety. One of the most important things that you learn in pulmonary rehabilitation is how to breathe more effectively
Breathing techniques such as “pursed lip breathing” can help to take the work out of breathing, slow your breathing down, keep your airway open for longer—and help you to relax. To do pursed lip breathing, you simply relax your upper body, and then breathe in slowly through your nose to the count of two. Then with lips pursed as if you were going to whistle, you breathe out slowly through your mouth to the count of four.
Many people with COPD find that individual counseling is effective in reducing anxiety, too. One common type of therapy called cognitive behavioral therapy helps people with anxiety symptoms decrease them through learning relaxation techniques and breathing exercises.
Group counseling, such as support groups can also help you to learn how to cope with COPD – and your anxiety – and being with others who have some of the same problems can help you to feel less alone.