When we talk about stress, we’re usually talking about psychological stress. Everyone feels stressed at times. But there’s a difference between short-term acute stress, and long-term chronic stress. Acute stress can be useful, by preparing us for “fight-or-flight” in the face of a threat. Certain hormones are released, which prime the body for explosive action. The body returns to normal after the threat is gone.

Many people, however, feel stress on a more continuous basis. This chronic stress can affect the body in negative ways. Chronic stress can weaken the immune system, for example. People who are stressed often feel anxious, irritable, or depressed. Chronic stress may also cause more frequent flare-ups of chronic obstructive pulmonary disease (COPD) symptoms. For this reason, it’s important to learn how to manage stress.

Stress management is about the way you react to stressors, the events or situations that cause stress in your life. The first step towards managing stress is to recognize your stressors. Living with COPD can be stressful, because it forces you to make changes in your life. Other things that may cause stress include changes in:

  • relationships
  • financial situations
  • employment
  • sleep habits
  • sexual relations
  • living sitiuations
  • the ability to perform ordinary tasks

Read more: Battling the stress of living with chronic illness »

Having COPD or any chronic disease can be emotionally stressful, stirring up worries about your long-term future and that of your family. It’s common to feel depressed, upset, and overwhelmed at times. These feelings can make your COPD symptoms worse. Feeling stressed can aggravate your shortness of breath, which in turn can make you feel more anxious.

These changes would be stressful even for the healthiest person. Unfortunately for people with COPD, stress can trigger a flare-up, so it’s important to learn to recognize the things that may cause stress in your life. By doing so you can take steps to reduce these stressors or change your reactions to them. Talk about your challenges and concerns with people who are close to you. Ask for help when possible, and avoid situations that are likely to cause stress.

After you’ve identified the things that may trigger anxiety and increase your stress, you can learn to put the brakes on stress before it causes a flare-up. According to the COPD Foundation, one effective method for reducing stress is to use breathing techniques.

Pursed-lip breathing

Pursed-lip breathing is a technique that will help you slow your breathing and exhale more air with each breath. It involves paying attention to the breath, breathing deeply and slowly, and exhaling slowly and mindfully:

  1. Begin by consciously relaxing your shoulder muscles. Stand or sit up straight and allow your shoulders to drop, while bringing your shoulder blades closer together in back.
  2. Inhale through the nostrils for 2 seconds.
  3. Purse your lips as if you’re about to blow out a flame.
  4. Exhale slowly through the lips. This should take 4 seconds.
  5. Repeat.

Belly breathing

Belly breathing is another potentially helpful breathing technique. You may need to enlist the help of a medical professional to learn this technique:

  1. While sitting or lying down, place a hand on your chest. Place your other hand on your abdomen.
  2. Inhale through the nostrils.
  3. Feel your belly rise, while attempting to keep your chest still.
  4. Exhale slowly.
  5. Repeat.

Various techniques have been developed to help you reduce stress and reverse the effects of anxiety. Research suggests these practices can help reduce stress and may help the body fight off infections. Keeping stress at a minimum may help reduce COPD flare-ups.


Visualization is a technique you can perform anywhere at any time. With visualization, you picture a quiet, stress-free setting, such as a quiet beachfront or a wooded trail. By imagining yourself in an environment where you are relaxed, you may start to feel less stressed wherever you really are. Sometimes, visualization is accompanied by guided imagery. This is a stress-reduction technique in which you listen to a recording of someone walking you through a relaxing scene or story. To make guided imagery and visualization work best, find a quiet place in your home and spend about 20 minutes alone listening to a recording or relaxing in the tranquil scene you’re visualizing.


Yoga is an ancient practice that combines mindful meditation, breathing techniques, and relatively simple physical exercises. Unlike visualization, which takes you away from your current situation, mindfulness meditation is a way of being extremely aware of your surroundings: the sounds, the smells, everything you’re feeling at that moment. Focused breathing exercises are ways to practice mindfulness. They can be particularly helpful if you have COPD, as they emphasize relaxation while breathing.

To try focused breathing, follow these steps:

  • Sit straight up, but relax your body.
  • Gently breathe in and out through your nose.
  • Focus your attention on the air moving through your nostrils.
  • Feel your lungs and abdomen as they swell and subside with each breath.

Do this for a few minutes, concentrating only on your breathing. Don’t worry about trying to achieve a meditative state. Let any worries or thoughts come and go in your mind as you focus only on quietly breathing in and out.

Getting adequate sleep is important for everyone. It’s especially important when you’re living with a chronic illness. Most adults require 7 to 9 hours of sleep every 24 hours to be at their best. Sleep isn’t just about feeling rested and clear-headed. It’s important for a strong immune system. It also helps reduce some of the negative effects of chronic stress.

Some experts recommend that you try to follow these guidelines to help encourage good sleep each night:

Get good sleep

  • Avoid caffeine or alcohol in the evening.
  • Do not work, watch TV, or use digital media in bed.
  • Don’t nap during the day.
  • Exercise in the morning or afternoon, rather than right before bedtime.
  • Stick to a regular schedule of waking and going to bed, even on weekends.
  • Sleep in a cool, quiet, completely dark space.
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Although COPD may limit your mobility, it’s important to remain physically active and maintain physical fitness to the greatest extent possible. Regular exercise has been shown to reduce the symptoms of COPD. It may even help you avoid being hospitalized repeatedly. People who have COPD and engage in physical exercise programs often report better quality of life. Exercise may also help improve sleep quality.

Even with the best of stress-reduction efforts, you’re bound to have a flare-up of COPD symptoms now and then. You should have an action plan for dealing with sudden shortness of breath or a coughing fit. For some people, a short-acting bronchodilator can start to relieve symptoms within a few minutes. For others, adding a combination inhaler that includes a bronchodilator and a corticosteroid may be helpful during days when flare-ups occur. It’s also important to remain still and try to relax.

Read More: COPD drugs: A list of medications to help relieve your symptoms »

COPD flare-ups can certainly increase stress. But the more you know about how to respond quickly to flare-ups and reduce stress in your everyday life, the better off you’ll be moving forward. If you want to know more about dealing with stress, talk with your doctor. Consider seeing a mental health professional with experience working with individuals who have COPD or other chronic illnesses. You can also consult with the providers who work in pulmonary rehabilitation programs. These rehab specialists should have good advice for stress reduction and prevention, especially with someone dealing with COPD.