Smoking cigarettes isn’t the only cause of COPD; however, according to the Centers for Disease Control and Prevention, smoking is the leading cause of COPD in the United States. People with COPD often find it difficult to perform day-to-day activities, as symptoms are progressive and worsen over time. COPD has many physical symptoms, but it’s also associated with high rates of anxiety and depression. Whether you have COPD or you are a caregiver for someone with this condition, it’s important to take care of your mental and emotional health.
Mental Health Effects of COPD
According to a study from the Journal of Thoracic Diseases: “Patients with COPD have a higher prevalence of depression and anxiety than the general population.” People with COPD may become depressed because of their reduced quality of life. They face many limitations throughout the course of their illness, such as relying on special equipment to help them breathe, not being able to perform the physical activities they used to, and in some cases, not being able to work anymore. Additional risk factors for depression and anxiety among people with COPD include living alone, the severity of their symptoms, and receiving end-of-life care. This could also lead to strained relationships with family, friends, and caregivers, as a person with COPD might withdraw from their social life. Other signs of emotional distress among COPD patients with depression are:
Feeling exhausted or fatigued Worsened irritability Losing self-confidence Believing symptoms are worse than they are Low social functioning Lack of motivation
People with COPD who continue to smoke could be worsening their depression. While people with depression are more likely to smoke, smoking cigarettes has been found to intensify symptoms of depression.
Diagnosis
If you have COPD and recognize your mental health is suffering, it’s best to talk to your doctor. If you are caregiving for someone with COPD and notice they display signs of depression and/or anxiety, be sure to consult with their doctor. Healthcare professionals have tools that help screen patients for depression and anxiety. A doctor might administer one of the following tests, or questionnaires, and add up the score which correlates with the severity of a patient’s symptoms.
Geriatric Depression Scale (GDS-15): This is a questionnaire for older adults, who circle “yes” or “no” to questions about how they feel, their outlook on life, and their energy levels. Hospital Anxiety and Depression Scale (HADS): This is used to diagnose anxiety and depression in people who are ill. It focuses on non-physical questions to assess a person’s emotional state. Geriatric Anxiety Inventory (GAI): Targeting older adult patients, this 20-question test assesses “typical anxiety symptoms.” Patients indicate whether or not they are experiencing these symptoms. Anxiety Inventory for Respiratory (AIR) Disease: This test was designed specifically to detect anxiety in COPD patients. Patients choose from four responses ranging from “0,” which means no anxiety at all to “3,” meaning anxiety most of the time. Brief Assessment Schedule Depression Cards (BASDEC): This screening tool is a series of flashcards handed to a patient with statements on them like, “I’ve been feeling low lately,” or “I feel anxious most of the time.” Patients answer “true” or “false.”
Treatment
A combination of therapy and medication may be effective in treating anxiety and depression in people with COPD. Note, most of these treatment modalities are used for anxiety and depression among the general population—more research is needed to understand how treatment can be more effective specifically for those with COPD.
Therapy
Cognitive-behavioral therapy (CBT), relaxation therapy, and self-management techniques are all common treatment types for both anxiety and depression. With CBT, a therapist will help a patient identify and change their underlying negative beliefs, specifically the ones that interfere with their quality of life. A relaxation therapist may help someone with COPD experience less pain. Studies have shown that this technique, which involves focusing on and relaxing various muscle groups, promotes both physical and mental well-being. Self-management techniques have also been shown to treat physical pain and reduce levels of depression. With this treatment type, a facilitator may show a patient:
Breathing exercises Meditation Body positioning Sequential muscle relaxation Mild exercise techniques Visualization techniques
A doctor may also prescribe pulmonary rehabilitation, which is commonly given to people with breathing and lung impairment. A facilitator teaches a patient how to perform day-to-day activities while experiencing less shortness of breath. One study found that people with COPD experienced improved symptoms of anxiety and depression after completing a program of pulmonary rehabilitation.
Medication
Medication to treat anxiety and depression might be prescribed to a patient in combination with therapy. Oftentimes, doctors prescribe antidepressants, or selective serotonin reuptake inhibitors (SSRIs). They work by balancing chemicals in the brain to regulate mood. In some cases, your doctor might prescribe you benzodiazepines, antipsychotics, anticonvulsants, or azapirones. These types of medications produce a tranquilizing effect that may help with anxiety. Be sure to consult with your doctor about possible side effects. With benzodiazepines, there is the potential for addiction so they should not be taken long term.
Coping
There are certain lifestyle recommendations that can reduce stress levels in patients with COPD. For instance, one study found people benefitted from a mindset of “taking control” of their COPD. If you have COPD, taking control of your diagnosis means accepting your condition. You come to terms with the fact that maybe you can’t do everything you used to. You understand you’ll face limitations, but you focus on what you can do. Another coping strategy is taking care of your emotional health. Some patients with COPD found that focusing on the positive as well as keeping a consistent routine throughout the day helped to lower their stress levels. You might hire a nurse who helps you out at home and monitors your symptoms. This can take some of the pressure off you and help you feel more supported by someone who is both knowledgeable and compassionate.
For Caregivers
It’s common for a family member—such as a spouse or child—to take care of a person with COPD. COPD takes a toll on the mental health of caregivers, too. If you’re a caregiver for someone with COPD, you might feel like your relationship with them becomes strained, and that you lose your own social life and activities. If you’re an informal caregiver, you might experience:
AnxietyFeelings of helplessnessDepressionSocial isolation
Know that it’s normal to experience these things, especially as your loved one’s quality of life declines. Talk to your doctor if you are caregiving for a loved one with COPD. They can recommend a mental healthcare professional you can speak to. The goal of CFT is to help you provide the best care you can while problem-solving the struggles you experience as a caregiver. If you aren’t already, trying keeping in communication with your loved one’s doctors. They can share knowledge with you about the patient’s circumstances, so you can mentally prepare for the challenges you’ll both face. Professional home care is another option that may take some of the pressure off you. A nurse can check in at home or speak with you over the phone to address any concerns you have. Remember, there are ways to ease the pressures of caregiving. You don’t have to do it all alone.
A Word From Verywell
Coping with COPD isn’t easy. Many people aren’t aware of the potential mental health effects of the condition as well as the physical symptoms. Taking care of your mental health is important if you have COPD or if you are caregiving for someone with COPD. Remember there are healthy coping strategies. Keep in close contact with a mental healthcare professional who can help you navigate the emotional journey of COPD.
