How to Handle the Emotional Aspects of COPD

Living with a serious disease like COPD can be scary, stressful, and sometimes even overwhelming. Just the feeling of shortness of breath, the main symptom of COPD, can be a very frightening sensation.

Feeling anxious, overwhelmed, and even depressed is a natural and, to an extent, even a healthy reaction to getting diagnosed with a chronic disease. However, you shouldn't let these negative feelings control your life.

If you don't take steps to manage your anxiety and fears they can end up taking a huge toll on your emotional and physical health. It's okay to feel anxious and depressed sometimes, but it's also important to learn to manage and minimize your stress.

In this article we'll help you better understand the effects of chronic anxiety and how to manage it while living with COPD. We'll show you a variety of effective relaxation techniques, breathing exercises, and lifestyle changes you can use to help you navigate the difficult emotional aspects of COPD.



Understanding The Emotional Impact of COPD


It's normal to be emotionally impacted by your COPD diagnosis.

Everyone experiences feelings of depression and anxiety from time to time. It happens as a natural reaction to unfortunate events and the troubles of everyday life.

However, nothing can truly prepare you for the emotional effects of getting diagnosed with a disease like COPD. Negative emotions like fear, anxiety, worry, and guilt can easily get out of hand if you don't learn how to manage them in healthy ways.

Here are some common emotional reactions people experience after getting diagnosed with COPD:

  • Anxiety and panic
  • Depression
  • Anger
  • Fear and worry
  • Grief
  • Helplessness
  • Frustration
  • Guilt and remorse
  • Feeling loss of control

As you can see, living with a chronic disease can be an immense emotional challenge. The good news is that it often gets better after you have time to adjust and get used to your treatment plan.

It is normal to feel a great deal of fear, stress, and guilt at first, but you can take back control over your physical and mental health by giving yourself time to adjust and make the life changes necessary to stay healthy. You will also find your disease much easier to manage if you seek support from friends and family and practice healthy coping mechanisms and relaxation techniques.

If you are able to manage the emotional aspects of your disease, it will become much easier to manage your symptoms, live a healthy lifestyle, and follow your treatment plan. That's why it's so important for people with COPD to learn how to manage negative emotions and practice habits that foster a positive mindset.

In the following sections we'll show you a variety of tips and techniques to help you feel better and manage the difficult emotional aspects of COPD. But first, we'll discuss how to recognize the signs of anxiety and depression and how to break out of negative thought cycles related to COPD.


Recognizing the Signs of Anxiety


Anxiety is more than a state of mind, it can have an impact on your physical well-being.

Anxiety is often associated with the “fight or flight” response, an instinctual reaction that all humans experience when confronted with danger. In many cases anxiety actually serves a practical purpose; it helps prepare us to recognize and respond to real threats.

However, anxiety becomes a problem when it happens too often and won't go away. This happens when we feel anxiety in response to things that are not real, immediate threats, like worrying over an argument or feeling anxious about the future.

Since there's no solution or easy “off” switch when you worry about these types of things, sometimes the anxiety just doesn't go away. It's easy to get caught in negative thought loops where you worry about the same things over and over again when there's no actual purpose or use for dwelling on those worries all.

It's common to feel anxiety in response to thoughts, fears, and situations that are out of your control, especially when you suffer from a chronic health condition like COPD. It's important to be able to recognize these feelings of anxiety because when you know they're there, you can actually do something about it.

Here are some of the immediate physical effects of anxiety you should learn to recognize:

  • Rapid breathing
  • Rapid heart rate
  • Nausea
  • Shortness of breath
  • Sweating
  • Paleness or flushing
  • Stiff, tensed muscles
  • Twitching or trembling
  • A tight feeling in your throat
  • Dry throat

Anxiety can also have less obvious physical effects in the short term that can affect your COPD:

  • Re-distribution of fluids throughout your body (and your lungs, which can affect breathing)
  • Increased blood sugar (because it triggers extra glucose production in the liver)
  • Increased blood flow throughout your body

As you can see, all of these different anxiety symptoms can affect your breathing and your COPD. Anxiety affects your heart rate, breathing rate, water distribution, and breathing muscles, all of which affect your respiratory system and together can make your COPD symptoms even worse.

If left untreated, chronic anxiety can even cause more serious health complications that are particularly dangerous for people who have COPD. Long-term anxiety can suppress your immune system, affect your short-term memory, cause problems with digestion, and even increase your risk for premature heart disease.




Breaking Out of The Negative Feedback Cycle of Anxiety



Negative thinking can make it more difficult to deal with a medical diagnosis.

Image courtesy of Fayez on Flickr.

Because the physical effects of anxiety often mimic or exacerbate symptoms of COPD, bouts of acute anxiety can quickly spiral out of control. You might start out feeling a little bit stressed out, but when the anxiety symptoms kick in it can be difficult to stay calm and control your breathing.

The cycle happens like this:

  • You start to feel stress or anxiety
  • The anxiety makes your throat tighten and increases your breathing rate, making you feel short of breath.
  • Feeling short of breath inspires even more fear and anxiety, causing your heart to race even faster.
  • Your increased heart rate and muscle tension makes it even more difficult to breathe, which inspires more anxiety... and the cycle continues on.

When you get stuck in this feedback loop, it can be difficult to calm down enough to pull yourself out of it. It becomes easy to confuse symptoms of anxiety with symptoms of COPD, and you can't manage your anxiety if you don't realize that it is what's causing your physical symptoms.

In these situations, breathing exercises and relaxation techniques are the most effective ways to bring your anxiety and physical symptoms back under control. However, the best solution is to learn how to recognize the early signs of anxiety so you can get a handle on it before the negative cycle starts.

The Negative Feedback Cycle of Depression


Seek help for depression to end the negative feedback loop.

Feeling depressed can also start a negative feedback loop that can be detrimental to your health. This happens when depression snuffs out your energy and motivation, leading to habits and behaviors that continue to make your depression, and your COPD, worse.

Here are some of the common symptoms of depression:

  • Decreased energy and fatigue
  • Feelings of sadness, anxiety, and emptiness
  • Feelings of helplessness, worthlessness, or guilt
  • Pessimism, cynicism, and hopelessness
  • Restlessness and irritability
  • Loss of interest in hobbies, exercise, and other activities
  • Changes in eating habits (increased or decreased appetite)
  • Increase in aches and pains, headaches, and other physical ailments
  • Reduced ability to focus and concentrate

The negative feedback loop of depression begins with feelings of hopelessness and helplessness that cause you to give up on healthy habits and treatment goals. When you're depressed, you're likely to give up and avoid activities when you feel breathlessness or other symptoms of COPD, which only leads to even worse symptoms and fuels further depression.

It's important to familiarize yourself with the symptoms of depression so you can address it and manage it if it occurs. It's also important to recognize the unhealthy habits that start the negative feedback loop of depression so you can take care of it before it spirals too far and takes a permanent toll on your health.


Knowing what the negative feedback loop looks like may help you stop it.

Here's what the negative feedback loop of depression looks like:

  • You feel depressed and hopeless because of your disease, so you choose to stay inside and do nothing instead of pursuing hobbies and other activities. You might have difficulty getting out of bed and motivating yourself to continue healthy habits like exercising and cooking healthy meals.
  • As a result of being less active, your symptoms get worse and your disease may progress even further. You feel more breathless and fatigued and have even less energy to exercise and do other activities.
  • This leads to even more anxiety and depression, which makes you feel even less motivated and less capable of managing your health. As your physical condition declines, it becomes more and more difficult to stay active and causes even more emotional distress.
  • This leads to even more depression, more time spent sedentary, and more physical symptoms. If the cycle isn't interrupted, it can make your COPD symptoms irreversibly worse and cause permanent physical decline.

Anxiety and Depression Can Have Long-Term Effects on Your Health

A certain amount of anxiety is healthy, and can even motivate us to take positive actions and make healthy choices. But when anxiety or depression is prolonged, it can have serious negative effects on your body.

Anxiety and depression can worsen your COPD symptoms.

Here are some of the long-term effects that chronic anxiety and depression can have on your body:

  • Insomnia
  • Suppressed immune system
  • Reduced ability to focus and problem solve
  • Impaired short-term memory
  • Reduced sex drive
  • Changes in your metabolism
  • Indigestion
  • Increased susceptibility to stomach ulcers
  • Cardiovascular problems
  • Nervous system malfunction

This is why it's very important to get support and learn new habits if you suffer from anxiety or depression on a daily basis. If you let it eat away at you for too long, it can have devastating effects on and start an unhealthy, downward spiral of physical and emotional distress.

How to Deal with the Emotional Aspects of COPD

There are many proven and effective methods for dealing with challenging, stressful times such as living with COPD. Relaxation techniques like meditation, breathing exercises, and a variety of other activities can make all the difference when you're dealing with overwhelming emotions.

In this next section, we're going to introduce you to a variety of these techniques that you can use today to help reduce your anxiety, feel better, and gain back control over your life. If you take the time to learn and practice some of these techniques when you feel down or overwhelmed, you can teach yourself to redirect your negative energy to relaxing and calming activities, instead.

Therapeutic Activities for Emotional and Mental Health

Physical Exercise


Physical activity may help you keep a positive outlook and avoid anxiety.

Staying active and doing physical activities is one of the best ways to keep your mind and body healthy. It's a great way to get rid of extra tension and negative energy, and it can strengthen your breathing muscles and help your COPD symptoms, too.

Regular exercise gives you more energy and strength during the day at the same time that it makes it easier to relax and sleep at night. You'll feel stronger, more confident, and more in control of your health if you get plenty of physical activity.

Here are just a few of the many emotional benefits of exercise:

  • Decreased stress and anxiety
  • Improved memory and cognition
  • Increased energy levels
  • Increased ability to focus and problem-solve
  • Increased feelings of happiness and well-being
  • Better self image and increased self-confidence
  • Feelings of satisfaction and accomplishment
  • Protection against cognitive decline
  • Increased ability to relax and sleep well at night

Along with its quantifiable physical and mental benefits, regular physical activity will help you feel more confident, secure, and give you a wonderful sense of accomplishment.

If you're not used to exercising regularly, work with your doctor to put together an exercise plan that will ease you into the habit. Start small and set realistic goals, and don't push yourself to the point of feeling too breathless or fatigued. At the same time, don't be afraid to challenge yourself and be as active as you can.

If you like structured activities, you can try joining a gym, group sport, or an exercise club. Many gyms offer a variety of classes such as aerobics, yoga, and tai chi that are great for building physical strength as well as practicing relaxation and breathing techniques.

Yoga & Tai Chi


Tai Chi is one way to help cope with a medical diagnosis like COPD.

Yoga and Tai Chi are both great physical activities for people with COPD. They are designed to improve your physical strength and endurance while practicing breathing and relaxation techniques at the same time.

Yoga is a slow-paced exercise that involves holding different stretches and poses which can be adjusted for different strength and skill levels and for people with limited mobility. It's incorporation of deep breathing exercises and meditative practices makes it perfect for patients with COPD, and can help you learn how to control your breath when you exercise.

Tai Chi is a more active exercise technique that uses graceful, flowing actions and encourages constant movement. Like yoga, what makes Tai Chi such a great exercise for COPD is that it also teaches deep breathing techniques as an integral part of the practice.

Both of these exercises are great for building physical endurance and deep breathing skills that can help you manage both the physical symptoms and emotional strain associated with COPD. If you'd like to give these exercises a try, you can look for a gym near you that offers group classes.

If you don't want to go to the gym, you can also follow Tai Chi or Yoga instructional videos by yourself in your own home. You can find guided Yoga and Tai Chi video classes in stores, at your library, and even watch them for free on sites like YouTube and elsewhere online.

Mindfulness Meditation


Mental health is just as important as physical health when it comes to coping with COPD.

Mindfulness meditation is one of the most highly-researched and effective methods for reducing anxiety and depression. In fact, it's considered to be so effective for mental well-being that it should be the one thing you try even if you don't use any of the other techniques on this list.

Mindfulness meditation isn't anything like the kind of meditation you've probably seen in movies and pop culture. It's actually a very simple and relaxing activity that anyone can do; all it takes is a bit of time and patience to see results.

Practicing mindfulness meditation is all about clearing your mind of worries, letting go of distracting thoughts, and living in the present moment. It helps you learn how to separate yourself from your stress and your anxious thoughts, enjoy life without worry, and achieve a quiet inner peace.

To practice basic mindfulness meditation, you start by finding a quiet, comfortable place to sit and close your eyes. Then, you practice just living and being in the present moment. Let go of any specific thoughts and worries, and instead just focus on your breathing and listen to your thoughts as they go by without judgment.

It can be helpful to listen to a guided meditation audio clip or follow along with a written meditation guide. is a great resource for a variety of textual guides and information on mindfulness meditation, or you use one of UCLA Health's guided audio meditation sessions by visiting their website here.

Keep a Journal


Journaling is a great way to manage your thoughts and cope with COPD.

Journaling is a proven and effective way to cope with difficult emotions and challenging times in life. In fact, research shows that journaling is a powerful tool for emotional and physical health, and something everyone should do for their mental well-being.

Journaling allows you to write and sort through your thoughts in an entirely private, safe, and non-judgmental environment. No one else will ever have to know the thoughts you put down; you are writing for just you and you alone.

Your journal can be whatever you want to make of it, but its' most helpful when you use it to better understand yourself, others, and sort through difficult feelings. It can be helpful to keep track of your moods and emotions on a daily basis so you can notice trends and patterns and see how you change and grow.

Here are some tips for a successful journaling experience:

  • Let Go of Your Internal Filter: Don't think about good grammar, good taste, or what anyone else would think about what you write. Try to write quickly and let the words flow, don't analyze them or judge them. The point is to write down raw, pure, honest thoughts, which is impossible to do if you're constantly editing yourself as you write.

  • Journal Every Day: It's easiest to journal regularly if you make it a daily habit. Keep a dedicated journal in an easy-to-access space, and try to set aside at least fifteen minutes of time every evening to write.

  • Write About What Matters to You: No one else will see your journal, so you can structure it however you like and write about whatever you want to. Let go of your inner critic and write about whatever comes to mind, or whatever has been on your mind lately.

Practice Breathing Exercises


Breathing exercises can reduce anxiety and improve oxygen intake.

It can be scary, or even panic-inducing, when you find it difficult to breathe. In fact, it's very common for people who have COPD to experience anxiety during bouts of breathlessness or wheezing.

One of the best defenses against this kind of worry and panic is breathing techniques. Breathing exercises like pursed lips breathing and diaphragmatic breathing are extremely effective and simple ways to calm down and reduce anxiety when you experienced worsened symptoms of COPD.

Most doctors recommend practicing breathing exercises every day, even when you don't feel anxious or breathless. This helps you learn the techniques thoroughly so you can easily remember how to do them in the moment when anxiety and panic strikes.

Diaphragmatic Breathing Technique

Diaphragmatic breathing helps you learn to use your diaphragm instead of your chest muscles to breathe. This allows you to breathe with less effort and can reduce symptoms like chest tightness, breathlessness, and fatigue that often get worse when you feel anxious.

How to Practice Diaphragmatic Breathing

  • First, lie on your back in a comfortable position.
  • Put one hand on your chest, and the other on your belly.
  • Take a deep breath in while trying to breathe from your belly, not your chest. You should feel the hand on your stomach rise while the hand on your chest stays still.
  • When you exhale, once again try to push from your stomach instead of your chest. You should feel the hand on your stomach fall as you breathe out while the hand on your chest stays still.
  • Repeat until you are successfully breathing from your belly and not your chest. Over time, this will become second nature and you will have better control over your breathing.

Pursed Lips Breathing Technique

Many people with COPD have airways that collapse and lungs that trap air, making it difficult to breathe. Pursed lips breathing helps you open up your airways and push all the air out of your lungs with each breath, which makes it easier and more comfortable to breathe.

How to Practice Pursed Lips Breathing

  • Stand or sit in a relaxed position with your back straight.
  • Relax your chest muscles and take a deep breath in through your nose lasting about two seconds.
  • When you breathe out, purse your lips together (as if you were blowing a kiss) and exhale slowly through your mouth. You should take about twice as long to exhale as you did when you inhaled, about four seconds.
  • Repeat several times, or until you feel your breathlessness subside.

Bringing your breathing back under control is the first and most important step to bringing your anxiety and panic back under control, too. Unfortunately, it can be difficult to remember how when you feel anxious or panicked, which is why it's important to practice often.

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