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COPD (Chronic Obstructive Pulmonary Disease)

Anxiety Attack

01/06/2011

Question:

two days ago i had to go to the hospital because of an anxiety attack i felt i couldnt breathe or something heavy was on my chest. i was crying i was so scared will this be happening more? im in stage 4 of copd i have all 3 emp. chronic bron. and asthma. any help???

Answer:

It is very common for patients with severe lung diseases to experience shortness of breath, often with associated anxiety. In turn, increased anxiety can make breathing more difficult by increasing the rate of breaths per minute and constricting the breathing tubes, among other changes. In the case of obstructive lung diseases (COPD) like yours, this can result in worsened over inflation of the lungs and overall decreased efficiency of breathing. Patients with COPD may already be working harder to breathe even before they become anxious, so they become even shorter of breath with a little anxiety that others may be able to handle without difficulty. All of that can spiral into a very difficult situation, as you experienced when you had to go to the emergency room.

Getting sufficient air is one of our very basic instincts. The sensation of shortness of breath, along with a very strong "fight or flight" response is the brain's action when it realizes that things are not right with the breathing. While it may not be possible to completely eliminate that sensation, there are things you and your doctors can do to work toward breaking the cycle and lessening the panic associated with shortness of breath.

First, it's very hard to do, but try to remain as calm as possible. The more worked up you get, the worse the breathing will become. Many Pulmonary Rehabilitation programs (available at most hospitals) include training in relaxation techniques. If you do not have access to relaxation training in association with a Pulmonary Rehab program, there may be other resources available in your community from a psychologist, psychological nurse specialist, or even certain social workers.

Second, there are breathing techniques that allow you to exhale more completely and remind you not to breathe too quickly. These are also taught during Pulmonary Rehab classes, but may also be taught by any respiratory therapist.

Third, I would urge you to consider enrolling in a Pulmonary Rehab program if you have not already done so. If it is at all possible for you during those sessions, you not only work on the above-mentioned techniques, but also begin to exercise under close supervision and in accordance to your abilities. It may seem unnatural or unhealthy to exercise since you're short of breath, but it's not! Rehab can help build your stamina, lessen the sense of shortness of breath over time, and give you more confidence in your body's abilities. In addition, you will learn how to tailor your activities to your breathing abilities and how to accomplish tasks more efficiently. Rehab may even help keep you from needing as many hospital admissions. Pulmonary Rehab can be arranged by your doctor.

Sometimes the anxiety and shortness of breath may be so severe that additional therapy is needed. If that is the case, then you may want to ask for a referral to a physician who specializes in symptom management or a psychiatrist skilled in the treatment of patients with severe lung disease. I would urge you to discuss your symptoms and fears with your doctors, who can help you choose and make arrangements from the above options.

I hope things go well for you.

For more information:

Go to the COPD (Chronic Obstructive Pulmonary Disease) health topic, where you can:

Response by:

Amy L Pope-Harman, MD Amy L Pope-Harman, MD
Clinical Associate Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University