The signs of COPD related anxiety, depression

As I discussed in a recent post, COPD (Chronic Obstructive Pulmonary Disease) is commonly and normally and understandably associated with anxiety and depression. The best way to help these patients is to be vigilant to the signs of anxiety and depression so help can be sought.

Therefore, it is important for us RTs to know these signs so that we can do our part in helping them out, make recommendations to the doctor and nurse, and empathize.

The following signs are from nationaljewishhealth.org:

Signs of depression:

• Feeling sad more days than not for several weeks in a row
• Sleep disrupted with early waking, restless quality, or difficulty falling asleep
• Sleeping either much more or much less than usual
• Decreased interest in favorite people or activities
• Decreased energy and motivation
• Difficulty concentrating and problem solving
• Altered appetite, either up or down
• Low self-esteem or feeling worthless
• Feeling hopeless - that you'll never feel better no matter what happens
• Crying much more easily and more frequently than is usual
• Feeling irritable with everyone and everything in your life
• Being much more sensitive to criticism than is usual
• Feeling excessively guilty
• Thinking about suicide or wishing your life would end
• Inability to laugh or enjoy yourself.

Signs of anxiety:

• I have trouble getting to sleep because I'm worrying.
• I can be sitting quietly and suddenly become short of breath.
• I almost always have a nagging worry about when I'm going to have an episode of difficult breathing.
• I seem to be getting more and more frightened to leave the house.
• I'd rather stay home so I can avoid being exposed to the "dangers" out there, e.g. people's germs or excessive perfumes.
• I'm frightened of getting onto elevators, airplanes, or bridges and will go out of my way to avoid them.
• I walk around feeling as if something bad is going to happen.

Likewise, National Jewish writes that sometimes COPD patients get so "overwhelmed" by the feelings of depression and anxiety that they decide to not take care of themselves the way they should. They may not pay attention to their health and enter a state of denial

Signs of too little worry:

• I frequently overextend myself and pay for it with worse symptoms the next day or two.
• I try to use as little medication as possible, and as little oxygen as possible, even when my doctor wants me to use more.
• Sometimes I pretend I don't have COPD, even in situations when I know it might be important to let others know.
• When I'm feeling "hassled" by my COPD, I drink more alcohol than I should because it lets me forget about the COPD.

Likewise, it's important to educate these patients that what they are experiencing, or may experience, is perfectly normal:

"There actually is an 'ideal level of worry.' At this ideal state, you understand that you have a chronic and challenging illness. You know there are things you can do that will help and hurt your experience with the illness. Over the long course of COPD you will likely go through periods of time when you worry "too much" and other times when perhaps you should give your illness more consideration. These fluctuations are absolutely normal. It is important to find the "just right" amount of worry that can help you keep your life and your illness more in balance.

Wisdom is good. The more you know about the diseases you have the better you will be able to help yourself. Likewise, the more wisdom we RTs have about the diseases we treat, the more help we will be to our patients.