Managing stress with COPD 

Strategies for people with COPD (chronic obstructive pulmonary disease) in dealing with stress include practising relaxation techniques and coping actions, such as doing something different, keeping active, pursuing interests, and sharing concerns with a friend or counsellor.

Stress and breathing difficulties

Having COPD is often stressful, and it is not easy to accept that your breathing limits your daily life. Stress can be created by any change, whether positive or negative. You can work out what triggers stress for you and note how it affects your body, thoughts and behaviour.

Causes of stress

Causes of stress may come from your environment (eg, crowds or a smoky room); your physical state (eg, discomfort from breathlessness or tiredness); or your psychological state (eg, unrealistic beliefs about yourself, or feeling frightened).

How does your body respond to stress?

The human body has only one way of responding to physical and mental stresses. Chemical changes occur as we prepare to confront or avoid the stress (known as the 'fight or flight' reaction).

Physical responses might include: 

• heart beats faster
• breathing rate increases
• muscles become tense or sore
• urge to go to the toilet
• sweating
• shaking 
• not able to sit still.

Emotional responses and thoughts might include:

• racing thoughts
• difficulty concentrating or making decisions
• anticipating or magnifying problems which may not exist
• thinking more about yourself and forgetting other people's needs
• feeling irritable or angry
• feeling anxious or panicky 
• feeling overwhelmed, helpless or hopeless.

Behavioural responses might include:

• sleep disturbances
• decreased ability to say 'no' to unhelpful fixes such as alcohol/cigarettes/coffee (caffeine)
• more aggression towards people and objects
• unable to complete goals. 

Ways to deal with stress

Sort out things you worry about by writing them down in three columns, labelled 'Action now', 'Action this week', and 'I can't do anything about this'. For example:

• Action now: eg, Pick up the phone to clarify a worry with your medication.
• Action this week: eg, Going to a concert, plan your trip in advance, obtain theatre plan to sort out the best seat for you.
• I can't do anything about this: Try to work out if there are any advantages in worrying about these events. If not, try to worry only about things you can take action on.

Coping actions for stress

• change your pace or do something different
• try to keep as active as possible. Ask your doctor, physiotherapist or nurse about exercise and COPD
• share the load with a friend or counsellor
• when you feel overwhelmed by tasks, write a list and halve it. Most people are far too ambitious about the amount of things they can do in one day 
• if you feel angry with someone else, distract yourself by going into another room, or listening to music 
• try to pursue interests. You may need to swap jobs in the house which demand too much energy (eg, cooking instead of gardening).

Accepting limits of your condition

• let go of unrealistic beliefs
• learn to accept responsibility for your own feelings
• make sure your goals are flexible - always have a Plan B
• talk yourself into being patient.

Relaxation

You can learn to turn off the stress response in your body. Relaxation can prevent or lessen the degree of tension you experience when feeling stressed. Start before the tension becomes intense, by scanning your body (do a mental check of each part, especially shoulders, neck, face, back and hands). Stress may also change your breathing patterns, causing shallow breathing from the chest.

To remove tension - try this in order, while sitting down:

• move and stretch all parts of the body
• realign body into correct posture. Check that your shoulders are down
• try the breathing techniques you were taught by your health professional
• shut your eyes if you can and try to visualise a pleasant scene. Water scenes are often very relaxing, particularly if they are repetitive, such as waves on the beach. Try putting some music to your visualisation and note details in your scene. Your mind will learn to associate that music with relaxation; you can then play it or sing it to yourself to help relax when you are away from home
• stay put for a while, and then open your eyes when you are ready. Rescan your body.

Related topics

Also see: COPD and COPD - energy saving tips

Original material provided by The Asthma Foundation of New Zealand, February 2008. Reviewed by everybody, October 2010.