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The Cycle of Infections, Exacerbations and Stress.

The Cycle of Infections, Exacerbations and Stress

So often I read in the groups of people being depressed and stressed due to the amount of exacerbation and infections their COPD has caused. Well, perhaps it’s time you rethink that scenario. Maybe it is not your exacerbation and infections causing you to be depressed and stressed, but the weakening of your immune system caused by your stress that is the reason for your infections, exacerbation, and depression. Stress is not only a possible cause of frequent infections and exacerbations but is also a major factor in several other diseases.

We all experience stress due to things like the loss of a job, a move, death in the family, or chronic illness. When you have COPD our health is already negatively affected, so stress makes it worse. The body reacts to stress first by pumping adrenaline and then cortisol into the blood. The adrenaline and cortisol released by stress does serve a useful purpose: Put simply, the adrenaline increases you heart rate and alerts the mind, helping you to focus, and the cortisol contributes to tissue repair. The adrenaline rush for the stress response can occasionally cause health problems, but the more significant problem comes from the cortisol that is released.1

Chronic stress exposes the body to an endless stream of cortisol which causes your inflammation to go wild. Acute inflammation that comes and goes signifies a well-balanced immune system. But symptoms of inflammation that don’t recede are telling you that the “on” switch to your immune system is stuck. The system’s inability to regulate inflammation is a good predictor of who might get an infection or exacerbation. Under constant stress, the immune system produces levels of inflammation that lead to repeated infections and exacerbation of COPD. 2

I’ve read many posts, particularly from newbies, asking if this symptom or that symptom is suffered by all with COPD. Some of the other things that chronic stress could be responsible for  are listed below.

Weight gain- it is well known that some people, when stressed, tend to eat more, particularly sweets. Many contribute side effects of medication as the reason for the weight gain. However, those under chronic stress experience a change in their metabolism, causing them to burn fewer calories. Stress also produces rises in the insulin levels and a decrease in fat oxidation, a process that produces fat storage. Excess cortisol is also related to abdominal fat.3

Sleep dysfunction- older adults as well as those with a chronic illness experience a decrease in the amount of deep sleep and increase in waking up throughout the night. Stress aggravates this condition making it especially hard to get back to sleep. The lack of sleep weakens/damages memory and emotional control making it harder to handle stress. High cortisol levels may be one reason for waking up so often at night. Then our brains remind us of our problems causing more stress, and the inability to fall back asleep.

Wound healing- is much slower when excessive cortisol is present. The more stress you’re under, the longer it will take for a wound to heal.

Stomach ulcers and other problems- is well known that ulcers can be caused by stress, but stress can also be a critical trigger for those with irritable bowel syndrome, indigestion, heartburn, ulcerative colitis, and Crohn’s disease which is characterized by chronic inflammation.

Depression, and stress are closely related. Stress throws several brain systems out of balance, negatively affecting the mood, appetite, sleep, and libido. Depression eventually takes on a life of its own, and many severely depressed people have permanently elevated cortisol levels. 4

Stress is right up there with smoking when it comes to its effect on COPD. I have been a stage 4 for 18 years, almost died three times, and have been on and off hospice. Every time I go to my pulmonologist he shakes his head in amazement that I’m still kicking. The reason why I do so well is I don’t stress the small stuff, I don’t stress the large stuff either. I’ve learned there are things like the fact I have COPD is something I cannot change. No amount of worry and kicking myself in the a** because I smoked for 51 years is going to change the fact I have COPD, CHF, and nodules growing on my lung. So why stress about it? Stress kills and I intend (God willing) to be around another 18 years.

Since everyone has a unique response to stress, there is no “one size fits all” solution to managing it. No single method works for everyone or in every situation, so experiment with different techniques and strategies. Remember: if you can’t change it, there is no use stressing over it. The one thing you can change that will help you tremendously is eliminating as much stress as possible.

Ways to reduce stress:

  • Maintaining a regular exercise routine. During exercise, the body releases chemicals called endorphins which interact with receptors in the brain to causing feelings of reduction in physical pain. An exercise routine does not have to be strenuous or get you short of breath. Keep your exercise within your physical limits. Just get yourself moving. You can find several videos on YouTube showing exercises that those with advanced COPD can do sitting down and they are fairly easy.5
  • Have a talk with yourself. “This feeling will pass.” “I will get through this.” “I am safe right now.” “I am feeling stressed now, but I have the power to make myself calm.”
  • Focus on what makes you feel calm and in control. Use pursed lips, diaphragmatic breathing, and meditation will help you feel more relaxed and slow your heart rate down. Go for a walk, spend time in nature, work in your garden, write in your journal, play with a pet, listen to music, curl up with a good book, or savor a warm cup of coffee or tea.
  • Focus on the positive. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life, and are still a part of your life. Family, children, grandchildren, friends for starters.
  • Adjusting Your Attitude. Set reasonable standards for yourself. You will never be able to do what you once did, so learn to be okay with what you can do, and let it be “good enough.”
  • I hope this helps some of you understand how important it is to get stress under control. Also, to let a lot of you who are new to COPD know that the symptoms you are asking questions about are common occurrences for the disease, particularly if you’re under stress or depressed.
    Breathe deep and easy.

    This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

    2. Dallman, Mary F., et al. "Chronic stress and obesity: a new view of “comfort food”." Proceedings of the National Academy of Sciences 100.20 (2003): 11696-11701.
    3. Kant, G. Jean, et al. "Effects of chronic stress on sleep in rats." Physiology & behavior 57.2 (1995): 359-365.
    4. Lupien, S. J., et al. "Increased cortisol levels and impaired cognition in human aging: implication for depression and dementia in later life." Reviews in the Neurosciences 10.2 (1999): 117-140.
    5. Edenfield, Teresa M., and James A. Blumenthal. "Exercise and stress reduction." The handbook of stress science: Biology, psychology, and health (2011): 301-319.


  • jsimerly9
    1 year ago

    I am later stage 3 COPD 35 years of body work in fiberglass got me it’s okay to be scared I was but now I live one day at a time do what your lung doctors tell you do not smoke and eat healthy I am to the point now where my doctors told me there is nothing else they can do for me but you can still live a long life with COPD I wish you and your family the best

  • Cas
    1 year ago

    I’m new to this condition, I have been diagnosed with COPD, Stage 2, eight months ago and still not sure how to feel or respond. I have not told anyone at work since I’m afraid of the consequences. My wife and kids are very supportive, and we have a loving relationship. I just want to know if anyone is experiencing anger issues. I have been a mellow sort of person, but lately my temper seems to get the better of me. Is this related to the medicine or simply adjusting? I sometimes find it difficult not to talk about it, since I am in a country that doesn’t speak English. My doctor barely speaks English but with body language I get the picture, still, it sometimes feels like I’m alone with these feelings and emotions. Thank you for your ears.
    Have a wonderful day.


  • girlbybay
    3 years ago

    love someone living in stage 4 for 18 years, I have felt very strongly about being around for awhile, then I have this week joined a few of these sites here to communicate with others with COPD , and this is the first person who is fighting it!! You give me hope!!Thanks !!!God Bless

  • Mary Ultes author
    3 years ago

    Never give up that hope, as the cure could be found tomorrow. God Bless you too, Breathe deep & easy. Mary

  • River Daniel
    4 years ago

    Mary, when did you actually accept the fact that you have COPD and you might as well learn to live with it? I wish you would write an article about that because I have been diagnosed for 11 years but I have believed every single second of those years that I will be healed. My own stem cells will grow new lungs. But another reality is trying to push through and I’m fighting it. I’m not doing well at making peace with this. How do we learn to deal with “I’d rather be dead than sick” ? Thank you.

  • Mary Ultes author
    4 years ago

    Hi 17ninja,I have had severe COPD for 18 yrs. I didn’t progress slowly from stage 1 to stage 4. I was given the wrong med in the ER for an Asthma attack. After 11 days in hospital I had stage 4 COPD was on oxygen 24/7 & heart meds. Over the years I have had tried every med available for COPD. Been intubated, coded, had a Tracheostomy & put on a ventilator to breathe for me. After 29 day told I would never lived the hospital & when I did told I’d be dead within a year. 5yrs later I again almost died, put on a sent home on a non intrusive ventilator 24/7 to help me breathe, put on home Hospice & given 6mon to live. After 4yrs went off Hospice, been off for 4 years now. I’m at the point where there in nothing that can be done for me. No Dr will do any intrusive procedure on me, they all say the same thing both my lung & heart are to weak. I put my self in God’s hands & I never give up trying now things on my own. Because I accept the fact I have COPD & learned to live with it doesn’t mean I gave up trying to find the best way to manage my COPD & I never stop hoping the I will stay alive long enough to see a cure. Since I don’t quality for any study, I’m doing my own on Hemp oil. I will wright about it when I’m done. Breathe deep & easy, Mary

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