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Cognitive Behavioral Therapy Offers Promise for Managing COPD Anxiety

Anxiety is a well-known byproduct of having COPD.1 Not every person with COPD will experience full-blown anxiety, but is it surprising that common symptoms such as these2 might make you feel frightened and at least slightly anxious?

And here’s something to keep in mind–failing to manage this anxiety can actually worsen your COPD.3,4 So, it can become a vicious cycle. You have trouble breathing well, so you become anxious. Then, your feelings of anxiety make you feel even more out of breath–and so on.

Unfortunately, anxiety and depression are often under-diagnosed and untreated.1 The stigma of any mental/emotional disorder may also keep patients from seeking treatment.6 Feeling anxious can have a negative impact on your quality of life and may even lead to using more health care resources. And that can get expensive in a lot of ways.

The good news is that there is a promising recent study out of Great Britain. The study suggests that cognitive behavioral therapy (CBT for short) might help people with COPD learn how to manage their anxiety better.

Details of the Study

The study was reported in the European Respiratory Journal Open Research. A group of nurse consultants and other health care staff from Newcastle-upon-Tyne National Health Service (NHS) Foundation Trust and Newcastle University in the United Kingdom conducted the study.

They aimed to find out if one-to-one CBT sessions delivered by specially-trained respiratory nurses might reduce symptoms of anxiety. They also wanted to look at whether CBT could be a cost-effective alternative for varying levels of COPD.

Here are a few facts about the research study:

  • 236 COPD patients participated in the study
  • Level of severity in COPD symptoms ranged the full spectrum in participants
  • Approximately half were simply provided handouts on how to manage anxiety
  • The other half received CBT from respiratory nurses over 3 months
  • All of the patients in the study had at least mild anxiety symptoms
  • 59% suffered from severe anxiety
  • Over half of the patients also had depression

The nurses involved in the study underwent rigorous classroom and on-the-job training on CBT techniques. Cognitive behavioral therapy usually involves efforts to change thinking and behavior patterns.7 Problem solving, facing your fears and learning to calm your mind and relax your body are all key with CBT.

Researchers used a specific anxiety questionnaire at the beginning of the study and again at the end of 3 months to measure the level of anxiety.

Results of the Study

Anxiety in both groups studied improved during the course of the study. However, the improvement was significantly greater in the group who received CBT from their nurses. (3.4% improvement vs. 1.9%)

Researchers also found that hospitalization and emergency care costs were significantly less in the group who had received CBT. They noted that although there is a cost associated with the nurses providing CBT, those costs were more than offset by the savings in other types of care related to the effect of anxiety on COPD.

In Summary

The link between anxiety and COPD should not be ignored. Many people who have COPD may experience anxiety. That anxiety can further worsen their COPD symptoms. This needs to be addressed more consistently by both the patient and their health care teams in the future. I’d love to see CBT being incorporated into COPD treatment plans here in the United States as well. It’s a non-invasive therapy that could also be quite cost-effective. Perhaps it could be added to pulmonary rehabilitation programs?

Have any of our readers been taught how to manage their anxiety by using cognitive behavioral therapy?

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.

  1. Maurer J, Rebbapragada V, Borson S, et al. Anxiety and Depression in COPD. Chest. 2008;134(4). doi:10.1378/chest.08-0342
  2. COPD Symptoms. American Lung Association. Accessed March 1, 2019.
  3. Xu W, Collet J-P, Shapiro S, et al. Independent Effect of Depression and Anxiety on Chronic Obstructive Pulmonary Disease Exacerbations and Hospitalizations. American Journal of Respiratory and Critical Care Medicine. 2008;178(9):913-920. doi:10.1164/rccm.200804-619oc
  4. Halpin D, Hyland M, Blake S, et al. Understanding fear and anxiety in patients at the time of an exacerbation of chronic obstructive pulmonary disease: a qualitative study. JRSM Open. 2015;6(12). doi:10.1177/2054270415614543
  5. Heslop-Marshall K, Baker C, Carrick-Sen D, et al. Randomised controlled trial of cognitive behavioural therapy in COPD. ERJ Open Research. 2018;4(4). doi:10.1183/23120541.00094-2018
  6. What Is Cognitive Behavioral Therapy? American Psychological Association. Accessed March 1, 2019.