Depression and COPD Part II: Why Are We Depressed?

In Part I of this series I wrote specifically about how COPD patients have an increased chance of being clinically depressed and how depression affected our illness, and vice versa. Now let’s explore the important question: Why are we depressed?

I know what you’re thinking. You’re thinking “Duh. It’s ’cause I’m sick and can’t breathe!” And that’s true. Yet it’s also a bit more complex. So here, in no particular order, are some of the reasons why COPD patients have depression and anxiety.

The reasons

1. Fatigue

Aside from not being able to breathe right, fatigue is our biggest complaint and the biggest cause of our depression. According to a study done by Wong, et al, the definition of fatigue is: “the multidimensional sensation of tiredness that the individual experiences when perceiving the reduced capacity to function normally1.” Our quality of life is significantly diminished by fatigue. As COPD patients, we are limited in what we can do and what we can do takes a lot of planning and prioritizing.

2. Fear

We have fear. M. Barnett conducted a study of COPD patients’ experiences and outlooks and found we have fear about our decreasing lung function, fear of more exacerbations, fear of becoming more and more dependent on other people, fear of being put into a medical care facility, fear of being bedridden for the rest of our lives, fear of death and dying2. Fear is a major emotional consequence of COPD for many of us and our loved ones.

3. Loss

We have lost our old selves and our old capabilities. We are not going to regain them. As Barnett’s patients recounted, we can feel grief, a loss of sense of self, and a vulnerability in our ill health2. We search for a new purpose and new hopes, sometimes not finding them.

4. Dependence on others

Some of us depend on others for help in everyday living. This can lead to feelings of “isolation, lack of support, vulnerability, anxiety, helplessness, powerlessness and/or a certain loss of freedom3 .” Gradually, this role of caregiver and patient between loved ones can become strained, and arguments between the two people can grow, especially when the expectations of either one of them has changed2.

5. Growing social isolation

The worse our COPD is, the further along it is, we tend to become more isolated, simply because of the constant fatigue and shortness of breath. Both are horrible and we don’t want to exacerbate either of them with activity. This causes us to feel like we’ve lost a lot of freedom. We feel like we’ve lost a lot of spontaneity because outings require so much planning. And if we’ve lost contact and social interactions with our friends we feel lonely.

6. Guilt

Barnett’s patients who were smokers felt a lot of guilt and self-blame for their disease. They also felt guilty because smoking and lung diseases carry some societal stigmatization. Non-smokers can also face stigmatization and assumptions because many people in society don’t realize non-smokers can also get COPD.

Conclusion

If you have depression for any of these reasons, please know that your feelings are valid. Know that you are not alone. So many of us react the same way when faced with this disease and our reactions are understandable. Please talk to your doctor if you think you are depressed.

Check out Part III of this series for what we can do to deal with depression.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The COPD.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. Wong, C. J., Goodridge, D., Marciniuk, D. D., & Rennie, D. (2010). Fatigue in patients with COPD participating in a pulmonary rehabilitation program. International Journal of Chronic Obstructive Pulmonary Disease, 319-326. doi:10.2147/copd.s12321
  2. Barnett, M. (2005). Chronic obstructive pulmonary disease: A phenomenological study of patients’ experiences. Journal of Clinical Nursing, 14(7), 805-812. doi:10.1111/j.1365-2702.2005.01125.x
  3. Simpson, A., & Rocker, G. (2008). Advanced chronic obstructive pulmonary disease: Rethinking models of care. Qjm, 101(9), 697-704. doi:10.1093/qjmed/hcn087

Comments

View Comments (3)
  • WillDoe
    5 months ago

    Hi michelle.vincent
    Your article about depression and COPD really hit home.
    I am dealing with all of these feelings.
    These things are not easy to talk about…

    Thank you
    The Best!
    Will

  • Barbara Moore moderator
    5 months ago

    Hi WillDoe
    As a person with COPD, I understand that it is not easy to talk about these things but what you are feeling is normal and natural after this kind of diagnosis.
    We are here to listen and have many resources for you. Please talk to your doctor and see how he can aid you in getting it all out. No one should suffer in silence.
    Barbara Moore (site moderator)

  • Lyn Harper, RRT moderator
    5 months ago

    Will – I’m sorry you have to deal with this as well. You’re right, it’s not easy to talk about feeling down and depressed. Michelle did a great job describing the reasons and validating them.
    Please know we’re here and understand. Feel free to share how you’re feeling anytime.
    Best,
    Lyn (site moderator)

  • Poll