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9 Ways to Manage Panic Attacks in COPD

Panic Attacks Place People With COPD At Risk

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Updated December 16, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

COPD is associated with high levels of anxiety that can negatively impact your quality of life. As anxiety builds, it may contribute to severe breathlessness and even panic.

Panic attacks are defined as sudden episodes of intense fear accompanied by several physical symptoms. While many people get panic attacks, people with COPD seem to be especially prone to them.

Symptoms of panic attacks include:

  • sweating
  • heart palpitations
  • trembling or shaking
  • severe shortness of breath and/or feelings of being smothered
  • chest pain, tightness or discomfort
  • fear of dying
  • dizziness, lightheadedness
  • numbness and tingling in the extremities
  • hot flashes
  • chills

Let's take a look at how you may be able to diffuse a panic attack when you feel one coming on:

1. Performing Breathing Exercises

Breathing Exercises
Dada Abhijit

Often described as "taking your breath away," a panic attack may cause you to feel like you are suffocating, hyperventilating or choking. That's why it is extremely important that when you recognize the sensation of panic, you begin to focus on your breathing. If you can control your breathing during a panic attack, you can usually get through it in a relatively short period of time. Start with the following technique:

  • While relaxing your shoulders, inhale slowly and deeply through your nose. When you inhale, your abdomen should expand outward and you should feel very little expansion of your chest. This is known as diaphragmatic breathing.
  • While keeping your jaw relaxed, purse your lips like you are going to blow out a candle. With pursed lips, breathe out slowly through your mouth. This is known as pursed-lip breathing.
  • Repeat this breathing exercise until you feel yourself becoming more calm.

Remember, in order to have better control over your breathing, it is important that you practice breathing exercises on a regular basis. Listed below are several techniques for you to choose from:

2. Utilizing Medication

Medication can be extremely effective in managing panic disorder and panic attacks. In COPD, anti-depressants are sometimes preferred over anti-anxiety medications, but which medication works best for you should be something you ultimately discuss with your doctor.

Note: Although you may experience a worsening of breathlessness during a panic attack, the emergency use of bronchodilators, which may increase heart rate and intensify anxiety, are discouraged. Instead, try taking slow, deep breaths and be sure to practice the breathing techniques mentioned in the previous section several times a day.

3. Practicing Mindfulness Meditation

Research suggests that mindfulness meditation -- a practice that may incorporate sitting quietly for 20 to 30 minutes every day to focus your mind on the present -- can provide long-term, beneficial effects in the treatment of anxiety disorders.

4. De-Stressing With Relaxation Techniques

Meditation CD
Photo courtesy of Pricegrabber.com
In today's fast-paced society, many people simply don't know how to relax. Relaxation is an important part of reducing anxiety levels and preventing panic attacks. In some instances, practicing relaxation techniques may help you manage a panic attack that has already begun.

5. Visualizing Your Way to Calm

Anxiety
Photo © Flickr.com, user The Andrea
Visualization is a powerful technique that allows you to use your imagination to help you unwind and reduce anxiety. Visualization prevents you from focusing on the worry and fear of having a full-blown panic attack. It guides you into relaxation by focusing your mind on serene, peaceful images, instead of those that may cause you to panic.

6. Using Cognitive Behavioral Therapy

Panic attacks occur in COPD when uncomfortable physical sensations (shortness of breath, increased heart rate) are catastrophically misinterpreted. This means that, instead of knowing that these symptoms are not life-threatening and you have the ability to overcome them, you believe you are unable to survive them. Cognitive behavioral therapy (CBT) is one way to treat anxiety symptoms and panic attacks in COPD patients.

7. Stopping Your Negative Thoughts -- Literally

Depression
Photo courtesy of Flickr.com, user um-Abbas-Outta
Can you actually "stop" your negative thoughts from leading to panic? You bet you can! Thought stopping is a cognitive behavioral therapy technique that involves consciously commanding your negative thoughts to stop and replacing them with more realistic, positive ones.

8. Enlisting the Help of Support Groups

Quitting Smoking
Support groups may be a useful part of managing COPD and panic attacks. Why? Because they let you know that you are not alone; that many people are experiencing the same thing you are. They can also help you find new ways to deal with anxiety, panic and COPD.

9. Practicing Daily to Make Perfect

COPD underdiagnosis
Elena Elisseeva/istockphoto.com
Like anything you want to get good at, pracice makes perfect. To get the most out of the techniques mentioned above, practice them on a regular basis -- don't wait until you are in the middle of a panic attack to try and remember how to do them. Practicing these techniques several times a day, every day, will help you easily recall them when they are needed most -- when you sense a panic attack coming on.

Sources:

Kummer. F. Panic attacks in COPD and the somato-psychosomatic feedback. ERJ. Eur Respir J 2010; 36: 457–461 DOI: 10.1183/09031936.00045310</p>

Livermore N, Sharpe L, McKenzie D. Catastrophic interpretations and anxiety sensitivity as predictors of panic-spectrum psychopathology in chronic obstructive pulmonary disease. J Psychosom Res. 2012 May;72(5):388-92. Epub 2012 Feb 25.

Livermore N, Sharpe L, McKenzie D. Panic attacks and panic disorder in chronic obstructive pulmonary disease: a cognitive behavioral perspective. Respir Med. 2010 Sep;104(9):1246-53.

Miller JJ, Fletcher K, Kabat-Zinn J. Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. Gen Hosp Psychiatry. 1995 May;17(3):192-200.

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