Health Team

Breathing problems fuel and are fueled by anxiety, depression

Posted October 13, 2008 3:24 p.m. EDT
Updated October 22, 2008 10:11 a.m. EDT

— Not being able to take a breath produces instant anxiety.

And for those who suffer from chronic obstructive pulmonary disease (COPD), the inability to breathe, anxiety and depression create a vicious cycle.

A program offered through Duke University and its medical center, though, might help patients better manage the mental and physical challenges of the disease.

Advanced COPD forced obstetrician Dr. Rick Lambeth, 60, into early retirement a decade ago. A former smoker, he experienced moments of gasping for breath.

"This causes a panic-like state," Lambeth said. "It feels like you're dying by suffocation."

An oxygen tank and hose became his lifeline, but depression set in.

"As the disease progresses, you start losing the ability to do many of the things that give life meaning," Lambeth said.

But some anti-depression drugs given to COPD patients can also cause breathing problems.

"Valium-like medications we can give patients kind of dull the anxiety, but are also going to depress their breathing and may actually be dangerous," Duke pulmonologist Dr. Scott Palmer said.

The multidisciplinary approach taken by Duke researchers offers patients, such as Lambeth, at-home help with a therapist over the phone. The therapist coaches a patient through relaxation and coping skills and encourages him or her through a structured exercise program.

"If we can get them up and moving in a safe way, we think it can have important physical and mental health benefits," Duke psychologist Dr. James Blumenthal said.

Good conditioning improves breathing and might slow the disease's progress.

The program improves their patients' quality of life, Duke researchers said – and the results show program participants can even live longer.

Lambeth said he knows that managing the mental challenges of COPD and sticking with an exercise program are vital.

"You can find that many things in life are still wonderful and enjoyable, even with this disease," Lambeth said.

The Duke study will be recruiting participants for the next few years. People who want information about participating can call 919-681-2471.