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Living Well: Mental Health and Chronic Obstructive Pulmonary Disease (COPD)

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What can we do to promote lifelong lung health?

Although there's currently no cure for Chronic obstructive pulmonary disease (COPD), it can be prevented and treated by pulmonary rehabilitation and quitting smoking. However, there is also a psychological element to COPD. Depression is the second most common condition that people with COPD report (40%). 36% have anxiety, and panic disorder is approximately ten times higher in people with COPD than in the general population (Wang et al., 2021). Anxiety and depression negatively affect a person’s quality of life and can increase the risk of death from COPD, especially among young patients, women, and smokers (Recio Iglesias et al., 2020). However, only about one-third of people with COPD and mental health difficulties seek help for psychological issues (Wang et al., 2021). Outlined below are some of the main barriers to access:

Psychosocial issues

The main reason people do not seek help is that mental health is not a first priority. Financial constraints and childcare are two examples of other barriers people face (Russell et al., 2018, Wang et al., 2021). However, looking after mental health doesn't have to take up much time. Taking 10 minutes of your day to make yourself a priority can increase feelings of wellbeing. Relaxation exercises and meditation techniques are free, quick, and great for symptoms of anxiety and fatigue.

Shame

People with COPD report two layers of shame. Shame and embarrassment for having a smoking-related disease and shame due to having mental health difficulties. There is no blame when it comes to physical and mental health. Guilt, shame, and self-blame are not helpful when dealing with COPD. What can be helpful is coming up with solutions to help lessen these emotions and the impact of symptoms. So, for instance, quitting smoking, speaking to a GP or trusted friend and getting help. 

Knowledge gaps

Quality of life is a word used to describe physical, mental, emotional, and social wellbeing. Poor quality of life among COPD patients relates to shortness of breath, fatigue, and mental difficulties, like anxiety. (Tabar & Alshraideh, 2019). Many people with COPD know the symptoms of COPD but many do not know the symptoms of anxiety, panic, and depression. COPD and mental health difficulties overlap. Symptoms such as fatigue, reduced motivation, tiredness, and insomnia are both symptoms of COPD and Depression/Anxiety. The good news is that by learning techniques to lessen anxiety, depression or panic, you are learning techniques to deal with COPD symptoms.

The health system

Navigating the healthcare system can be challenging and frustrating. A few things can be done to get the most out of medical appointments.

  1. Plan

Plan questions or topics to discuss. Think back over the last month - what has confused, surprised, encouraged, or frightened you about your health? What would you like to know or say to your health professional? Write these answers down to take to your appointment.

  1. Take part

When at the appointment follow the ABC style of communication. Assertiveness: express yourself with confidence. Brevity: speak as briefly as you can and keep to the point. Clarity: express yourself clearly.

  1. Partner

You and the healthcare professional are equals. You are both experts: the healthcare professional has expertise in COPD and the physical aspects of the condition and you have the expertise of daily life with COPD and how it affects you.

What can we take away

Learning to live well with COPD is often a long and challenging process. For COPD self-management to be effective, mental health needs must be looked after alongside medication and symptom management (Russell, et al. 2018). Frustration, depression, and anxiety are common, as people adapt their lifestyles. Healthcare professionals may not have enough time, resources, or confidence to give self-management support, particularly around mental health and emotional needs. SilverClouds Space in Lung Conditions from Depression & Anxiety is a programme specifically made for people with COPD. It helps improve mental health while also teaching ways to overcome and face challenges in daily life.

World COPD Day

The 2022 theme for World COPD Day will be "Your Lungs for Life" on November 16th. This year's theme aims to highlight the importance of lifelong lung health. Keeping lungs healthy is integral to future health and wellbeing (World COPD Day 2022, 2022).

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References

Recio Iglesias, J., Díez-Manglano, J., López García, F., Díaz Peromingo, J. A., Almagro, P., & Varela Aguilar, J. M. (2020).     Management of the COPD Patient with Comorbidities: An Experts Recommendation Document. International          journal of chronic obstructive pulmonary disease15, 1015–1037. https://doi.org/10.2147/COPD.S242009                

Russell, S., Ogunbayo, O. J., Newham, J. J., Heslop-Marshall, K., Netts, P., Hanratty, B., ... & Kaner, E. (2018). Qualitative      systematic review of barriers and facilitators to self-management of chronic obstructive pulmonary disease:              views of patients and healthcare professionals. NPJ primary care respiratory medicine28(1), 1-13.      

Tabar, N. A., & Alshraideh, J. A. (2019). Correlates and predictors of health-related quality of life among patients with         COPD: an integrative review. Open Journal of Nursing9(12), 1203-1225.)

Wang, J., Willis, K., Barson, E., & Smallwood, N. (2021). The complexity of mental health care for people with COPD: a   qualitative study of clinicians' perspectives. npj Primary Care Respiratory Medicine31(1), 1-8.

World COPD Day 2022 - Global Initiative for Chronic Obstructive Lung Disease. Retrieved October 24, 2022, from              https://goldcopd.org/world-copd-day-2022/

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