Calling Dr. Bauer …
For those with lung disease, shortness of breath or dyspnea – both chronic and acute – can certainly lead to symptoms of anxiety. I have some suggestions for an approach to manage these concerns.
First are strategies to minimize the production of acute dyspnea: Use your pursed lips breathing techniques as well as diaphragmatic breathing. Sometimes increasing oxygen flow rates from the typical 2 liters up to 3 to 4 liters helps. Enrolling in a formal pulmonary rehab program can be life changing for assistance in this area. You can practice your techniques with a trained professional.
Often, using a fan to produce a nice cool air breeze to the face can be helpful. Gentle chest percussion therapy by a spouse or friend helps to diminish the perception of dyspnea. Listening to music as well as learned-guided-imagery meditation techniques can relieve anxiety symptoms.
Medications to treat anxiety can be helpful but need to be used with caution. It’s not usually a concern of becoming “dependent” on medication. The problem here is that most medications that treat anxiety also depress the respiratory drive centers in the brain. Lower breathing rates can cause oxygen levels to decrease and carbon dioxide to build up. Carefully monitored doses of medications like Ativan (lorazepam) or even low-dose morphine are options. Make sure your physician is comfortable and knowledgeable about the effects of these medications on respiratory function.
Finally, having a “plan of action” is comforting. Always have your rescue inhaler or nebulizer immediately avail- able. Have portable oxygen at hand if you are traveling outside the home. For long vacations away from home, talk to your doctor about having some prednisone and/or antibiotics available to take with you.
Encouragement and reassurance from family and friends are often two of the best medicines.