If you live with a lung condition, you might be more likely to experience problems with your mental health in addition to your physical symptoms. This factsheet explains how to look after your mental wellbeing, what mental health conditions you might experience, and where to find support if you are not feeling well.
What is mental wellbeing?
Mental wellbeing is a term used to describe how you are feeling and how you cope with daily life. This includes how you feel about living with your lung condition.
If you have good mental wellbeing you are more likely to be taking good care of yourself and managing your treatment well. You will feel positive about life and want to be a part of things that are happening around you.
If you are experiencing poor mental wellbeing you may find that you are less interested in doing things you once enjoyed. You may feel more anxious and tense and find it harder to cope with daily life and the stress of your condition.
Living with a lung condition
You may be more likely to experience poor mental wellbeing or a mental health condition if you are living with a lung condition. This might be because:
you find it harder to do the same activities that you did before you became ill
you worry that you will not be able to breathe
you feel frustrated if you now need regular medical treatment and more support from others, or
you worry about the future with your lung condition.
This could then have an impact on how you view your role at work, interactions with your family and friends, and your self-esteem.
Having a mental health condition may also affect your ability to cope with your lung condition. This might mean:
feeling anxious about being out of breath, so you avoid exercise
being depressed and not feeling able to take your medication, or
avoiding social situations and feeling isolated.
This creates a negative circle of events; if your symptoms are not well-managed, it could then make you feel worse.
How can I look after my mental wellbeing?
Looking after your mental wellbeing is a personal process and it is important to find something that works for you. There are lots of different approaches:
Keeping active
Living an active life when you have a lung condition can help to manage your symptoms and keep you feeling well. The more active you are, the easier you will find daily activities, despite your breathing difficulties. It is important to find an activity that matches your level of breathlessness. You could find something to build into your daily routine, such as gardening, walking up and down the stairs or getting off the bus one stop early and walking home. Or you could try something more structured like keep-fit classes, running or strength exercises. Remember that experiencing some breathlessness during activities is normal and not a sign of disease flare-up.
You could also look to join a pulmonary rehabilitation course. This is a highly effective structured programme of exercise and information classes that are specific for people with lung conditions to help you stay active.
Mindfulness
Mindfulness means focussing on the present moment. It teaches that an emotion or feeling is our normal reaction to something, but that you can respond to this feeling in different ways. It helps you understand that some thoughts and feelings might be positive and some negative. But that neither of these reactions changes the reality. Research has shown the benefits of mindfulness for people with lung conditions, particularly to help relieve the stress that could be caused by breathlessness. Experiencing some breathlessness during activities is normal in people with lung conditions and accepting this can help you feel better about your condition and about life in general.
Self-help
You can take steps to help yourself, such as learning what affects your mood - what improves it and what makes you feel worse? This may help you to prevent feelings of being unable to cope. You might also want to build things into your life that you find enjoyable, such as learning something new, a phone call with a friend or taking more time for yourself to relax. This might be particularly helpful if you feel that you cannot do the things that you used to. Instead, you could find something enjoyable that you can do now.
It is important to regularly ‘check in’ with yourself. Notice how you are feeling and whether you have felt better or worse recently. If you begin to feel like you are not coping well, then discuss this with your healthcare professional early on before your mental or physical symptoms become worse.
“It's okay not being well. It's normal to feel defeated or like you can't stand to do anything else. It's important to remember that this is not a problem and you can find support to help you manage this, just as you would do if you experience bad physical symptoms. The other thing that helped me a lot is to remind myself that I am not less for having the condition. I am not less of a person and I don't deserve less than others just because of my condition. Remembering this really helped me manage my mental wellbeing in times when I felt low.”
David
What mental health conditions might I experience?
Approximately one in four of us will experience a mental health condition at some point in our lives. Here we take a look at three conditions that might be more common for people with lung conditions.
Anxiety
Many experiences linked to your lung condition could lead to anxiety. These could include:
being hospitalised if you have a chest infection or your symptoms flare up
being frequently or constantly breathless
losing your job or missing interactions with friends and family, or
feeling that your symptoms are out of control.
If this feeling of worry continues for a long time or overwhelms you, these are symptoms of anxiety which you can get help for.
Things to look out for
Racing thoughts
Difficulty concentrating
Feelings of panic, dread or doom
Problems with sleep
Feeling like you want to escape
Heavy and fast breathing linked to your mood
Sweating or hot flushes
Nausea
Palpitations and trembling
Depression
Living with a lung condition can feel like hard work. You may feel angry or disheartened at times, particularly if your condition stops you taking part in your usual activities. If this feeling lasts for weeks and affects your daily life or is accompanied by strong feeling of joylessness or feeling really down, this could be a sign of depression. Depression is not the same as just feeling low for a few days - it is a serious mental health condition and one you can get help for.
Things to look out for
Feeling helpless or hopeless
Joylessness
Losing interest in daily activities
Sleep changes-either more or less
Appetite changes-eating more or less
Lack of energy and concentration
Anger, irritability towards yourself or others
Feelings of low self-esteem and guilt
Thoughts about death or suicide
Post-traumatic stress disorder (PTSD)
As a person living with a lung condition, you may experience traumatic events that have a lasting effect on your mental health. One example is if you require time on an intensive care unit in hospital or if you require mechanical assistance to breathe. This can be a traumatic experience and some people are left struggling to cope. It can lead to a condition called post-traumatic stress disorder. This condition can cause severe disruption to your daily life as the stress you felt at the time of the event continues to affect you. This is a serious mental health condition and one you can get help for.
If you notice the signs or symptoms of any mental health conditions, it is important to seek help from your healthcare provider as soon as possible.
Things to look out for
Flashbacks to the trauma you experienced so you feel that it is happening to you again
Nightmares
Severe stress at reminders of the trauma
Sweating, nausea or trembling when you remember your experience
Treatments for mental health conditions
Everyone is different and will have different needs that your healthcare provider will discuss with you. These are some of the treatments for mental health conditions for people with lung disease.
Multidisciplinary pulmonary rehabilitation. This has been found to be a very effective option for improving your mental and physical health if you have a lung condition.
Talking therapies with a counsellor or psychotherapist. This could include cognitive behavioural therapy (CBT), exposure therapies - which help overcome specific fears as well as help with depression and PTSD - or trauma therapy.
Medication such as antidepressants or anxiolytics. Doctors may suggest this as a treatment option and will work with you to find the right dosage to limit side-effects.
You may be offered a combination of these treatments and your healthcare team will work to find the best solution for you.
Where can I find support?
Having issues with your mental health is very common and nothing to be ashamed of. It is good to be able to speak openly about it. If you feel like you are not coping, discuss this with your healthcare provider who will be able to talk through your options for finding support. In addition to this, you could also try the following.
Find a support group for people living with your condition. This could be local to you, or an online community. Many people find it beneficial to talk to others who have similar experiences.
Talk to your family and friends. Although they may not be living through the same experience, you can help them to understand what it is like for you. You could discuss with them the ways in which they can help you and explain to them the times when you need your own space. They may be able to help you notice changes in your mood and if you need further support.
“One thing I learned from my time spent networking with people from other patient organisations is the useful phrase - it is okay not to be okay. You have to allow yourself not to be okay at certain times in your life. It's so difficult to be strong and cheerful and happy and okay all the time. You have to allow yourself to be in a bad mood. I have bad days sometimes - I don't see anyone and they are days just for me. I cover myself in a blanket and stay home. I cry, I shout or I sleep if I have to. I allow myself not to do anything and then I wake up the next day and feel refreshed - it's a new day and I almost feel reborn, I can be positive again and I feel like new.”
Elena
Connect with patient organisations working to support people with your condition. You may find that becoming actively involved with these organisations gives you communication with a range of people with similar goals to you and also keeps your mind active as you work towards these shared goals.
For families/friends/carers
Caring for someone can be stressful and this could impact your mental wellbeing. This is very normal, and it is important for you to look after your own mental health. If you notice the signs or symptoms of a mental health condition in yourself, it is important to seek help as soon as possible. Your health matters and you will be able to provide better care and support if your own health is well looked after.
If you are caring for someone with a lung condition and you want to be able to support their mental wellbeing, it can be hard to know how best to do this. Everyone's experience of mental wellbeing or mental health conditions will be unique and personal to them. Having open discussions about what can trigger negative moods, what the person finds helpful and what support they would like from you can be a good place to start.
If you notice a change in their mood and you are concerned, ask how the person is feeling, if they feel they are coping and what kind of support they may need. You may not be able to help them directly, but you can point them in the right direction for professional help and let them know you are there for them. Often listening is more important than giving advice. You could also offer to accompany them to appointments if they are worried about discussing their condition with a healthcare professional.
Additional resources
Patient organisations
Mental Health Europe: www.mhe-sme.org/
GAMIAN-Europe: www.gamian.eu/
You can search for patient organisations in the field of lung health on the ELF Patient Organisation Network directory: www.europeanlung.org/en/get-involved/european-patient-organisation-network/
Mental health resources
The Five Ways to Wellbeing: neweconomics.org/2011/07/five-ways-well-new- applications-new-ways-thinking
Mindfulness: Finding Peace in a Frantic World: franticworld.com/what-is- mindfulness/
Oxford Mindfulness Centre: www.oxfordmindfulness.org/
ELF factsheets
Living an active life with COPD: www.europeanlung.org/assets/files/en/publications/living-an-active-life-with-copd-en.pdf
Your lungs and exercise: www.europeanlung.org/assets/files/factsheets/exercise-and-the-lungs-en.pdf
Pulmonary Rehabilitation: www.europeanlung.org/assets/files/en/publications/pulmonary-rehab-en.pdf
The European Lung Foundation (ELF) was founded by the European Respiratory Society (ERS) in 2000 with the aim of bringing together patients, the public and respiratory professionals to positively influence lung health.
Produced in June 2020.
- Copyright ©ERS 2020
Breathe articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.