In a message from the COPD Foundation, it is possible to stay healthy, maintain quality life, and maintain emotional well-being during this COVID-19 pandemic. These are challenging times. We feel isolated if we are doing the right thing by maintaining our distance to avoid the spread of the virus. We are concerned about our health and safety. People with heart and lung conditions are particularly vulnerable. Our economy is suffering and many are not working or earning an income. We need to know that we are all in this together. The better we respond, the sooner we can safely open up to a more normal life.
While anxiety and depression are frequent for those with COPD, pulmonary rehabilitation can help you deal with this added stress. Since anxiety and depression aggravate shortness of breath, your exercise program, breathing retraining, taking your medication and oxygen, if prescribed, will help both. Adherence to your rehabilitation program will render a hospital admission less likely. However, being physically present in a pulmonary rehabilitation program is not available during this pandemic. Nevertheless, pulmonary rehabilitation tools and principles have not changed and are still particularly useful. See our basic’s pages for guidance on how to start an exercise program. Also, you can join in pulmonary rehabilitation at home using this great set of videos from the British Lung Foundation.
The COPD Foundation based their resource pack on an insightful presentation in March 2020, Michelle Eakin, PhD, at Johns Hopkins School of Medicine, discussed “Coping strategies for people with COPD during COVID-19”. Dr. Eakin highlights the strong relationship between shortness of breath, fatigue, increased arousal, maladaptive thoughts, and panic which leads back to shortness of breath. This is a downward spiral. In pulmonary rehabilitation, we learn that inactivity can drive this spiral down while exercise training and an active lifestyle can put you back in charge – generating confidence that goes with it.
Sometimes we make the distinction between the mind and body as if they were separate. In fact, the mind exerts control over the body and what the body is able to do influence the mind. Exercise is a good example of the latter effect. Exercise actually changes the chemistry in the brain: serotonin, norepinephrine, dopamine, and brain derived neurotrophic factor (BDNF) are altered by exercise and can positively impact anxiety and depression. Also, exercise helps with shortness of breath in part by distraction, change of scenery, and modification of thought patterns.
The COPD Foundation’s resource pack reminds us that stress causes or amplifies shortness of breath and fatigue. The article teaches about negative triggers and how to avoid them; how to reframe negative thoughts. It reminds us of the importance of good self-care by improving sleeping habits, get out of doors (safe distancing), avoid alcohol, be appropriately informed, explore new things, laugh, smile, and meditate. For meditation, you can use an App on your phone, YouTube or simply go out for a walk in a pleasant (safe) location.
For social distancing, engage but don’t touch; schedule important times of communication with family and friends, help others, be active, be thankful, and express thanks to others. These activities can help you in maintaining your emotional wellbeing now and in the future.
Brian Tiep, MD 6/2/20
PERF Board Member