Overview

When battling chronic respiratory conditions, especially if it is persistent, there is a high chance that they will start affecting your mental health. You are then faced with the physical symptoms of the disease as well as managing your mental well-being. How can you cope with this?

What is good respiratory health?

Good respiratory health is one without any visible disease in the lungs.¹ The lungs are the main organ in the respiratory system. They are in charge of us taking in oxygen present in the air we breathe and expelling carbon dioxide, while the other organs supporting them include the nose, trachea (windpipe), larynx (voice box), diaphragm and intercostal muscles.² The intercostal muscles and diaphragm help the chest to expand and contract as we breathe in and out.

Common respiratory conditions

The presence of a respiratory condition leads to a decline in how well the lungs function, which can affect our breathing, causing discomfort or can be potentially terminal. Respiratory conditions have different causative factors, ranging from age, lifestyle, genetics, environmental exposure, and infections of the lungs.¹

Lung disease is classified into two:

Obstructive lung disease

Where the airways are narrowed, resulting in breathing difficulties and an increase in the duration of time required to empty the lungs.

Restrictive lung disease

Which is distinguished by a decrease in the capacity of the lung to expand, a loss of lung tissue, or a reduction in the ability of the lung to transfer the carbon dioxide and oxygen as we breathe in and out.³ 

According to the American Lung Association⁴, some diseases of the lungs include asthma, chronic obstructive pulmonary disease (COPD), collapsed lung, pulmonary embolism, idiopathic pulmonary fibrosis (IPR),  lung cancer, and bronchitis- the inflammation of the bronchial tubes which are responsible for moving air from the windpipe to the lungs, or emphysema - inflammation of the air sacs.

Chronic respiratory conditions and mental health

About one in four of us will have issues with mental health at some point in our lives⁵. On the other hand, research shows that respiratory conditions are associated with a higher chance of mental health problems in adults.⁶

Some mental health issues occur in synchronisation with chronic health conditions, known as comorbid or co-occurring mental health conditions. These make it harder for you to cope with your lung condition. Expected to have comorbid mental health conditions if dealing with respiratory diseases include:

• Depression - You may feel angry, out of touch, or have an intense feeling of sadness that may last more than a few weeks. Depression causes you to lose interest in activities you love, a feeling of hopelessness or helplessness, irritability towards yourself or others, always sleeping or lack of sleep, eating less or more, lack of energy and concentration, feelings of low self-esteem and guilt, and suicidal ideation.⁴

• Anxiety - The frequent trips to the hospital, constant breathlessness, and missing interaction with loved ones can cause the fear of breathing problems.  When our breath becomes shallow, the brain can sometimes misjudge that there is a stressful situation at hand. This can cause anxiety, a stress response in the body.⁷ Anxiety is symptomized by racing thoughts, difficulty concentrating, 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, and feelings of panic, dread, or doom.

• Social anxiety - With the decline in respiratory health comes the fear of having breathing problems in public. You may avoid going out to social gatherings or events because you are unsure of when your symptoms will start. You keep yourself in seclusion to prevent this, but when you cannot avoid a social gathering, it causes an incredible feeling of distress. Things to look out for when experiencing social anxiety are nausea, rapid heart rate, sweating, and, occasionally, full-blown anxiety attacks when faced with a scary social situation. Other symptoms may be so extreme that they affect your daily life and seriously interfere with your lives, relationships, and jobs.⁸

• Post-traumatic stress disorder (PTSD) - Acute breathing events that occurred in the past can impact your mental health, giving rise to PTSD. These past events affect you so much that you always remember them and dread when they would happen again. Signs to look out for are nightmares, anxiety that the traumatic event is happening to you again due to having flashbacks to the trauma, you are severely stressed when you remember the traumatic event, sweat, and feeling nauseous or trembling whenever you remember the experience. 

If you or someone close to you is struggling with mental health

Now that we know some signs accompanying mental health issues in people with chronic respiratory conditions, it is easier to recognize their onset and be better prepared to cope with them. The following can help to promote and improve your respiratory and mental health:

• Positive well-being - You can check in with yourself to consider what improves or affects your mental health. Exercising, drinking enough fluids, getting the right amount of sleep, eating more greens, eating a healthy diet, and quitting smoking will improve your respiratory health. Avoid exposure to impurities and irritants. You may also invest in an air purifier to help remove pollutants and irritants like dust and smoke from the air in your home.⁵

• Prevent infection - Good personal hygiene helps to reduce the chances of contracting an infectious disease that will cause complications to your respiratory condition. Wash hands regularly; especially after using the bathroom or coming in contact with someone who may be sick, avoid crowded places particularly during flu season, practice good oral hygiene, and go for regular check-ups.⁹

• Multidisciplinary pulmonary rehabilitation - This program teaches breathing techniques and coping mechanisms, and it is facilitated by and done with the supervision of medical personnel. This program aims to help reduce the symptoms of mental health issues, increase your strength, and make it easier for you to manage your daily activities.¹⁰

• Medication - Your healthcare provider may prescribe medication to help with your co-occurring symptoms.

• Support-  Talking to a counsellor about how you feel while getting the help you need can cause a change in patterns of negative thinking and behaviours, reduce depression and anxiety and improve quality of life. You can help out in an organisation dedicated to helping people with your condition, join a group of people living with the same condition as you, or talk to your family and friends about the ways they can help you feel better; when to offer support and when you need your own space. 

If you are a carer, family member, or friend of someone having co-occurring respiratory and mental health conditions, it can be stressful, and it is entirely normal. Take care not to get stressed out yourself, as it may also affect your mental health. You can only provide support when you are at your best. Furthermore, having an open discussion with them will enable you to know how to help them or, if you can’t, point them in the right direction to receive help. 

Conclusion

Living with a respiratory condition can take its toll on your mental health but knowing the indicators will help you manage them better. Take care of yourself, have a positive outlook on life, and believe in your support system. When the intrusive thoughts start to come, have an honest conversation with your family, friend, or counsellor, and you will feel better in no time.