Feelings of Guilt

Spot Emotional Distress Early for a Better COPD Prognosis

It’s difficult to stay upbeat with chronic obstructive pulmonary disease (COPD) — that’s no secret. Struggling with breathing difficulties, lifestyle changes, and general weakness can sour your mood. But while it’s common to have some “down" days, when those sad feelings begin to multiply, it’s time to meet the challenge head-on.

Depression can begin slowly, but it will turn your life upside down before you realize it. When you live with COPD, the danger is double-edged: not only will your depressed state interfere with your self-care, it can physically aggravate your pain and discomfort, too.

Keep an eye out for these early signs of depression, so you can get treatment started and avoid emotional catastrophe.

1. Irritability

Everyone goes through irritable phases, especially when the stress of life and your disease are interfering with your schedule. However, ongoing irritability and moodiness can also point to a hormone imbalance, which is a known source of clinical depression.

If you find yourself getting annoyed at the slightest event, and irritability quickly escalates into anger and frustration, it’s time to take a closer look. Depression doesn’t always manifest through tears and sadness; it’s a complex web of mood changes that can favor less common symptoms.

Men are more likely to experience anger and irritability, while women are often feel more sadness and helplessness.

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2. Anxiety

Anxiety and depression are technically different disorders, but they often attack together. Emotional, environmental, and social factors can trigger both conditions, and stress will make things worse. Since COPD is a physically and psychologically stressful condition to live with, it can set the stage for emotional turmoil that manifests as anxiety and panic.

Uneasiness, fear and worry are the classic symptoms of anxiety. Once these become your regular emotional state, you could be struggling with an anxiety disorder, and that may also point to depression.

Keep an eye out for physical signs of anxiety, too, like sweating, hot flashes, twitching, muscle aches and headaches.

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3. Feelings of Guilt

Depression brings a loss of confidence and it can diminish your self-esteem quickly. Some people will begin to take responsibility for every problem in life, convincing themselves that they are to blame for their condition. Guilt goes hand-in-hand with helplessness and hopelessness.

COPD tends to bring along a sense of guilt from the very beginning. If you’ve smoked all your life, you could feel ashamed and disappointed in yourself for creating the conditions for your COPD.

This guilt is something you need to deal with, and it should by no means hold you back from building a healthier life. If you can’t shake the guilt, it’s time to see a therapist for some help and support.

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4. Changes in Appetite

Mental states are intimately tied to physical needs and desires. Many people find their relationship to food shifts depending on how they’re faring emotionally. Overeating, undereating, or eating the wrong sorts of foods are all common consequences of depression.

If your eating habits lead to a weight gain or loss of 5 percent of your total body weight within a month (without making conscious, healthy lifestyle changes), you might be in a depressive episode. If you’ve lost interest even in your very favorite foods, that’s a big red flag.

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5. Lethargy

Fatigue is an unfortunate reality when you live with COPD. Your body takes in less oxygen and expels less carbon dioxide with every breath, and that means your cells won’t get all the energy they need to function well. It can be difficult to separate the usual COPD fatigue from fatigue associated with depression, but mood changes are helpful clues.

When fatigue comes with a consistently low mood, lack of motivation, and confusion or cloudy thinking, you may be depressed. However, these changes can also precede a COPD exacerbation, so it’s important to consult your doctor right away to get to the bottom of the problem — and stay in control.

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6. Sleep Disturbances

Sleep problems and depression feed off each other: problems sleeping can create the conditions for depression, and depression can make sleep problems worse. Since everyone has a different “normal" when it comes to sleep patterns, the key is to spot major changes in your sleep routine.

Insomnia and oversleeping are both associated with depression. It’s natural to have some stretches of poor sleep — stress, excitement, and countless other factors can be to blame — but if there’s no clear trigger to your sleep disturbances, they could point to depression.

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7. Confusion or Trouble Concentrating

When sleep is a problem, memorizing and concentrating become difficult. However, if you have a hard time focusing, feel easily distracted, and can’t seem to think clearly, your problem could run deeper than a few sleepless nights.

Persistent negative thoughts are a hallmark of depression, and they can crowd out your problem-solving and decision-making abilities. It becomes difficult to follow a train of thought, and that can leave you feeling restless. In some people, this confusion and cognitive trouble manifests as agitation.

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8. Difficulty Engaging in Conversation

Isolation is depression’s best friend: when you feel helpless, gloomy, anxious and tired, social interaction is the last thing on your mind. However, there are some subtle signs that you might notice in conversation well before you feel the need to cut yourself off from your social circle.

Having to muster the energy to carry on a simple back-and-forth chat is a red flag. You might notice that you voice has become monotone, since you can’t seem to inject any emotion into your dialogue. It’s common for some depressed people to lose their thoughts and blank on certain words, while others begin to speak in rapid, incomprehensible sentences. The bottom line is that any noticeable changes in conversation can point to a bigger issue.

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9. Disinterest in Favorite Activities

Everyone has something they like to do — some activity that makes them happy. Living with the discomforts of COPD means you may not be up to it all the time, but if you lose all interest in the things you used to enjoy, there may be a deeper problem.

When depression interferes with your mind and personality, you will tend to become apathetic. Activities and events no longer inspire much interest or disdain; you don’t feel strongly in any way and you stop reacting. In some cases, your lack of focus or the burden of sadness keeps you from participating.

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10. Changes in Perception

Depression is a personal and internal struggle, but it also affect the way you perceive your surroundings. Not only will your mood affect your interactions and interests, but it can also quite literally color your world.

When you’re depressed, all your senses can suffer. For many, colors will appear dull or lifeless and sounds may seem muffled or muted.

However, if you’ve been living in a depressed state for a while, you won’t notice that your perception has been damaged. Only when you begin treatment will you realize that colors, sounds, tastes and feelings are much more vital and pronounced than you had thought.

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11. No Sense of Humor

You may not consider yourself to be a bubbly and lighthearted person, but most people have a sense of humor. It’s part of interacting with others, seeing the absurdity in life, and not taking yourself too seriously. Once you lose your ability to laugh, you lose an important social tool and vital character trait.

Sometimes life isn’t funny. Physical symptoms can be painful and frightening, and it’s difficult to smile when you’re weighed down with worry. However, the longer you go without finding humor in anything, the more likely you’ve started down the road to depression.

A startling percentage of COPD patients (up to 50 percent) struggle with depression, but care, concern, and healthy priorities can significantly reduce that statistic.

When you spot the early warning signs, more helpful interventions are at your fingertips: from social support to behavioral therapies, you can try a number of less invasive treatments before turning to strong medication.

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