Many people with chronic obstructive pulmonary disease (COPD) also experience anxiety. The symptoms of COPD may indicate danger to the brain, which can react by causing anxiety or possibly triggering a panic attack.

A 2016 study concluded that people with COPD have a significantly higher likelihood of anxiety. However, it can be difficult for doctors to accurately diagnose anxiety in a person with COPD, as the symptoms of the two conditions can overlap.

In this article, we look at the link between COPD and anxiety in more detail. We also cover some treatments that may help manage the symptoms of both conditions.

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People with COPD often struggle for breath.

The brain reacts to this by sending signals of distress.

These distress signals may trigger anxiety, which can lead to a panic attack in some people.

Panic attacks and anxiety can also cause a person to have difficulty breathing or to change their normal breathing patterns.

Due to this overlap of symptoms, a person with COPD often becomes trapped in a cycle in which the breathing difficulties of COPD trigger anxiety, which makes it even more difficult to breathe.

People with COPD are often aware of the symptoms of a panic attack, as it is normal for the brain to send stress signals out during an episode of breathlessness.

Panic attacks can be dangerous for people with COPD because they can exacerbate breathing difficulties and make it even more challenging to get air from each breath, leading to worsening symptoms.

There are many ways to identify a panic attack. A panic attack may:

  • be sudden and intense
  • come on without warning
  • cause an irrational level of fear

Specific events, such as breathlessness, may trigger panic attacks, but an attack may sometimes come on with no apparent trigger.

Panic attacks cause symptoms that include:

  • difficulty breathing
  • rapid heartbeat
  • tightness in the chest
  • shaking
  • cold sweats
  • sudden changes in body temperature, such as hot flashes or chills
  • dizziness
  • feelings of dread or a sense of impending doom

Panic attacks generally only last for a few minutes, but they can affect some people for longer. In some people, they may occur regularly.

COPD may link to depression and anxiety in a similar way.

A 2014 study noted that the relationship between COPD and depression seems to flow both ways.

COPD may cause depression, and depression may worsen COPD by increasing a person’s anxiety, which can adversely affect their breathing ability.

The study notes that psychotherapy techniques, such as cognitive behavioral therapy (CBT), may work for both COPD and depression, but the extent of treatment necessary to see results is unclear.

A comprehensive COPD treatment strategy will ensure that people know how to deal with symptoms of anxiety and panic attacks.

Treatment strategies often involve therapies or techniques to help relax the body and calm the mind, including:

Breathing exercises

A person may feel as though they are suffocating during a panic attack.

Practicing diaphragm breathing can encourage people to breathe more efficiently and help them regain control of their breath.

People can practice diaphragm breathing by:

  • Sitting with the shoulders relaxed or lying down on the back, making sure not to hunch over or block the chest or abdomen.
  • Inhaling slowly through the nose and paying attention to the abdomen as it expands outward with a full, deep breath.
  • Exhaling slowly while pursing the lips.

The breath should not cause the chest to expand too much. It is important to focus on breathing using the diaphragm and feeling the abdomen rise and fall with each breath.

Placing one hand on the abdomen can help a person physically feel this motion as it happens.


CBT may help train the brain to respond to panic triggers more positively.

CBT is the process of talking through these triggers with a therapist and learning how to respond to them differently to change the brain’s focus from panic to relaxation.

Doing this can help people change how they think or feel about a situation that is out of their control, hopefully reducing the number of panic attacks that occur.

Pulmonary rehabilitation

Pulmonary rehabilitation (PR) techniques, such as exercises, educational information, and energy-saving advice, can help people maintain a higher quality of life and keep their lungs functioning as well as possible.

PR is useful for people with COPD and anxiety because it helps the body deal with the physical symptoms of COPD. This may make psychological triggers less likely to occur or more straightforward to manage.


Meditation may be beneficial for people who have COPD and anxiety.

Adopting the practices below may help people feel less stressed or anxious in their daily life:

  • guided meditation
  • yoga
  • chanting, often using a calming word or phrase

Meditation may not be enough to treat the underlying issue, but it can supplement other treatment options.


Standard medications for anxiety include alprazolam (Xanax) and diazepam (Valium). These drugs often help people manage anxiety symptoms in the short-term, but they may not be suitable for people with COPD.

Some anxiety medications may interact with COPD medications, and the possible side effects may interfere with how a person breathes.

However, medication may help people control their panic attacks safely. People should talk to their doctor to determine whether or not medication is suitable for them.

COPD commonly causes stress and anxiety. Other issues, such as panic attacks or depression, can make the symptoms of both conditions worse, but people can use a range of methods to help manage them.

It is important to note that certain techniques, such as meditation and breathing, require regular practice. Using these techniques consistently may help people prepare for and deal with a panic attack or other anxiety symptoms.

Anyone having trouble managing their symptoms should speak to a doctor about possible treatments.