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Depression

While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes without any apparent reason. Depression is more than just a low mood – it's a serious condition that has an impact on both physical and mental health.


Depression affects how a person feels about themselves. A person may lose interest in work, hobbies and doing things he or she normally enjoys. Some people may lack energy, have difficulty sleeping or sleep more than usual, while some people feel anxious or irritable and find it hard to concentrate.


The good news is, just like a physical condition, depression is treatable and effective treatments are available. 

 

A person may be depressed if he or she has felt sad, down or miserable most of the time for more than two weeks and/or has lost interest or pleasure in usual activities, and has also experienced some of the signs and symptoms on the list below.


It’s important to note that everyone experiences some of these symptoms from time to time and it may not necessarily mean a person is depressed. Equally, not every person who is experiencing depression will have all of these symptoms. The symptoms will not provide a diagnosis – for that you need to see a health professional – but they can be used as a guide.


Some common symptoms of depression include:

  • Not going as much, loss of interest in enjoyable activities.
  • Withdrawing from close family and friends.
  • Being unable to concentrate and not getting things done at work or school.
  • Feeling overwhelmed, indecisive and lacking in confidence.
  • Increased alcohol and drug use.
  • Loss or change of appetite and significant weight loss or gain.
  • Trouble getting to sleep, staying asleep and being tired during the day.
  • Feeling worthless, helpless and guilty.
  • Increased irritability, frustration and moodiness.
  • Feeling unhappy, sad or miserable most of the time.
  • Thoughts such as, “I’m a failure”, “Life’s not worth living”, “People would be better off without me”.

Being diagnosed with a progressive and incurable lung disease that can eventually make activities of daily living such as showering or making a cup of tea challenging can create feelings of nihilism and may lead to feelings of depression.


Both COPD and depression, if untreated, can impact greatly on a person’s ability to keep active and enjoy life. Research has identified a relationship between severe COPD and depression. Prevalence of depression increases with the severity of COPD. It is important that people with severe COPD see their doctor, as those with depression have a higher likelihood of flare ups, frequent hospital readmission and worse survival.


People with COPD are not only at high risk of depressive symptoms and mood disorders, but are at higher risk than people with other chronic conditions. People with COPD are more likely to report depressive symptoms than people with stroke, hypertension, diabetes, coronary heart disease, arthritis or cancer.


It is very important to know that both COPD and depression can be treated. Managing anxiety and depression can greatly improve people’s wellbeing and quality of life as well as their COPD and their attitude towards it. People with anxiety and/or depression can find it difficult to take the first step in seeking help. They may need the support of family, friends and a health professional. Seeking proper treatment for COPD and anxiety and/or depression will slow the progress of the disease.

There is a range of effective treatments and health professionals who can help people on the road to recovery from anxiety or depression. There are also many things that people with anxiety, depression and COPD can do to help themselves to recover and stay well. The important thing is finding the right treatment and the right health professional that works for you.


Different types of anxiety or depression require different types of treatment. This may include physical exercise for preventing and treating mild anxiety and depression, through to psychological and medical treatment for more severe episodes. The treatment for anxiety and depression in someone with COPD involves a coordinated approach that monitors and treats the symptoms of anxiety, depression and COPD.

Smoking is not only the most important risk factor in the development of COPD, but it also has a complex relationship with mental health.


There is evidence of higher occurrences of depression in smokers. There is also an element of shame associated with a smoking-related disease and some people may feel that they brought it on themselves, or that they deserve to have lung disease. While smoking is the main risk factor, not everyone who smokes gets COPD and no one deserves lung disease.


Numerous studies have concluded that depression and anxiety are risk factors for initiating tobacco smoking, often in adolescence or early adulthood.


Smoking rates amongst those with severe mental illnesses, such as major depression, are high.


People who are trying to abstain from smoking often increase their caffeine consumption and this increases agitation and symptoms of a racing heart, which can lead to anxiety and in some cases panic attacks.


Smokers with a history of depression and/or anxiety are more likely to experience worse nicotine withdrawal and have significantly more failed cessation attempts. A number of studies have found that smoking cessation itself may induce depressive symptoms in some individuals, particularly smokers with a history of depression leading to the suggestion that nicotine has an effect on mood.


Repeated, unsuccessful attempts to quit can result in feelings of worthlessness as a consequence and lead to depression.

Growing evidence shows benefits of pulmonary rehabilitation (a 6-8 week program involving medically supervised exercise and education) for COPD patients who have depression and anxiety.


Pulmonary rehabilitation involves assessment of patient problems and goals, exercise training, education, nutritional intervention and psychosocial support with the aim of restoring the patient to the highest possible level of independent functioning.


Pulmonary rehabilitation has been shown to improve mood and decrease depression, assist with control of symptoms of anxiety and panic and removes social impediments.


For more information on pulmonary rehabilitation or to find out how to access a program contact Lung Foundation Australia or visit the website: www.lungfoundation.com.au.


Click here to download the Pulmonary Rehabilitation Fact Sheet.