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COPD and Panic Attacks

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This blog post was written by Ryan Rivera,

Panic attacks are a type of mental health disorder that can feel overwhelming. Most people associate the word “panic” with fear, but panic attacks are not necessarily a fear-related disorder. Indeed, while they can be triggered by fear, panic attacks may have no trigger at all, and the symptoms are almost entirely physical. They include:

  • Severe shortness of breath.
  • Racing heartbeat.
  • Chest pain and difficulty breathing.
  • Feeling faint, lightheaded, or dizzy.

People that have never experienced panic attacks before often describe the experience as “feeling as though they are dying.” Over-sensitivity to your own physical responses is one of the clear culprits. A little bit of anxiety or nervousness (which is common for those with panic disorders as they worry that they may get a panic attack) causes the person experiencing the panic attack to overact to the heart beat increasing, triggering another panic attack.

Panic attacks are difficult enough for those that have no other physical or mental health problems, leading to agoraphobia and the occasional hospitalization despite nothing being physically wrong. For those with COPD, panic attacks can be much worse, because when you have COPD, a panic attack – which, again, has no physical cause – can be misconstrued as a serious health complication. Worse is that, for safety, it would be dangerous for a doctor to assume that someone living with COPD is having a panic attack, so they may load those with COPD with medicines and treatments they otherwise don’t need, potentially exacerbating your health problems or, at the very least, causing considerable medical expenses.

The most important thing you can do to help with your panic attack management is to learn as much as you can about panic attacks, pay attention to your own panic attack symptoms, and make sure those around you understand that you suffer from panic disorder.

Panic attacks are difficult to cure, but they’re made worse by a complete lack of understanding both in and out of the medical field about what they are and what the experience of a panic attack is like. Many doctors still treat panic attacks like a medical disorder, when in reality they need mental health treatment. In addition, those that suffer from panic attacks often struggle to believe that something so severe could be caused by something mental, especially if you have COPD. But the more you and others understand panic disorder, the less you’ll be affected by the symptoms.

Similarly, learn to understand your own triggers and focus on the differences between your COPD and your panic attack problems. Your ability to tell the difference is an important part of limiting the panic attack symptoms and unnecessary medical visits. You should also consider all of the following:

Give yourself a task to complete when you have a panic attack. Panic attacks happen in cycles, and if you have a go-to task (like drinking water or counting to 20) that you do when you have a panic attack, you’ll be able to manage the attack better and worry less about the next one. Never reinforce it. Agoraphobia – or the fear of being outdoors – is a common side effect of panic attacks. Too many people fear leaving their home because they worry that they’ll get a panic attack if they do, and of course these panic attacks become self-fulfilling prophecies, thus reinforcing their fear. Instead, expect a panic attack. Wait for it, have a plan in place, and move on once it comes. Only by acknowledging that they’re coming can you learn to live with them.

Find a buddy/partner. Someone to call is always useful, especially if they understand both your COPD and your panic attacks. They’ll be there with you to talk you down from your anxiety/panic, and you know that if something goes seriously wrong you’ll have them on the phone with you to help. Panic attacks involve some of the most severe anxiety symptoms available, and are difficult enough for those in otherwise good health. If you have COPD, they can feel overwhelming. Learn as much as you can about panic disorders and coping strategies, because only if you learn to live with both can you enjoy the quality life that you deserve.

About the Author: Ryan Rivera used to suffer from unbearable panic attacks and agoraphobia, but learned to cope and can now live more comfortably out in the open. He writes about panic attacks and anxiety at


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  • Good advice.
  • So glad to see this post -- such great tips. Anxiety is so common with COPD and there is no shame in seeking assistance for something that impacts your life in such a significant way (just as we do for breathing difficulties or pain). Just as with medication, what works for one person may not work for another, so it helps to talk to a professional and see what is the best fit for you. Glad to see too that the author is managing his anxiety and sharing his experience with others. Thanks for this!
  • My wife has Stage IV Copd with an FEV1 of 16%. She has been having horrible numbers of full blown panic attacks. The psychiatrist has her on 2 anti depressants and increasing Ativan with very little success. An exacerbation stopped her first psychologist appointment to use cognitive behavior therapy.
    During the recovery phase after the initial day of the exacerbation, she was given a bipap overnight treatment while in the midst of a major panic attack. Within about 30 seconds the panic attack not only subsided, it ended completely.

    I have researched this phenomenon and while I find lots of evidence of increased CO2 levels causing increased acidosis of her blood and lots of studies showing increased acidosis causing panic attacks in both healthy people (add 5% CO2 to their air supply) as well in COPD patients.
    I can't find any info on using bipap as a treatment for COPD panic attacks.
    Does anyone have any info or better yet experience using a bipap machine to counter daytime panic attacks. I'm thinking a 5 or 10 minute bipap use should do the trick.
    Respiratory techs don't seem to think this is a good idea and panic attacks are not a pulmonologists concern. When you have a panic disorder its considered a mental issue for treatment by psychologists and psychiatrists. But they have little or no experience in pulmonary issues. I really need a pulmonary psychiatrist, but those don't seem to exist.
    • I completely understand your dilemma and I'm so sorry that both of you are experiencing this. I have researched the respiratory journals and it looks like antidepressants are not helpful.
      And it only makes sense since the air hunger experienced and panic or anxiety it causes has a real cause. It's a bit like giving someone medication when they are drowning, but not pulling them out of the water.
      Of course there is purse lip breathing, but I'm sure you know about that. Regarding the bipap, I have heard of people using them intermitantly, and considering how well she responded to the bipap, I have no clue why the pulmo would not give it a try. I think if something is not harmful, why not try it for a better QOL.
      I think it is just awesome that you are not ready to stand by, but are looking for answers for her. You sound armed with knowledge and information, it sounds as if you need someone on your side to help your wife.
      I have used ativan, but they now make it worse, especially at night. They obviously interfere with my breathing and allows more co2 to build up. This is my own experience.

    • Also I wanted to draw your attention to this sentence in the article :

      "Worse is that, for safety, it would be dangerous for a doctor to assume that someone living with COPD is having a panic attack, so they may load those with COPD with medicines and treatments they otherwise don’t need, potentially exacerbating your health problems or, at the very least, causing considerable medical expenses."

      I think it is important to realize that panic attacks in people without COPD can cause shortness of breath feelings, but in COPD it is the other way around. =If you take away the dyspnea, the panic stops.

    • Jim, hopefully your wife's physchiatrist and Pulmonologist can work together to help her have an action plan on how to treat her symptoms promptly so they don't escalate into a full panic attack and can be gotten under control if she DOES get panic attacks.

      So glad that the bi-pap helps her. Maybe a refresher training on pursed lip and diaphragmatic breathing would also be useful. That is something we review frequently in our support groups and the patients find it very useful.

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