COPD Living With Breaking the Dyspnea Cycle in COPD Anxiety leads to breathlessness and then to more anxiety By Deborah Leader, RN Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. Learn about our editorial process Updated on March 31, 2022 Medically reviewed by Susan Russell, MD Medically reviewed by Susan Russell, MD Susan Russell, MD is a board-certified pulmonologist and currently the Medical Director for Northwestern Memorial Hospital's Inpatient Pulmonary Unit. Learn about our Medical Expert Board Print Have you ever noticed that when you are having trouble breathing, you become increasingly anxious, which makes you start to panic, which in turn causes you to become even more short of breath? This sequence is known as the dyspnea cycle, which is incredibly common in COPD. Paul Bradbury / Getty Images Dyspnea, more commonly known as shortness of breath, can be described as the sensation of having the urge to breathe which results from a lack of oxygen in the bloodstream. It is one of the hallmark symptoms of COPD, and can also be the most frightening. Patients with COPD often suffer from anxiety and panic attacks due to dyspnea, and these can start to dominate your life. In fact, for some people, certain emotional situations — for example, starting an argument with a family member, or being in a crowd — may spark or contribute to a cycle of breathlessness. The breathlessness then can lead to additional anxiety ... and a vicious cycle starts. Understanding the Cycle To learn how to break the dyspnea cycle, you must first understand how it occurs. When you start to feel short of breath, you worry you are not getting enough air, which causes anxiety. Anxiety makes you breathe harder and faster, which makes the dyspnea worse. This is when panic can set in, and some people with COPD have been diagnosed with panic disorder. When people experience this sensation, it can be so distressing that they start to limit their activities in order to avoid anything that may cause them to feel shortness of breath. Not only does this eventually end up taking all the joy out of life, but being sedentary can lead to many other problems, like obesity, which makes it even tougher to breathe. How to Break the Dyspnea Cycle Follow these steps to break the dyspnea cycle: Take control -- During an episode of dyspnea, take control using diaphragmatic breathing with pursed lips. Pace yourself -- Pacing yourself helps to conserve energy which will allow you to do more before dyspnea gets out of hand. Exercise -- Daily exercise will help you handle more activity with less shortness of breath. The dyspnea cycle is not only frightening but can lead to feelings of sadness and worry. If these feelings become overwhelming, they can start to interfere with daily life. Depression is also linked to COPD exacerbation. The good news is that anxiety and depression are treatable medical conditions. Talk with your healthcare provider to see what treatment options are available to you. Once depression and anxiety are under control, your overall health will improve and you can start to enjoy life again. 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Tselebis A, Pachi A, Ilias I, et al. Strategies to improve anxiety and depression in patients with COPD: a mental health perspective. Neuropsychiatr Dis Treat. 2016;12:297-328. doi:10.2147/NDT.S79354 Burki NK, Lee LY. Mechanisms of dyspnea. Chest. 2010;138(5):1196-1201. doi:10.1378/chest.10-0534 Livermore N, Sharpe L, Mckenzie D. Panic attacks and panic disorder in chronic obstructive pulmonary disease: a cognitive behavioral perspective. Respir Med. 2010;104(9):1246-1253. doi:10.1016/j.rmed.2010.04.011 Ambrosino N, Vagheggini G. Is there any treatment other than drugs to alleviate dyspnea in COPD patients? Int J Chron Obstruct Pulmon Dis. 2006;1(4):355-361. doi:10.2147/copd.2006.1.4.355 Pumar MI, Gray CR, Walsh JR, Yang IA, Rolls TA, Ward DL. Anxiety and depression-Important psychological comorbidities of COPD. J Thorac Dis. 2014;6(11):1615-1631. doi:10.3978/j.issn.2072-1439.2014.09.28 Additional Reading Bailey PH. The dyspnea-anxiety-dyspnea cycle--COPD patients' stories of breathlessness: "It's scary /when you can't breathe". Qual Health Res. 2004;14(6):760-78. By Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit