Chronic obstructive pulmonary disease (COPD) is associated with high levels of anxiety that can negatively affect your quality of life. Panic attacks are sudden episodes of intense fear accompanied by several physical symptoms. While many people get panic attacks, people with COPD seem to be especially prone to them. As anxiety builds, it may contribute to severe breathlessness.

Symptoms of panic attacks include:

  • SweatingHeart palpitationsTrembling or shakingSevere shortness of breathSudden claustrophobiaChest pain or tightnessSudden chills or hot flashesDizziness and fainting

Fortunately, there are things you can do to overcome panic attacks when they occur.

Breathing Exercises

Often described as “taking your breath away,” a panic attack can make you feel like you are suffocating, hyperventilating, or choking. That’s why it is extremely important when you recognize the sensation of panic, you begin to focus on your breathing. If you can control your breathing during a panic attack, you can usually get through it in a relatively short period of time.

Start with the following technique:

  • While relaxing your shoulders, inhale slowly and deeply through your nose. When you inhale, your abdomen should expand outward and you should feel very little expansion of your chest. This is known as diaphragmatic breathing.
  • While keeping your jaw relaxed, purse your lips like you are going to blow out a candle. With pursed lips, breathe out slowly through your mouth. This is known as pursed-lip breathing.
  • Repeat this breathing exercise until you feel calmer.

To have better control over your breathing, practice breathing exercises on a regular basis.

However, it’s important to understand that if breathing exercises and other alternative therapies such as mindfulness and visualization do not help relieve your panic symptoms quickly, there may be another issue at hand such as COPD exacerbation and you should seek care from a healthcare provider immediately.

Medication Options

Medication can be extremely effective in managing panic disorders and panic attacks. With COPD, antidepressants are often preferred over anti-anxiety medications, especially in older adults. But ultimately the choice of medication will be based on your health and the types of conditions and medications you are currently managing. Always discuss any new medications or supplements with your healthcare provider first to ensure there are no unsafe drug interactions that may occur.

Although you may experience a worsening of breathlessness during a panic attack, the emergency use of bronchodilators is discouraged as they can increase heart rate and intensify anxiety. Instead, try taking slow, deep breaths.

Mindfulness Meditation

Research suggests that mindfulness meditation―a practice dedicated to focusing your mind on the present―can help treat anxiety disorders as well as relieve stress.

Relaxation is an important part of reducing anxiety levels and preventing panic attacks. In some instances, practicing relaxation techniques may help you manage a panic attack that has already begun. Chief among them is the daily practice of mindfulness meditation. It is an effective technique used in many clinical situations.

A 2013 study in the Journal of Clinical Psychiatry concluded that an eight-week course of mindfulness meditation reduced acute episodes of panic in 93 people with generalized anxiety disorder (GAD).

Visualization Techniques

Visualization is a powerful technique that allows you to use your imagination to help you unwind. Visualization prevents you from focusing on the worry and fear of having a full-blown panic attack. It guides you by focusing your mind on serene, peaceful images, instead of those that may cause you to feel panicked.

Studies have found that intrusive mental images are linked to many psychological disorders, including panic disorder, post-traumatic stress disorder (PTSD). depression, eating disorders, and psychosis. Visualization aims to expand your ability to relax by focusing your mind on more calming and serene mental images.

Cognitive Behavioral Therapy

Panic attacks occur in COPD when uncomfortable physical sensations (shortness of breath, increased heart rate) are catastrophically misinterpreted. This means that instead of recognizing that these symptoms are not life-threatening and you have the ability to overcome them, you believe you are unable to survive them.

Working with a therapist and trying cognitive behavioral therapy (CBT), a type of talk-based therapy, can help treat anxiety symptoms and panic attacks.

Thought-stopping is a specific type of CBT used in people with generalized anxiety and panic disorders. It involves the conscious replacement of negative thoughts with ones that are more realistic and positive.

Support Groups

Support groups may be a useful part of managing COPD and panic attacks because they let you know that you are not alone. They can also help you find new ways to deal with anxiety, panic, and COPD. COPD support groups can be found on Facebook or through your local chapter of the American Lung Association.

A Word From Verywell

Like anything you want to master, practice makes perfect. To get the most out of the techniques mentioned above, practice them on a regular basis―don’t wait until you are in the middle of a panic attack to try and remember how to do them. Practicing these techniques several times a day, every day, will help you easily recall them during a panic attack when you need them the most.

It’s important to recognize the differences between a panic attack and a COPD exacerbation. If you have a worsening cough or increase in phlegm along with breathlessness, you should consult your healthcare provider as soon as possible.