A COPD exacerbation can feel scary in the moment, and it’s natural to experience lingering worry about another flare-up. Having a set of go-to tips can help you mentally cope during — and recover from — a severe COPD exacerbation.
Chronic obstructive pulmonary disease (COPD) can make regular breathing difficult, and it’s possible to have times when symptoms suddenly worsen. These flare-ups, known as exacerbations, can be alarming and
Having expert-recommended rescue tips can help in the moment and the long term when a severe COPD exacerbation occurs.
COPD exacerbations can occur suddenly and may last for days. They can be mild, but it’s possible that symptoms will progressively worsen during that time or won’t go away without medical attention.
Signs you may be experiencing a severe COPD exacerbation
- severe shortness of breath even at rest
- not being able to do activities because of breathing
- not being able to sleep due to breathing
- chest pains
- hemoptysis (coughing up blood)
- fever or chills
- shaking
- confusion
- extreme drowsiness
When symptoms start to worsen, Dr. Steven Davis, a pulmonologist and Associate Professor of Internal Medicine at Burnett School of Medicine at Texas Christian University in Fort Worth, TX, said the the very first step is to recognize what’s happening.
Understanding you’re having an exacerbation directs you to the action plan you’ve established with your doctor. Your action plan will include a list of symptoms across a spectrum of severity and instructions for what to do when you experience them.
“If you have a plan established with what to do for an exacerbation, follow it,” advised Davis. “Sometimes, this means increasing inhaler use; sometimes, this involves oral steroids or antibiotics.”
No matter what, he noted, even if you have an action plan, call your doctor to check whether you need to go in for a visit.
Next, Davis said to check your oxygen levels if you use supplemental oxygen. “If they’re below 88%, you’ll need to increase your oxygen. But make sure to call your doctor — if they get too low, you will need to go to the emergency room.”
He indicated a severe COPD exacerbation warrants immediate medical care. While your action plan and speaking with your doctor can help you differentiate between life threatening symptoms and symptoms that just feel severe or scary, it’s always OK to call emergency responders when you’re unsure.
While you wait for medical treatment to bring symptoms under control during a severe exacerbation, Dr. Jessica Beachkofsky, a board certified psychiatrist in Tampa, FL, recommended the following mental tips to remain calm and keep fear at bay:
- “Count backward from 100, name objects you see in the room, or tap your fingers in a rhythm. It sounds simple, but this type of grounding can break the mental cycle of panic and fear.
- “During an acute COPD exacerbation, your brain will want to spiral into worst-case scenarios. Gently remind yourself, ‘Right now, I’m doing everything I can.’
- “Talk to your breath like it’s a friend in crisis. Tell yourself, ‘It’s OK, we’re going to get through this together.’ It shifts your perspective from being fearful and upset to feeling more compassionate and optimistic.”
In addition to specific calming strategies, practical tips to cope during a severe COPD flare-up include:
- conserving your energy to reduce physical strain and oxygen demand
- staying hydrated to help thin mucous
- using pursed-lip breathing techniques to slow your breathing (inhale through your nose and exhale gently through pursed lips)
- using diaphragmatic breathing to help improve airflow (breathing deeply into your abdomen rather than your chest)
Recovery from a severe COPD exacerbation means more than just feeling your symptoms improve. It can take time to get back to the same level of activity before the flare-up, and many people experience persistent worry and stress about having another exacerbation.
Long-term recovery strategies may include:
- avoiding COPD triggers
- keeping up with hydration and following a balanced diet
- developing breathing techniques
- learning relaxation strategies
- getting plenty of rest
- getting the right amount of exercise for living with COPD (generally 20 to 30 minutes of moderate exercise 3 to 4 days a week)
“After an exacerbation, take it easy for a few days and allow yourself to rest; it will usually take longer than normal,” said Dr. Russell Buhr, pulmonologist and assistant professor of medicine and public health at the David Geffen School of Medicine at UCLA in Los Angeles. “This is also a good time to talk [with] your doctor and make sure that your vaccines are up to date, your inhaler regimen is optimized, and that you’re using your breathing medications correctly.”
Buhr added that recovery is a prime time to consider pulmonary rehabilitation if you’re not already on a program. “Pulmonary rehabilitation is a specialized exercise program for individuals with lung issues, such as COPD, and has been shown to significantly improve quality of life and reduce the risk of recurrence exacerbations,” he explained.
Pace yourself. It’s natural to feel tired — there’s no need to force yourself back to high productivity right away.
To boost your mental health during the long-term recovery phase, Beachkosky recommended making the most of your recovery space. “If you’re stuck resting for a while, turn your space, even if it’s a comfy chair or quiet corner, into something uplifting. Add pictures, tchotchkes, or art that makes you smile. Recovering is easier when your environment feels good.”
Take time to relax and focus on self-care. You’re recovering. “Do something small that feels good today, even if it’s just sitting outside for a few minutes or watching a favorite show,” Beachkofsky said. “Little joys remind you there’s life beyond the struggle!”
If feelings of anxiety or depression aren’t improving, a mental health professional can help.
Your mind and body are connected, and taking care of your physical health after a COPD exacerbation can support your overall mental state and quality of life — and vice versa.
Being physically healthy means that processes that influence mental state, such as those related to sleep, hormones, and stress responses, are well regulated. Your body is able to physically cope more effectively with the stress of COPD.
On the flip side, positive mental well-being supports physical health by promoting stress reduction, resiliency, and a proactive mindset toward COPD management.
“It’s important to pay attention not only to how your body feels while breathing but also to your emotional well-being,” said Buhr. “Research shows that individuals with COPD who seek help for their mental health during difficult times experience better breathing and fewer exacerbations over time, as well as reduced hospital visits.”
You can’t always predict or prevent a COPD exacerbation, but you can be prepared if one occurs by
- having a copy of your COPD action plan easily accessible at all times
- keeping a travel bag of medications, medical records, emergency contacts, and rescue items
- making sure to refill all prescriptions before they run out
- regularly monitoring your symptoms to keep track of patterns or changes
- practicing your breathing and calming techniques to become comfortable using them
A severe COPD exacerbation requires medical attention and can take a toll on your physical and mental well-being. It’s natural to experience worry, fear, anxiety, and feelings of depression.
During and after an exacerbation, mental recovery involves taking care of both your physical and mental health. Resting, hydrating, and exercising go hand in hand with strategies for relaxation and stress reduction.
By improving your physical health with COPD, you can boost your mental well-being and vice versa.