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Q and A about Depression with COPD

Depression and COPD
Answered by
Dr Maria Buckley, PhD, Staff Psychologist
The Miriam Hospital Pulmonary Rehabilitation, Providence, RI

𝒬. How common is depression in COPD?

𝒜. Approximately 40% of COPD patients have depression symptoms.

𝒬. Can depression be effectively treated?

𝒜. Depression is very treatable but has to be recognized.

𝒬. How Can Depression be Defined and Identified?

𝒜. So what is depression? The signs and symptoms of depression can include depressed mood, loss of pleasure, appetite increase or decrease, sleep difficulties, a sense of worthlessness or extreme feelings of guilt, fatigue, slowing down or agitated movement, suicidal thoughts (if you are having suicidal thoughts, seek immediate attention by calling 911 or going to your local emergency room). It is also important to rule out a medical cause for your symptoms. See your doctor to evaluate for a medical issue. Sometimes a medical condition, such as hypothyroidism can be the cause of your symptoms, rather than depression.

𝒬. How is depression treated?

𝒜. There are different treatment options for depression. Psychotherapy and medications are common treatments for depression. Some people benefit from one or the other or both types of treatments. Cognitive behavioral therapy has been shown to be an effective psychotherapeutic treatment for depression. This type of therapy teaches patients how to reshape their thinking patterns. For example, when people are depressed they often have a negatively skewed view of themselves, the world and the future. For example, an individual may be overly critical of himself or herself by saying things like “I am such an idiot for not quitting smoking sooner”. Cognitive behavioral therapists can help people look at their thoughts in a more objective, positive manner. For example, most people smoke because it triggers a pleasure center in the brain. If people can look at their behavior from this perspective they may stop labeling themselves as idiots and understand the function of their actions. The therapist can help the patient to move in a more productive path in living his or her life. The patient may learn to reframe the situation and say “It was a mistake to smoke; I take responsibility for my actions. At this point I need to understand why I smoked and move on so that I can focus my energy on the priorities in my life.” Cognitive behavioral therapists also prescribe behavioral steps for patients to take to improve their moods. For example, aerobic exercise can help to reduce depression. Ask your physician if you are cleared to exercise and for an exercise prescription. Additionally, many people who are depressed do not have enough pleasure in their lives. Therefore, therapists advise patients to begin to increase pleasurable activities in their lives on a regular basis. Some examples could include going to the movies, having a manicure, reading a favorite magazine, going to lunch with friends or joining a club. Medications can be helpful as well in treating depression. Be sure to review the benefits and risks of medication with your physician. Often times, patients are prescribed antidepressants by primary care physicians or psychiatrists.

𝒬. How do I find a Cognitive Behavioral treatment provider?*

𝒜. Contact the Association for Behavioral and Cognitive Therapies website at www.findcbt.org.

Search the internet for “board of licensed professional counselors” in your state. Also search for licensed psychologists. Professionals are trained and certified in cognitive behavioral therapy, but are licensed for practice.

𝒬. Are there any books on Cognitive Behavioral Therapy?

𝒜. “Feeling Good” by David Burns, MD and “Learned Optimism” by Martin Seligman, PhD

* Cognitive Behavioral treatment provider answers updated by Nancy Behrendt, webmaster.