“I’m fighting for every breath here, doc. I can’t do anything I used to. I was a strong guy, a firefighter for goodness sake. Now I can barely carry my garden hose. I can’t sleep, I can’t concentrate, I don’t feel like doing anything anymore.” Jerry sat across from Dr. Rogers, leaned over, his elbows on his knees. He looked down and sighed. “I don’t know, doc. This COPD thing has really knocked me down.”
Jerry’s experiencing a few of the many signs of clinical depression, and he’s not alone. Depression is common in people with COPD. And why shouldn’t it be? After all, it’s like any other chronic disease, right? Well, maybe not. Experts are learning more about depression with COPD, and they’re finding that there may be a closer connection than we thought.
COPD and Your Emotional Self
To start, let’s take a quick look at COPD and how it can affect your emotional well being. Left untreated, COPD can be a wasting disease. You begin to do less and less, becoming increasingly weak until you’re unable to do much of anything at all. This can lead to diminished independence prompting feelings of anger, frustration, isolation and loss of control. Once you’re on this downward spiral, depression may not be far behind. Again, this may seem to be an obvious ‘cause and effect.’ But there appears to be more to it than this, as we learn from a study completed last year in the Netherlands.
The study found that patients with COPD appear to have a significantly higher risk of becoming clinically depressed than healthy individuals and even patients with another common chronic condition - diabetes.
"It seems that the increased risk of depression is not the result from having a chronic disease in general but is specific for COPD," said Lisette van den Bemt.
In the study, van den Bemt's team compared the risk of an initial diagnosis of depression in patients with COPD, diabetes, and control subjects without chronic health conditions. They found that the risk of a first diagnosis of depression was significantly higher in the COPD patients than in the control patients.
"Patients with COPD have a higher probability of a first episode of depression at any time...compared to patients with diabetes and the control subjects," the researchers note.
Why the Prevalence?
So, why is depression more prevalent in COPD? Could it be due, not to only behavioral issues, but to some organic or chemical-reactive component of COPD? In an interview published in Foothill Pulmonary, Dr. Rachel Norwood of the National Jewish Medical and Research Center in Denver, Colorado says that one such chemical reactive component could be the nicotine ingested through smoking. Smokers have a higher rate of depression than individuals in the general population. Norwood calls this the "double-barreled situation." Depressed people tend to smoke, and smoking can cause COPD. Impairment and dysfunction associated with COPD makes a patient even more depressed, which leads to more smoking!