When you have COPD (chronic obstructive pulmonary disorder), breathing can be difficult and even scary. You may worry about your next breath. But doing so can make breathing even worse: Feeling like you are suffocating can lead to anxiety and panic. This reaction triggers an alarm in your brain that causes your muscles to become tense, making it harder to for you to bring in air. A lot of times, the fear of not being able to breathe well enough is what keeps people with COPD from doing the activities they need to do or used to love. Sometimes, the breathing problems happen even at rest because you become afraid at the thought of such trouble. This type of anxiety is common among people with COPD. The good news is there are many ways to calm down and make breathing a little easier. Breathing Techniques Two breathing techniques are recommended for patients with COPD. Both help you bring oxygen into your lungs without exerting yourself too much. Pursed-lips breathing This is the first technique to try if you start to feel anxious about your breathing. Stop what you're doing. Drop your shoulders to relieve tension and to relax your breathing muscles. Now, try this: Breathe in (inhale) through your nose for 2 seconds. Pucker your lips like you're going to blow a kiss to someone (these are called "pursed lips"). Breathe out (exhale) very slowly through pursed lips for about 6 seconds. Repeat. Abdominal (diaphragmatic) breathing Your diaphragm is the big muscle under your lungs that helps you breathe. If you have COPD, this muscle does not work as well as it should. This breathing technique helps make that muscle stronger. A trained respiratory professional or physical therapist should show you how to breathe from your diaphragm—also known as belly breathing. It can be tricky to learn. You can try it with these tips: Practice diaphragmatic breathing when you are relaxed and sitting back or lying down. It’s also helpful to have loose-fitting clothing that isn’t restricting your waist. Relax your shoulders. Place one hand on your chest and the other on your stomach. Breathe in through your nose for 2 seconds. You should feel your stomach fill with air and move outward as you breathe in. It should move out more than your chest. Breathe out slowly through puckered (pursed) lips while gently pressing down on your stomach. (This helps your diaphragm push out air.) Repeat. Medications and Counseling Sometimes, COPD patients need medication to help control their anxiety symptoms. Remember that anxiety is common with this disease. Getting help doesn't mean you are weak. In fact, studies show that doing so can ease your COPD symptoms and help you live a better life. Talk with your doctor about which type of anti-anxiety medication is best for you. There are many types available. Some anti-anxiety medicines, like benzodiazepines, may not be safe for people with COPD because they reduce breathing function. Psychotherapy, or counseling, may also be helpful. With psychotherapy, you talk about your feelings and what’s bothering you. You may have counseling alone or with your family or in a group setting. Sometimes, counseling is combined with medication. Other Methods to Try These techniques that may help you relieve breathing-related anxiety: Know the tripod pose: Sit or stand leaning forward with your arms supported. This pushes your diaphragm down and raises your chest, helping air get in and out more easily. Identify your best breathing time: Save intense activities for the time of day when you feel you are best able to breathe. Stay away from shortness-of-breath triggers (like air pollution, pollen, etc.). Try a relaxation program: Soothing music, meditation, yoga, and classes that help you visualize relaxing places may help soothe you. Practice these strategies daily. This way, you’ll know exactly what to do when breathing becomes difficult or when you become restless.