Psychological therapies have been found to be as effective as antidepressants in patients with COPD and preferred by many patients.16 Cognitive-behavioral therapy can help “decrease the sensation of dyspnea, and can also address symptoms of anxiety and depression,” Borson said.
Collaborative care has been studied and found effective in reducing symptoms of depression and anxiety and increasing adherence to COPD therapy.13 The role of the psychiatrist in collaborative care is to provide caseload supervision, clinical advice, and decision support to mental health and allied health professionals and primary care physicians.3
Even in the absence of a formal collaborative care program, psychiatrists should still work collaboratively with the patient’s primary physician or respiratory care specialist, said Borson.
Additional effective interventions include pulmonary rehabilitation, counseling, exercise, smoking cessation, relaxation therapy, supportive psychotherapy, yoga, social support, respite care for caregivers, and telephone health mentoring.10
“COPD is a progressive condition, creating increasing major limitations in everyday life,” Borson said. “One of the important roles a psychiatrist can play is to help patients figure out how to cope with this, and develop a new type of life that is also rewarding and pleasurable. Psychiatrists should be on the lookout for patients who need this type of help.”
Batya Swift Yasgur MA, LMSW, is a psychotherapist and freelance writer who lives in Teaneck, N.J. She practices therapy in New York City.
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