This week marks the annual IPF World Week where charities and organisations all around the globe are coming together to raise awareness of a debilitating and devastating disease. Idiopathic pulmonary fibrosis (IPF) is a progressive and deadly lung disease that in the UK is as prevalent as leukaemia, yet has little awareness, treatment, or support systems in place. One of the main symptoms of IPF that can deteriorate quite dramatically is the ability to breathe and the intense feeling of breathlessness medically referred to as dyspnoea. Most previous research has looked into the impact of symptoms on those diagnosed with chronic obstructive pulmonary disease (COPD), but most of the findings can be applied to pulmonary fibrosis and other progressive illnesses that debilitate lung function.
Breathlessness can bring about physical pain similar to that of anxiety and depression such as a tightening in the chest, shallow breaths, and an increase in pulse rate. While some of us may deal with excessive breathlessness at certain periods in our life, those with underlying medical conditions can experience dyspnoea on a regular and sometimes daily basis, especially once a progressive illness deteriorates. This can impact on their quality of life more so than any other symptom of their illness because of the physical and psychological symptoms that are difficult to effectively manage and has been shown that eventually patients will become conditioned to avoid tasks that bring about breathlessness.
Dyspnoea can impact psychosocial health on the individual due to their decrease in mobility and increase in fear and anxiety, induced when doing everyday tasks. This deterioration in independence also goes on to create a ripple effect by complicating relationships with carers and loved ones. As the lung disease progresses, the dyspnoea will increase which can cause a spiral decline in mental health with those diagnosed as they come to terms with the changes in their lifestyle. It is not uncommon for those diagnosed with chronic lung disease to later be treated for depression.
Current research into the psychological underpinning of dyspnoea has been lacking, although it has been suggested that confronting this as an anxiety disorder with cognitive therapy can help the individual manage increasing symptoms. Dyspnoea has also been identified from an emotional perspective as a complex individual experience that can impact the severity of feeling breathless due to the complex psychological underpinning of its nature which varies between each individual.
It has been suggested that developing positive word cues can help the individual stay active and learn to manage their breathlessness when undertaking gentle exercise. Pulmonary rehabilitation, for example, is an effective opportunity for those with chronic lung disease to improve their mobility but has also been shown to improve emotional processing and cognitive performance to better manage dyspnoea symptoms. However, it has also been identified that treating dyspnoea with pain management can also bring about positive outcomes and teaching new methods of breathing to manage exertion.
While there are improvements taking place in providing support to those who deal with exertion and dyspnoea on a daily basis, it is clear that there is plenty more still to be done in which to help those who are diagnosed with chronic lung conditions, including IPF.
Katie Bagshawe is currently pursuing her MSc Psychology degree at Sheffield Hallam University after completing a BSc Computing degree from the University of Cumbria. After acting as her father’s carer in his final years with Idiopathic Pulmonary Fibrosis, she has become impassioned to do research on the Psychological impact of Progressive Lung Disease and hopes to continue doing a PhD in the same research area. You can connect with her on Twitter.