Psychological Aspects Of Breathing Discomfort

Vijai P. Sharma, Ph.D

Breathing discomfort or "dyspnea," is a widespread problem in the U.S. and around the globe, and it is rapidly increasing!

Dyspnea is the feeling of being short of breath or experiencing discomfort in your breathing. Dyspnea affects about 25% of the U.S. population over forty. It can limit the extent to which you engage in daily activities or exercising. It can cripple a person.

Dyspnea is the major symptom of asthma, emphysema, chronic bronchitis, pulmonary hypertension, heart failure, lung cancer, and other medical conditions.

While pain is caused by a medical condition, its severity and resulting limitation or disability may in part be determined by the individual's psychological make up; the severity, suffering and limitations in dyspnea are often be a combination of medical and psychological factors.

The analogy between pain and dyspnea is not without merit. The same area of the brain involved with pain perception is also involved in the perception of dyspnea. That area of the brain in question is the "emotional brain." Realization that the emotional brain plays a part in dyspnea perception has been discovered only recently.

Note that the emotional brain is implicated in the PERCEPTION of pain and dyspnea and is not the CAUSE of them. Pain or dyspnea is "in the head" means that the intensity of perception and emotional reaction related to them is in the head.

The emotional brain, as is obvious from its name, is involved in the experience of negative emotions such as anxiety, anger and depression, and positive emotions such as joy, love and hope.

Since all emotions trigger some activity in the emotional brain, can they influence the perception of pain and dyspnea? Such a question is not without merit. For example, we all know that when we are more stressed out, upset or depressed, we tend to feel pain even more.

In the example given above, why do we feel pain even more? After all, the medical condition did not worsen in that moment. More likely than not, the reason we feel more pain might be due to the change in our emotional condition rather than in our medical condition.

Likewise, you may have a medical condition such as heart disease or chronic obstructive pulmonary disease that causes shortness of breath. As a result, you may be slightly breathless all the time. But, when you feel fearful or upset, you may experience an increase in breathlessness and discomfort. Again, your basic medical condition didn't change but your emotional condition did.

In human beings the emotional brain does not act alone. The "thinking brain" interacts with the emotional brain and exercises some influence on how intensely you experience an emotion.

Say, for example, that you suffer from chronic pain or dyspnea and you have begun to increasingly think no one really cares and no one understands your disease and how much you are suffering. Living in such an emotional state, you ask your partner to do something for you and your partner forgets or doesn't respond to your request promptly.

To continue with the example, how you think about your partner's action or lack thereof, may determine the severity of your anger and frustration in that moment. Consequently, the severity of your anger and frustration would likely influence the severity of your pain or dyspnea in that moment.

So far we have discussed the potential influence of thoughts and emotions on pain and dyspnea as they relate to our response to the external events. Let's now consider the influence of thoughts and emotions related to pain and dyspnea themselves.

Your thoughts and emotions related to your medical condition may, in part, determine how severely you suffer from symptoms such as the pain or dyspnea. Furthermore, your thoughts and emotional reaction during the episode of pain or dyspnea may, in part, determine the severity of your symptoms during that episode.

For example, every time you experience an increase in your heart rate or breathing rate and you take that to be a sign of heart attack, stroke or acute exacerbation of lung disease, you may feel terrified rather than being merely concerned. The severity of your anxiety reaction might have direct impact on your heart and lung activity.

(In other words, the severity of pain or dyspnea episodes may be greater if you tend to have catastrophic thoughts and emotionally react to them in an exaggerated manner. Try to concentrate on reassuring thoughts to moderate your emotional response to such episodes.

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Copyright 2005, Mind Publications 
Posted January 2005