Overcoming Depression In COPD Part II

Vijai P. Sharma, Ph.D

In a previous article, I discussed several explanations for high prevalence of depression in "Chronic Obstructive Pulmonary Disease (COPD)." One such explanation referred to "depression-breathing connection."

Depression is associated with depressed breathing while open, full and vigorous breathing with amelioration in depression. Some breathing techniques are specially suited for treatment of depression. This article examines the validity of such claims.

Six breathing studies conducted by the faculty of the National Institute of Mental Health and Neurosciences (NIMHANS) in India and three studies by the All India Institute of Medical Sciences (A.I.I.M.S) suggest that some breathing techniques can provide effective treatment for mood disorders and related problems. These studies employed acceptable scientific standards of controlled and randomized samples.

Studies specifically examined a set of three breathing techniques, collectively referred to as "Sudarshan Kriya and (related) Practices (SK&P;)." SK&P; basically consists of a sequence of breathing exercises involving slow, medium and fast rate of breathing, and gentle and vigorous breathing in a rhythmical fashion. The set of breathing exercises take anywhere between 30 to 45 minutes for completion.

To provide an overview of the six studies conducted by the NIMHANS researchers is that SK&P; demonstrates 68 to 73% success rate in treatment of depression regardless of the severity of depression, though the bulk of the studies investigated low to moderate level of chronically depressed patients, clinically referred to as "dysthymic" patients.

Furthermore, substantial relief was experienced in 3 weeks. By the end of the month patients were considered in remission. Follow up at the end of three months showed that patients remained asymptomatic and stable.

Improvement in depressive symptoms was not entirely based on subjective reports, but changes were observed at the biological and chemical level. In one study, researchers compared the brain wave activity during and after a depressive episode because abnormal brain activity is sometimes observed during depression. For patients whose brain electrical activity was found abnormal at the beginning of the study returned to normal when tested three months later.

Improvement at the physical-chemical level was sometimes observed relatively quickly. For instance, increase in plasma Prolactin level associated with amelioration of depression increased after the very first SK&P; practice. Significant decrease was observed as early as three weeks in the plasma Cortisol, which is a stress hormone.

Studies conducted by various departments of the All India Institute of Medical Sciences (AIIMS) also identify such physical-chemical benefits of SK&P; as reduction in blood lactate level, cortisol and cholesterol levels.

The Endocrinology Department of AIIMS found that people who regularly practice SK&P; have lower levels of cortisol and higher levels of natural killer cells.

Symptomatic relief was noted by various medical departments of AIIMS in the areas of tension headaches, insomnia, alcoholism eating disorder and obesity.

However, various researchers point out that patient commitment is a very important factor because such breathing treatment typically requires 45 minutes of practice every morning, day after day, for months on end. I don't know what their drop-out rate was.

In summation, specialized breathing techniques are found to be effective not only for treatment of depression but also for stress reduction and physical health. Physical benefits of SK&P; are observed in the brain's electrical and chemical activity.

Benefits of SK& P were comparable to psychotherapy or antidepressants for chronic depression.

Some of the breathing techniques included in these studies require initial training and supervision and were not specifically designed for people with COPD. Adaptations need to be devised and scientifically investigated specifically for people with COPD.

If you can't access some sort of breathing training through your pulmonary rehab, make sure you exercise on a daily basis. Regular exercise such as walking, using various kinds of treadmill or cross country machines and light to moderate weight lifting also invigorate breathing, strengthen muscles, alleviate depression and increase the sense of personal well being. Connect with a support group that encourages members to join similar programs.

You may do these exercises with mindfulness. For example, be mindful of your breath as you walk and breathe slowly and deeply. Walk and exercise mindfully.

Both aerobic and non-aerobic exercises are likely to improve physical conditioning, help to calm and clear the mind and reduce toxic effects of chronic stress.

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Copyright 2005, Mind Publications 
Posted September 2005