However, the complexity of this reality extends beyond the physical manifestations, also involving the emotional and mental state of patients and often their families and/or caregivers. Anxiety and depression are comorbidities frequently associated with respiratory diseases, acting as a cycle of reciprocal impact, intensifying suffering and complicating the management of the medical condition. The relationship between respiratory disease and mental health is multifaceted and manifests itself on various levels, such as:

Physical symptoms: Difficulty breathing, shortness of breath, persistent cough, and chest pain, common characteristics of respiratory diseases, generate fear, apprehension, and panic, fuelling anxiety. Shortness of breath, for example, can trigger panic attacks and promote the feeling of "suffocating to death."

Physical limitations: Respiratory diseases impose physical restrictions that limit daily activities, such as exercise, work, and leisure. This reduction in functional capacity impacts self-esteem, generating frustration, hopelessness, and leading to depression.

Social isolation: The need to avoid environments with allergens, pollution, or crowds—common precautions for patients with respiratory problems—can lead to social isolation. Physical restrictions can also be limiting. Loneliness, lack of social contact, and feelings of exclusion contribute to the development of depression.

Impact on sleep: Studies have shown poor sleep quality, both clinically and objectively in the laboratory. Dyspnoea, hypoxia/hypercapnia, secretion retention, coughing, and the effects of certain medications contribute to this. Consequently, sleep deprivation increases sensitivity to stress, hindering emotional control and increasing vulnerability to mental illness. Anxiety and depression can intensify the perception of respiratory symptoms. Fear and apprehension increase sensitivity to shortness of breath, leading to more panic attacks and asthma attacks. Depression can lead to neglect of treatment and a lack of motivation to perform respiratory therapy exercises, contributing to the worsening of the disease.

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On the other hand, anxiety and depression hinder treatment adherence. Lack of hope, feelings of helplessness, and lack of motivation can lead patients to discontinue medication, neglect rehabilitation, and avoid medical appointments. Anxiety and depression are also associated with an increased risk of respiratory complications. Studies show that patients with respiratory diseases and psychiatric comorbidities are more likely to develop pneumonia, asthma exacerbations, and hospitalisations.

In addition to early diagnosis and targeted treatments (multidisciplinary approach; behavioural therapies; psychotherapy; medication, etc.), a commitment to prevention is essential. A healthy lifestyle, social support, and open and honest communication with healthcare professionals about emotional symptoms are crucial to receiving appropriate treatment and preventing the disease from worsening.

In conclusion, anxiety and depression, common comorbidities of respiratory diseases, represent a significant public health challenge. The reciprocal impact between respiratory disease and mental health intensifies suffering and complicates treatment. An interdisciplinary approach, early diagnosis, appropriate treatment, and prevention are essential to improve the quality of life and promote the well-being of patients with respiratory problems.

For more information, please contact Grupo HPA Saude on (+351) 282 20 400.