Anxiety and worry in pulmonary hypertension

Dr Rawlings has worked with a range of individuals in the community and NHS who have experienced mental health difficulties. He has also published a number of studies examining the psychological impact of illness and is currently investigating how to help improve quality of life in those living with pulmonary hypertension. In collaboration with the PHA UK, University of Sheffield and Cardiff University, he has developed a self-help intervention for anxiety and worry associated with pulmonary hypertension. Find out how to access it by clicking here.

I have written this article to help debunk common misconceptions about anxiety. The term anxiety is used to describe a range of types of thinking processes, emotion, feelings and physical sensation. Anxiety is also commonly associated with particular types of coping behaviours. Challenging misunderstandings about anxiety is important as this can actually help reduce experiences associated with anxiety. Misunderstandings about common forms of distress associated with long-term conditions such as pulmonary hypertension can also cause stigma, and prevent people from talking to others and seeking help.

“I am the only one experiencing problems with my anxiety”

Many people experience anxiety to a level that significantly impacts on their quality of life. In England, 6 out of 100 people will experience anxiety to such a level that they may benefit from seeing a mental health professional, such as a psychologist or counsellor. In pulmonary hypertension however, up to 50 out of 100 people experience clinical levels of anxiety. Given the nature of pulmonary hypertension, experiencing worrying thoughts and feelings of nervousness is to some extent to be expected. So the take home message here is you’re not alone in experiencing anxiety!

“Anxiety is just worrying”

It is true that worrying thoughts are a common characteristic of anxiety; however, in anxiety that has become a problem, levels of worry can become all-consuming and typically trigger other reactions or ‘symptoms’. For example, it’s not uncommon for people to also experience palpitations, tightness in chest, fatigue, dizziness, distressing emotions, sickness and difficulty breathing. As you may have already noticed, there can be an overlap between symptoms of anxiety and symptoms of PH. For this reason and more, anxiety in pulmonary hypertension is particularly important to address. Please do seek support if you are experiencing the reactions described above and they are negatively affecting your quality of life.

“It is just my pulmonary hypertension that is the problem, not my anxiety”

Pulmonary hypertension does of course have a considerable impact on those living with the condition. As already stated, this can also increase the likelihood of experiencing difficulties with anxiety. The good news is that some relatively simple techniques can help with reducing anxiety. Find out more about this here.

“It can be embarrassing talking to people about my anxiety”

Although as a society we have come a long way in being more open to talking about distress, unfortunately, mental health difficulties can still be stigmatised. This can make people feel uncomfortable and experience distressing emotions when talking about their mental or psychological health and wellbeing. Like most things, this can become easier with practice and time, and the benefits of discussing your anxiety do outweigh the negatives.

“People who have anxiety are weak or crazy”

Holding these beliefs tend to be linked to the stigmatisation of mental health conditions, which influences how people view themselves. In fact, it takes a lot of strength and courage to acknowledge, be open to discussing and learn strategies to cope with anxiety. In addition, as already discussed, experiencing some feelings of anxiety from time to time is pretty much normal when living with a long-term condition, such as pulmonary hypertension.

“I just need to snap out of it”

Unfortunately, it is not as simple as just “snapping out of it” or “stop thinking about it”. To help illustrate this point, I want you not to think of a pink elephant… I bet you thought of a pink elephant. This shows us the more we try to not think of something (such as a thought that triggers our anxiety), the more likely we are to think of it. Instead, there are a range of more helpful strategies to cope when our anxiety is causing us problems.

“Men do not experience anxiety”

While it is true that women are more likely to seek help from their GP for anxiety, men also experience difficulties with anxiety. After all, anxiety is a natural response that we all have and need as it helps keep us safe. For example, anxiety makes us worry about our health, which is why we (try to) eat healthy and keep as active as possible. The belief that men do not have problems with anxiety can be very unhelpful, as it can prevent people from seeking help.

“Seeking support or treatment will lead to strong medications being prescribed”

The choice of treatment depends on the severity of the person’s symptoms and distress. The first line of treatment is typically ‘talking therapies’ and learning how to use techniques to manage the anxiety. Importantly these forms of treatment have been shown to be effective, and are now widely available within the NHS. So there is a lot to gain by seeking support, learning about techniques to manage anxiety, and if necessary, seeking access to NHS support via your GP.

“There is nothing I can do about it”

It can sometimes feel like there is nothing you can do to help; particularly if your anxiety is very severe and/or you have been experiencing it for a long time. However, there are a range of interventions that have been shown to help people with their anxiety. Members of your healthcare team can provide you with more information.

In collaboration with the PHA UK, University of Sheffield and Cardiff University, Gregg has developed a self-help intervention for anxiety and worry associated with pulmonary hypertension. Find out how to access it by clicking here.

Gregg is supervised by Professor Nigel Beail (University of Sheffield) and Professor Andrew Thompson (Cardiff University).