Mood disorders are often eclipsed by the primary task of respiratory management in those with chronic respiratory diseases. This is likely for a variety of reasons, including that it is not the forte of the primary respiratory provider to identify and/or manage these symptoms, that the presenting problem is the respiratory illness itself and that resources to identify and manage quality of life issues and mood disorders are often lacking. Though pharmacological options are generally readily available, identification of the mood disturbance is, in itself, time-consuming and requires some expertise to properly identify. Additionally, resources of psychotherapists with expertise in behavioral medicine are lacking. The largest of psychosocial problems faced by those with respiratory illnesses might be the same issues as those faced by any patient facing significant medical challenges. Though there may be some common psychosocial difficulties between the patients who share specific medical disorders, to some degree, individual differences with regard to resilience, coping strategies, comorbid complications, disease manifestation, hardiness, meaning attributed to the disease, and psychosocial supports all influence the direction and toll the disease itself may take on the individual. Lazarus describes a pattern of appraisal which is critical to any stressors; this involves the person evaluating the threat of the stress as well as the resources they need to minimize, tolerate, or eradicate the stressor. This appraisal process is critical to the patient’s future steps of how to rally resources to address the needs for managing the illness. It is at this stage that the patient is in vital need of resources to facilitate decision making and that they are vulnerable to decompensation in decision processing if they cannot rally these resources.