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Shortness of Breath

Panic Disorder and Hyperventilation

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Updated March 19, 2012

Photo Copyright Microsoft

Try a breathing exercise to help with shortness of breath.

Photo © Microsoft

Panic attacks are the most prominent symptom of panic disorder. These attacks often come on unexpectedly and are accompanied by many frightening physical sensations, such as shortness of breath or hyperventilation.

The subjective experience of shortness of breath can be a terrifying symptom. People who have panic attacks often report that shortness of breath feels as though they are unable to breathe or get enough air into their lungs. Many people describe it as a choking, smothering or suffocating sensation.

Shortness of breath can bring about fear that one may pass out or potentially die, which only heightens a person’s panic and anxiety. Others worry that they have an underlying medical condition, such as asthma or heart problems. However, shortness of breath is a common symptom of panic attacks. In this situation, it is rarely of medical significance.

What Causes Shortness of Breath

The shortness of breath that occurs during panic attacks and anxiety is often caused by a change in our normal breathing pattern. Typically, we are not conscious of our breathing. When panic and anxiety occur, our breathing may become more shallow and restricted. Instead of filling the lungs with full, complete breaths, we take in quick and short breaths.

Known as hyperventilation, this over-breathing causes carbon dioxide levels in the blood to decrease. Reduction of carbon dioxide can cause many physical symptoms, such as tingling and numbness, chest pain and dry mouth.

Hyperventilation can also develop into feelings of faintness, dizziness, lightheadedness and confusion. A person who is hyperventilating may start taking quick and loud gasps of air. However, many people will only show slight signs of hyperventilation, such as coughing and rapid breathing.

What You Can Do to Manage Shortness of Breath

One of the most valuable things you can do if you experience shortness of breath is to try not to panic even more. Shortness of breath is a very frightening feeling. However, if you become even more fearful and anxious, you are at risk of hyperventilating and significantly increasing the intensity of your panic attack. The next time you experience shortness of breath, be prepared to cope with your physical sensations and anxiety-provoking thoughts.

There are numerous strategies for getting through a panic attack. It is important that you pick a technique that feels right for you and that you practice this skill on a regular basis. For best results, practice your relaxation technique at times when you are not having a panic attack. By practicing while in a more relaxed state, you will be better prepared to use your strategy when you really need it.

A Breathing Exercise for Shortness of Breath

When experiencing shortness of breath, you are taking rapid and shallow breaths. A good way to counteract this pattern is to learn how to take deep, full and complete breaths. Deep breathing can help you return to your normal breathing pattern and may also have a relaxing effect. To get your breathing back on track, follow these basic guidelines:
  1. Notice your breath and how it has changed. Remind yourself that you are in control of your breathing.

  2. Place your hands on your rib cage. Now, inhale slowly through your nose, filling your rib cage with air. Slowly exhale through the nose, taking note of how the rib cage contracts.

  3. Repeat several breaths, counting to 10 as you inhale and 10 as you exhale. With each breath, try to relax any tension in your face, neck and shoulders.

  4. Place your hands on your belly. Stay with your deep, smooth breathing. Take a deep breath in and fill your belly with air. Notice how your belly rises into your hands as you inhale and how your navel pulls into the spine as you exhale. Repeat for several more breaths.

Set aside at least five to 10 minutes a day to practice this breathing exercise. Try practicing when you wake up to reduce morning anxiety or before bed to get a better night’s rest. By breathing with intention, you may be able to manage your next panic attack, including shortness of breath.

More on breathing exercises.

Seeking Professional Help

Aside from developing your own set of coping skills, you should always consult your doctor or other healthcare provider who treats panic disorder. He or she will be able to determine if the shortness of breath is caused by your panic disorder or a separate medical condition.

Sources:

Bourne, E. J. The Anxiety and Phobia Workbook. 5th ed. Oakland, CA: New Harbinger, 2011.

Davis, M., Eshelman, E.R., & McKay, M. “The Relaxation & Stress Reduction Workbook, 6th ed." 2008 Oakland, CA: New Harbinger Publications.

Seaward, B. L. “Managing Stress: Principles and Strategies for Health and Wellbeing, 7th Edition” 2011 Burlington, MA: Jones & Bartlett Learning.

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