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Shortness of Breath: Panic Disorder and Hyperventilation

Does Panic Disorder Take Your Breath Away?

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Updated February 01, 2009

Many people with panic disorder experience shortness of breath or sensations that they are smothering. Most people describe this as a feeling that they can’t get enough air into their lungs. Since we need to breathe to sustain life, these symptoms quickly bring about a sense of panic and fear. If you feel like you can’t catch your breath or are smothering, it may seem logical to conclude that you may faint, or even die, from lack of oxygen. But, in reality, these sensations are not life threatening or dangerous.

Hyperventilation and Panic-Related Breathlessness

The majority of time, panic-related breathlessness can be linked to the way you are breathing. When experiencing anxiety or panic, your breathing may become quick, short and shallow. This is called chest (thoracic) breathing and can result in “over breathing” or “hyperventilation.” It may also be possible that poor breathing techniques are actually triggers for anxiety and panic.

When you breathe in air, blood cells receive oxygen and release carbon dioxide (CO2). CO2 is a waste product that is carried back through your body and exhaled. Hyperventilation, or over breathing, reduces the level of carbon dioxide and calcium in the blood. This causes the brain's blood vessels to constrict and leads to physical symptoms, including dizziness, numbness, headache and others. These symptoms can be frightening and tend to cause considerable psychological distress along with increased panic and anxiety.

When most people think of someone hyperventilating, they tend to visualize a traumatic scene with someone outwardly gasping for breath. While this type of hyperventilation may occur, it can also be much more subtle and not easily identified. You may not be “gasping” for air, but you may sense that your breathing is not as productive as it should be, and you feel a little short of breath. You may experience dizziness, numbness, headache and other disturbing symptoms, that you may not even associate with the way you are breathing. It is possible that subtle changes in your breathing pattern, such as breathing more from your chest rather than your stomach, are causing you to hyperventilate.

Some studies have linked panic disorder to hyperventilation syndrome. In someone with PD, improper breathing may cause enough of a change in the CO2 and calcium levels in the blood to produce many unpleasant symptoms associated with hyperventilation.

Common Symptoms Associated with Panic-Related Hyperventilation

Everyone is different, so you may experience other symptoms of hyperventilation or poor breathing techniques that are not included here. This list is not meant to self-diagnose your condition. Shortness of breath and the symptoms presented below may be associated with other, more serious, conditions. It is important to see your primary care physician to rule out other possibilities for your symptoms.

Any of the following symptoms may be related to improper breathing or hyperventilation:

  • Dizziness
  • Feeling faint
  • Sensations of smothering
  • Numbness or tingling sensations
  • Sensations of choking
  • Rapid heartbeat
  • Chest pain

These symptoms can be quite frightening and lead to troubling emotional symptoms, including increased anxiety, panic and fear.

What About Breathing Into a Paper Bag?

Many people have heard that someone who is hyperventilating should breathe into a paper bag. The theory is that by re-breathing exhaled CO2, your body can quickly regain the CO2 lost due to hyperventilation. This technique has been shown to be somewhat effective, but it is not without certain risks. For example, when you’re breathing in an out of a paper bag, you are not getting a good supply of oxygen. If it turns out you were not hyperventilating, but having an asthma attack, breathing into a paper bag could make things much worse. Another consideration is that studies have linked increased CO2, with increased panic and anxiety. If you have PD, using the paper bag method may trigger a panic attack, which won’t help you breathe easier. The bottom line is before using this technique, check with your doctor.

Things You Can Do Now to Breathe Easier

You can counteract your breathing troubles by learning to breathe properly. The technique of proper breathing may be called deep breathing, belly breathing, abdominal breathing or diaphragmatic breathing. Despite these different terms, the technique is the same. By learning to take slow, deep and even breaths, you will be able to breathe easier. This is the way newborn babies naturally breathe. You are also probably using this pattern of breathing when you are in a relaxed stage of sleep.

Source:

Carbonell, D. "Panic Attacks Workbook: A Guided Program for Beating the Panic Trick" 2004 Ulysses Press: Berkeley, CA.

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