A Breathing Technique for Panic Attacks – 4 Points

Those suffering from some anxiety disorders such as panic attack often chronically over-breathe or hyperventilate, and more so during an attack. A proper breathing technique for anxiety and panic attacks is often one of the most effective means of controlling anxiety and restoring a sense of calm.

Hyperventilation may in part be caused by some level of anxiety, but it also feeds and heightens anxiety. Hyperventilation apparently heightens anxiety in two ways: (1) by decreasing the oxygen/carbon dioxide exchange efficiency, thus raising carbon dioxide levels in the brain, and (2) by contracting blood vessels and hence blood flow to and from the brain.

Typical symptoms of hyperventilation include dizziness, a sense of unreality, numbness in extremities, sometimes nausea, and of course feeling faint. One can see how such symptoms of hyperventilation can cause greater anxiety feelings.

Slower breathing seems counter-intuitive. The panic attack sufferer feels as if s/he needs more air, not less. Thus the panic sufferer must do two things. One, try out slower breathing to see that it works to reduce panic and anxiety. Two, one must practice breathing techniques between attacks.

Certainly when at rest and calm, breathing should be slow, comfortable and effortless (barring lung problems, sickness or air pollution). Elevated breathing rates are normal under physical exercise, but not when at rest. Lung efficiency varies with age, environment, special uses (like regular singing or flute playing), and physical condition. Poor breathing habits can be developed not only from anxiety, but poor posture sitting in front of a computer or stress from smoking, asthma and allergens or learned behavior, and so on.

Getting out of a bad habit and into a good replacement takes time, discipline, and regular exercise. Panic attack and anxiety disorder sufferers should have sufficient motivation to work at slower breathing, but be aware that failure in this area may emotionally reinforce negative thinking and anxiety. Set reasonable breathing goals for yourself that you will keep and that will reinforce your feeling of progress and hope.

Some variations in technique may be effective, but here is one basic pattern.

I. Timed breathing

On average, people breath at about 12 breaths per minute. Half of that would be nearer to optimal for most.

Test your breathing pace. If it is too distracting to test yourself, have someone with access to a time piece reading in seconds measure the number of your normal, at-rest breaths per minute or the average number of seconds between complete breath cycles–from beginning of inhaling to beginning of inhaling or the like. You may need to do this a few times to get a more accurate average.

Set a reasonable goal for yourself for the first three weeks or so of practice. Perhaps inhaling for three seconds, then exhaling for three seconds, but in any case slower than your average according to the test noted above. Once you are well-practiced and comfortable with a slower rate, make it a little slower, say four seconds for inhaling and four for exhaling. If you need to adjust your initial goal after a day or two of practice, feel free to do so and proceed from there.

Use a time piece or count “one, one thousand, two, on thousand” and so on to approximate seconds. Practice twice a day, once in the morning and once in the evening… preferably more often during the day. Practice for a few weeks for five minutes each session and work your way up to ten minutes each session. Write down your schedule on a calendar at set times each day. Simplicity and consistency of schedule will help keep you on track.

The goal is to slow down your normal breathing rate. It is also to practice so as to make slower breathing almost second nature during a panic attack.

During an attack, one can focus on breathing. Count “one, one thousand” and so on or use a time piece so as to hold to the measured breathing rate according to the practice sessions with which you have become comfortable. Focus on breathing may also distract your mind away from morbid thoughts, an added help in controlling anxiety.

II. Abdominal breathing

But there is more to it. Most of us tend to practice shallow breathing in the upper rib cage area. Breathing efficiency is increased when breathing more deeply. Below the lungs lies a thin muscular sheath called the “diaphragm.” Breathing from the abdominal area will help.

One’s timed breathing practice sessions should thus not only include counting seconds for each inhalation and exhalation, but also deep, abdominal breathing from the diaphragm.

To start, lie down or recline in a comfortable chair. Rest your hands on your stomach area. This is to let you know when you are breathing from the abdomen, so anything that alerts you when you stop breathing from the abdomen will suffice, like putting a book on your stomach when lying down.

When breathing from the diaphragm, the stomach region should rise and fall gently as one breathes. The stomach or abdomen should rise on the inhalation and fall when one exhales.

Abdomnal breathing may take a little practice or if necessary a doctor’s instructions in order to get started. One will need to focus carefully on maintaining abdominal breathing, espcially at the beginning, when also timing one’s breaths.

In the short run, you may already know that deep exhalation is often relaxing. And using the whole lung will make slower breathing easier to maintain.

III. Nasal breathing

Breathing efficiency is further enhanced by breathing through the nose as opposed to the mouth. Often those suffering from anxiety disorders have developed the bad habit of mouth-only breathing. Of course your sinuses may be chronically inflamed by allergies, perhaps to pollen or household mold or dust mites in your pillow. In order to make nasal breathing viable, you may first need to install a HEPA filter or air purifier or clean the house more regularly or buy a new (hypo-allergenic, non-feather) pillow, whatever works.

Nasal breathing has various advantages over mouth breathing. One, the lungs and bronchial tubes become less dehydrated. Proper hydration is key to many cellular functions, as is certainly true here. Second, nasal breathing makes hyperventilation more difficult because the nasal passages are smaller than the mouth-to-lungs passage. Third, nasal breathing may increase blood flow and oxygen in the sinuses–which being near the brain may be helpful. And fourth of course, the sinuses are better equipped to handle dust and local air pollution than mouth breathing.

In other words, one’s timed breathing practice sessions should include abdominal breathing through the nose in inhalations and exhalations timed to be slower than has been your habit. Ideally, you will work toward constant nasal and abdominal breathing at about six breaths per minute, but to accomplish that you may need to improve other factors at the same time.

IV. Improve other factors

Nutrition, sleep habits, stress, physical exercise, exposure to environmental toxins or allergens (such as in foods as well as in the air, depending on your body), and so on can all affect breathing rates and efficiency. Improvements in these areas typically will enhance one’s ability to breathe properly and to control anxiety and panic. And there is no shame in getting professional help when you need it.

And in any event, slower, nasal, abdominal breathing is a technique that has already helped many anxiety and panic attack sufferers. It will very probably help you.