Your question: Why can’t I  breathe when I have anxiety?

My reply:

Hi, I hope this message finds you well. My name is Cesar Guedez, a psychologist trained in cognitive behavioral therapy.

Anxiety is a complex phenomenon, which in small doses does not imply a problem. Anxiety is a state of alertness that occurs when your brain detects a situation, thing or person that it considers threatening, and therefore demands a reaction from your body to protect you from danger.

The problem is when anxiety becomes recurrent and intense, causing difficulties in daily life such as work, sleep, eating and interpersonal relationships. One of the most common symptoms in anxiety is shortness of breath or labored breathing.

In general, breathing is altered by anxiety because the state of alertness your body enters when you are anxious throws all your functions out of control. You feel tachycardia, sweating, fatigue, headache, numbness and of course, trouble breathing.

This is momentary and your breathing should return to normal when the anxious episode is over, however, it can be extremely exhausting and unpleasant. Therefore, you need to learn breathing and relaxation techniques to help you regulate the shortness of breath you experience during anxiety.

Although it is a distressing problem, I guarantee there is a solution. You have the ability to deal with your anxiety problems and prevent it from taking control of your life. It is also advisable to see a health professional if you feel that your breathing problems are persistent even when you do not feel anxious.

What other symptoms occur during anxiety?

Anxiety is not only accompanied by trouble breathing or shortness of breath. There are other symptoms associated with anxiety attacks, such as:

  • Hyperventilation.
  • Muscle tension.
  • Tachycardia.
  • Sweating.
  • Fatigue, tiredness or feeling faint.
  • Feeling a lump in the throat.
  • Fear, irritability or intense and uncontrollable sadness.

Why does your breathing change when you have anxiety?

During anxiety your body goes into a state of alert. Your brain detects something or someone that may be a danger and sends a signal to your body to prepare to flee or face the threat. Anxiety is not always rational, so this threatening situation does not have to be a dangerous animal or a thief, it could be an exam, a work meeting or money worries.

Your body reacts to that perceived threat with intensity. The sensation of choking or shortness of breath occurs because your body sends more oxygen to your muscles while your heart rate speeds up. Therefore, you may feel that your breathing becomes heavy and that you are lacking oxygen.

The panicky feeling of not being able to breathe makes the situation worse. This is completely normal in anxiety episodes and you should not feel bad about experiencing it.

How to learn to control your breathing during anxiety?

Research has shown that there are extremely positive psycho-physiological changes in the mind and body of people who begin to do breathing and relaxation exercises. It is a key element in combating anxiety, since breathing in a controlled way, allows both your body and mind to stabilize and gives you more calm and serenity to deal with the problems that cause your anxiety (1).

There are several breathing and relaxation strategies that you can consider applying during your anxiety attacks.

Diaphragmatic breathing

This is done lying on your back, with a pillow under your head and another under your knees to slightly elevate your legs. Close your eyes while resting one hand on your chest and the other on your abdomen. Inhale gently through your nose and exhale through your mouth. Concentrate on your body and feel the tension in your muscles decrease. Maintain a slow breathing rhythm for 5 to 20 minutes. This technique is useful if you are at home and can lie down.

Breathing 4-4-4

This technique can be done sitting, lying down or even standing. Close your eyes and concentrate on your breathing. Inhale through your nose for 4 seconds, hold your breath for 4 seconds and exhale through your mouth for another 4 seconds. While doing this exercise repeat motivating and reassuring phrases in your mind, for example “you can do this, you have been through this before, you have the strength to face it”.

Although it sounds like something out of a movie, breathing into a paper bag is helpful. This is because it allows the person to regulate the amount of oxygen they inhale and exhale by keeping it in an enclosed space.

5, 4, 3, 2, 1

This technique consists of using your senses to dissuade emotional discomfort at a given moment. It is useful when you experience a lot of physical agitation or when you feel you have a lot of unpleasant thoughts, and you find it difficult to control your emotions. Wherever you are, you will focus on identifying 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste. This will allow you to focus your attention on specific things during the period of anxiety, and slowly, the feeling of intense worry will diminish.

In my experience…

It’s common for anxiety to throw people’s breathing out of control, either making it difficult for them to breathe or speeding up their breathing too much. It’s part of the same chaos your body goes through when you’re anxious. But this problem is solvable, and through coping strategies and professional help, you can learn to breathe properly to relieve your anxious symptoms.

I believe you have the ability to improve and heal these feelings of discomfort you are experiencing now. The fact that you are seeking professional help through this medium proves it to me, and I applaud you for making that decision and being on track to improve your mental health and overall, your physical health.

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