Your question: Why does deep breathing make my anxiety worse?

My reply:

Hi, I hope this message finds you well.My name is Cesar Guedez, a psychologist trained in cognitive behavioural therapy. Anxiety is undoubtedly an unpleasant experience, and in your case, trying a strategy to improve and it only makes you feel worse, undoubtedly aggravates the anxiety.

Many times we hear that “deep breathing” helps us to reduce the anxiety, stress or worry we are going through. The problem is that in most cases, people do not know how to explain correctly what they mean by “deep breathing” leading to confusion and people implementing strategies on their own that are counterproductive (1).

The truth is that, as in your situation, it is common that when trying to breathe deeply the feeling of anxiety worsens, because during episodes of anxiety our body deregulates vital physical functions such as breathing, so that in the attempt to “modify” our breathing we collide with the current deregulated state of the body by the anxiety episode (2).

So, like any medicine that does not work and worsens the symptoms, the same happens with psychological strategies, you have to discard them and look for new ones. Learning to breathe correctly during an episode of anxiety or panic attack is complicated, and in most cases it is necessary to go to a professional consultation for a therapist to instruct and guide you in the process.

What can you do? 

There are strategies you can implement on your own to improve and alleviate anxiety symptoms. First it is important that you learn to understand your anxiety, identify the symptoms you experience and find a way to assess it, since everyone’s experience of anxiety is different. 

Keep a journal about your anxiety

In this diary, you will keep a record of all the episodes of anxiety you experience during the day, emphasising what was happening at the time, how you felt and what people you were surrounded by.

You can also rate on a scale of 1 to 10 how intense the anxiety episode in question was for you, as not all have the same intensity.

You know your body and emotions more than anyone else, so little by little you will be able to establish criteria to give this score to the anxiety episodes. This will help you to feel connected to your body and emotions, and then find breathing strategies that suit your specific needs.

Instead of taking deep breaths, take soft breaths

One thing I would recommend for you is that instead of “deep breathing” you use a slow, not deep breath. Inhale and exhale in short periods of time, 3 to 5 seconds (1). The key to breathing is to find a rhythm to it, and that you don’t focus on it, in other words, don’t think about the fact that you are breathing.

Although it may seem like a movie cliché, it helps a lot to breathe into a bag, as this allows us to better regulate the amount of air we take in and expel. You must be careful and apply slow breathing when using the bag so as not to break it and do not use it for very long periods of time, no more than 5 minutes.

The 5, 4, 3, 2, 1 Technique

In conjunction with breathing there are other strategies you can implement. One of them is called “5, 4, 3, 2, 1” (3). This consists of using your senses to dissuade emotional discomfort at a specific moment. It is useful when we are experiencing a lot of physical agitation or we feel that we have a lot of unpleasant thoughts, and find it difficult to control our 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.

Whether you are in your room, in a car or a public place, you can sit and practise this exercise in silence, breathing slowly as you do it as many times as you feel necessary to decrease the anxious symptoms. With time of practice this exercise will become easier, and you will realise how helpful it is to focus on our essential senses when we are overthinking things that make us feel bad.

In my experience…

Since breathing is a basic unconscious function, you don’t think rationally about how to do it “correctly”. However, through practice and in some cases the help of a therapist, you can learn to find the right slow rhythm of breathing during your anxiety episodes.

I hope that with these suggestions you can improve. I recognize and applaud you for seeking professional counselling, because it shows that you want to feel better and you are on the right path to change the things that make you feel bad. I believe that we all have the capacity to improve, although sometimes our mind makes us believe that we have no solution.

Apply the techniques at your own pace and I am confident that you will gradually improve. It was a pleasure to write to you.

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