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Breathing Retraining for Stress & Anxiety

Breathing Retraining

This is one of the most powerful coping skills for dealing with all forms of stress and anxiety.  It works by counteracting a major cause of anxiety symptoms: hyperventilation.

Physiology of Breathing and Hyperventilation

  • In normal breathing air goes into lungs and oxygen is transferred to the blood, which then carries oxygen to tissues. Carbon dioxide is excreted as a byproduct of this process and exhaled.
  • During an emergency, our breathing rate and pattern change. Instead of breathing slowly and gently from our lower lungs, we begin to breathe rapidly and shallowly from our upper lungs.
  • This shift not only increases the amount of oxygen into our bloodstream but it quickly “blows off” an increasing amount of carbon dioxide. In a physical emergency we are producing excess carbon dioxide, so this breathing rate is essential.
  • However, when we are not physically exerting ourselves, it produces the phenomenon called hyperventilation by discharging too much carbon dioxide.
  • This lowered level of carbon dioxide causes the pH of the blood to increase, leading to alkalosis.
  • Alkalosis interferes with the ability of oxygen to bind to blood cells (The Bohr effect).  The result can be a feeling of not getting enough oxygen.  This can make a person breath faster in order to make up for the lack of oxygen.  However, this just makes the situation worse!
  • In addition, the initial cardiovascular response to hyperventilation is a reduction in blood pressure, including a drop in cerebral blood pressure, with an increase in heart rate and cardiac output.

Here are some of the symptoms from hyperventilation.  Look familiar?  

Cardiovascular: Palpitations, tachycardia (increased heart rate), chest pain, coldness in extremities

Neurological: Dizziness, disturbance of consciousness/vision, tingly sensations, numbness

Respiratory: Shortness of breath, “asthma” chest pain

Gastrointestinal: Lump in the throat, trouble swallowing, abdominal pain, gas, belching, nausea

Musculoskeletal: Muscle pains, tremors, spasms

Psychic: Tension, anxiety, feeling of “unreality”

General: Fatigue, weakness, exhaustion, sleep disturbance, nightmares

Ways to Stop Hyperventilation

Diaphragmatic breathing:

  • Allows for full lung capacity; it slows down and evens out breathing, which re-balances oxygen and carbon dioxide levels.
  • The best way to stop hyperventilation
  • Even if you don’t hyperventilate, this is probably the best way to help your body slow down and diminish panic and anxiety because it also elicits a calming response.

Hold your breath:  

  • Holding your breath temporarily prevents the expelling of carbon dioxide.
  • Hold your breath a few times in a row for maybe 10-15 seconds.
  • Just hold your breath, then take a breath, then hold your breath again, until the hyperventilation decreases.

Breathe in and out of a paper bag:  (yes, it really works)

  • The carbon dioxide in the bag is breathed back in, thereby increasing the ratio of carbon dioxide to oxygen.

Vigorous exercise:  

  • Doing exercise increases your metabolism.
  • You will then demand higher rates of oxygen and create more carbon dioxide, thereby putting your body back in sync.

Anxious and Calm Breathing

Breath When Anxious is….                                   Breath When Calm is….

Shallow                                                                          Deep

Rapid                                                                              Slow

Through the mouth                                                  Through the nose

In the Upper Chest                                                    In the stomach

A sympathetic Nervous System Response             A Parasympathetic Response

*Eric Ryan, Ph.D. (a former supervisor of mine) is to be credited for the information above