Anxiety Can Be Caused by Breathing Discomfort

Vijai P. Sharma, Ph.D

Recently, I received an e-mail from a teenager that one day during summer vacation, all of a sudden he felt his chest severely tightening but it went away after a few minutes. He went on to say, "But then it came back for longer and by the second day I was having a tight chest constantly for a week, every second of everyday my chest felt heavy. I felt like I could stop breathing at any second. I was really scared I thought I was dying. My asthma inhalers didn't help so my mother said it was probably anxiety, but I wasn't anxious about anything!!"

Here is this young man who is on summer vacation, not taking a school test, perhaps enjoying his time, not consciously worrying about any problem but still felt very anxious solely because of the breathing discomfort. The fear that one might not be able to draw the next breath would scare any sane person. It was perfectly a normal feeling that he felt. In his words, "I was really scared I thought I was dying." When you can't breathe, nothing else matters!"

People with asthma, Chronic obstructive Pulmonary Disease (COPD), Pulmonary Fibrosis (PF), Pulmonary Arterial Hypertension (PAH), lung cancer and many other lung disorders can tell you about the moments when they gasped and struggled for breath and how they panicked despite knowing they had experienced a similar event before and they had survived. When you feel you are going to suffocate, choke, or not be able to catch the next breath, it's sometimes hard to believe you can survive THIS one! Our brains know that not being able to breathe could be a matter of life and death.

Don't be embarrassed or hesitant to seek help if anxiety is hard to bear because feeling anxious or having a panic attack on such occasion is not a sign of personal weakness or mental illness; it is actually very normal. It just shows you are a normal human being with normal reaction to a threatening event. The distress of uncomfortable symptoms and the challenges of living produce an enormous amount of stress and chronic severe stress can cause anxiety and depression.

There is a Tibetan saying, "breath is the horse and mind is the rider." The horse at times can go wild and take the mind on a ride for a while but given time and patience and support of medicine, mind can ride the breath. there is a lot we can do in addition to seeking help for natural emotional consequences of our medical condition. We can use the power of our mind to shield ourselves from the tyranny of our symptoms.

Keep telling yourself "I will come out of it. It will eventually blow over." Keep trying to slow your breathing. Keep doing Pursed-Lip Breathing (PLB). Keep lengthening your exhale. Keep reducing the upper chest breathing and restoring the abdominal breathing. Your mind will eventually tame the "wild horse!"

Pursed-Lip Breathing (PLB)

• "Imagine smelling a rose (Inhaling slowly) blowing at the candle like you are bending or flickering the flame but not so forcefully as to put out the candle. Imagine blowing softly, gently and slowly." If possible, exhale while gently contracting your belly towards the back
• "Relax your shoulders and neck."
• "Pucker your lips as if you were going to whistle or kiss a baby."
• "Softly, VERY GENTLY, and s-l-o-o-w-w-ly breathe out through the pursed lips. If possible, breathe out through both sides of the lips."
• "Breathe in slowly through your nose."
• Do not force air out of your lungs.
• Blow out the breath softly." "Make your exhalation longer than inhalation. However, increase the length of exhalation gradually. Exhaling longer than your capacity could make the next breath jerky. If your breathing gets agitated, take a break.

PLB with Abdominal Breathing

Now you know how to do PLB and you also know how to do abdominal breathing. PLB combined with very gentle contraction of abdominal muscles can be even more effective. Follow these instructions:

"Slightly, very gently, pull in the navel towards the back, purse your lips and start exhaling slowly with a gentle and consistent pressure. Do not exert or forcibly contract the abdominal muscles as that can tire you out quickly. Just a mild "suggestion" to the abdominal muscles for gently pulling in the navel towards the back is good.

PLB with inhalation-exhalation ratio (desirable for some people)

Count in your head as you inhale and exhale so you can keep track of the length of breath. Always breathe slowly and softly.

When possible, breathe in through the nose and breathe out through the pursed lips.

The ratio of inhaling to a count of 4 and exhaling to a count of 6 is good for most of the time. However, if lungs are hyper inflated, you may gradually make your exhalation twice longer than inhalation. For example, if possible, inhale to a count of 5 and exhale to a count of 10.

Don't try to inhale longer than exhale!

Copyright 2010, Mind Publications 
Posted November 2010