You’ve heard it often—if you need to calm down, breathe deeply. It is startling to learn, then, that new research has found that breathing deeply is exactly what not to do, especially for people who suffer from anxiety and panic attacks.
Deep breathing actually makes the situation worse. To find out what to do instead, High Energy for Life turned to Alicia Meuret, PhD, assistant professor of psychology at Southern Methodist University in Dallas, who has studied breathing patterns and how they relate to anxiety.
FEEDING THE PANIC
Dr. Meuret said that the best way to calm anxiety or panic actually is to take a series of shallow breaths. The key to this finding relates to carbon dioxide—in particular, the amount of carbon dioxide that you have in your blood under normal circumstances compared with when you are very anxious or panicky. Contrary to what most people believe, she and her colleagues found that when people prone to panic attacks become anxious, they don’t breathe too fast—instead, they breathe in and out so deeply that they end up blowing off too much carbon dioxide. The resulting low levels of carbon dioxide remaining in the blood cause symptoms strikingly similar to those of a panic attack—the feeling of not having enough air, choking, chest pain or pressure, dizziness and a sense of unreality. Dr. Meuret said that it’s common for people with panic disorder to have chronically low carbon dioxide levels and an overly sensitive “suffocation alert system.” This makes them feel like they are not getting enough air when they actually are getting plenty—a situation that makes them more vulnerable to panic. She explained that it is not clear whether the low carbon dioxide levels are a cause of panic disorder or it is the other way around.
To normalize carbon dioxide levels, these people must learn to breathe shallowly, which is more difficult than it sounds. Initially, for people with low carbon dioxide, taking shallow breaths intensifies the panicky feeling because it creates a feeling of not getting enough air. To get them over this hump, researchers have adapted a machine called a capnometer—which tracks blood carbon monoxide levels and is used in many medical settings, including during surgery to monitor the effects of anesthesia or in the ICU to check patient carbon dioxide levels—to provide biofeedback.
The treatment developed by Dr. Meuret and her colleagues helps patients learn to breathe in a more helpful way. It is called capnometry-assisted respiratory training (CART). Patients in the study practiced breathing slowly and shallowly twice daily (15 minutes each session) for four weeks. But even though people in CART using the instrument saw that they were getting plenty of oxygen, Dr. Meuret said that it took about two weeks for them to relax into the new breathing pattern. After that, she said, most patients found it quite helpful, and they achieved good mastery of the technique after four weeks.
TO LEARN SHALLOW BREATHING
Unfortunately, CART is not yet available to the public. Dr. Meuret and others are hoping to devise a capnometry machine for at-home use, but it will take time. Until then, here are her suggestions on how to breathe shallowly, which will help decrease panic and anxiety…
Never breathe deeply when you start to feel anxious. Although it feels counterintuitive, concentrate on taking shallow breaths only.
Breathe only through your nose—this will make it easier to keep your breath shallow.
Breathe from the abdomen but so lightly that you experience almost no movement in your belly or anywhere else in your body.
Time yourself—try to take nine breaths per minute, which is somewhat slower than normal breathing.
Dr. Meuret had one more bit of conventional wisdom to lay to rest. If you find yourself hyperventilating, do not breathe into a paper bag—not only does it not help with panic, but the oxygen deprivation that results from it can be dangerous for people with lung or cardiac disease. Instead, try the techniques mentioned above.