Breathing for anxiety, panic & big feelings

Those dizzy, tingly, can’t-get-enough-air feelings are scary, so you try to gulp in more air. That keeps the cycle going. Slower, softer breaths with a long, gentle out-breath help break it.

How the loop goes

1. A worry or stress sets off your body’s alarm.
2. Breathing speeds up, and you breathe out more than you take in.
3. Carbon dioxide drops, bringing dizziness, tingling and a pounding heart.
4. Those feelings seem dangerous, so fear rises and breathing speeds up more.

In overbreathing you are actually moving more air than your body needs. That is why big gulps rarely help. Breathing out slowly, as if through a straw, helps carbon dioxide build back up.

The American Lung Association says there is no evidence that anxiety damages the lungs themselves. But stress can trigger asthma symptoms or make breathlessness from COPD feel worse.

The VA notes many people don’t even realize their breath has become shallow or fast. Learning your own early signs means you can slow down before the alarm gets loud.

Common early signs

• Breathing high in the chest, with shoulders lifting
• Holding your breath while you concentrate or worry
• Lots of yawning or sighing
• Tight jaw, tight chest or tense belly

NIMH notes that many people worry about having another attack, and that fear of future attacks can lead to ongoing anxiety. Some people start avoiding places where an attack happened.

Breathing tools can help you feel less helpless. Knowing you have a plan makes the fear of “what if” a little smaller.

Cognitive behavioral therapy (CBT) is commonly used for panic. It teaches new ways to think about and respond to the body feelings of panic. NIMH says attacks can become less frequent once a person learns to react differently to these sensations.

Exposure therapy, a common part of CBT, means slowly facing avoided situations and body feelings, step by step, with support. It may be used along with relaxation exercises and breathing training.

Breathing works best as a way to stay put and let the wave pass. If you start to feel you must never feel anxious, or that breathing must stop every sensation, the fear can grow. A therapist can help you find the balance.

The NHS advice for a panic attack is to stay where you are if possible, breathe slowly and deeply, and remind yourself the attack will pass. Most panic attacks last between 5 and 20 minutes.

Try this

1. Notice and name it: “This is panic. It feels awful, but it will pass.”
2. Plant your feet on the floor or lean against a wall.
3. Breathe out first, slowly, through pursed lips, as if blowing out a candle.
4. Let the next breath come in gently through your nose. Don’t gulp.
5. Keep the out-breath longer than the in-breath. Count “in 2, out 4” if counting helps.
6. Keep going, even if it doesn’t work right away. The wave usually peaks and then fades.

Try to avoid

• Big, fast “deep breaths.” They can keep you overbreathing.
• Long breath-holds. In panic, skip the “hold” parts of box or 4-7-8 breathing.
• Trying a brand-new technique for the first time mid-panic. Use one you’ve practiced.
• Running away mid-attack if you are safe where you are. Staying teaches your body the feeling passes.
• Judging yourself. Panic is a body alarm, not a weakness.

If the breath focus itself is making it worse, switch to your senses instead: hold something cold, name 5 things you can see, or press your feet into the floor.

Fast breathing can also come from physical causes, such as asthma, lung infections, heart problems, severe pain or high altitude. Cleveland Clinic says if you are breathing fast like this for the first time, it may be a medical emergency and you should get help right away.

Get medical help if

• It is the first time this has happened
• You have chest pain, a head injury, a fever or bleeding
• Episodes are getting worse or happening more often
• You are not sure whether it is panic or something else

The NHS lists body signs of anger such as a faster heartbeat, tense muscles, clenched fists, a tight chest and feeling hot. Its advice is to give yourself time to think before reacting, for example by counting to 10 and doing calming breathing.

In a heated moment

1. Notice your first body sign (hot face, tight jaw, fast breath).
2. Breathe out first, slowly, before you say anything.
3. Count 10 slow breaths, or step away and say, “I need a minute.”
4. Only come back to the talk when your breathing has settled.

Crying is a natural release, not something you need to stop. Afterward, your breath may stay shaky and catching. A few gentle, slow out-breaths can help your body settle when you are ready.

Gentle ideas

• Put a hand on your heart or belly and feel it rise and fall
• Let out a few long sighs
• Breathe out through pursed lips, like blowing on soup
• Sip some water slowly between breaths

When we concentrate hard, feel tense or get startled, many of us hold our breath or breathe very shallowly without noticing. The VA notes many people don’t even realize their breath has become shallow or fast.

A quick check

1. Ask yourself: “Am I breathing right now?”
2. If you’re holding it, let it out with a long sigh.
3. Let the next breath drop low into your belly.
4. Pick just one thing to do next.

Try 5-4-3-2-1

1. Name 5 things you can see.
2. Name 4 things you can touch, and feel them.
3. Name 3 things you can hear.
4. Name 2 things you can smell.
5. Name 1 thing you can taste, or one kind thing to say to yourself.

More grounding ideas

• Hold something cold, like an ice cube or a cold drink
• Press your feet into the floor and notice the pressure
• Say the date, where you are and that you are safe
• Trace the edges of a nearby object with your eyes

Adjustments to try

• Breathe normally and just count the out-breaths
• Do just 2 or 3 breaths, then stop
• Focus on your hands or feet instead of your chest
• Keep your eyes open and look at something calm
• Move while you breathe, like walking or rocking gently
• Skip all breath-holds

For some survivors, closing the eyes or tuning into the body can bring up memories. A trauma-informed therapist can help you build calming tools in a way that feels safe.

The NHS says most panic attacks last between 5 and 20 minutes. They can feel terrifying, with a racing heart, breathlessness, shaking or dizziness, but they are not dangerous. Its advice is to stay put if possible, breathe slowly and deeply, and remember the attack will pass.

How you can help

1. Stay with them and speak slowly and quietly.
2. Say: “You’re safe. This will pass. I’m right here.”
3. Offer: “Want to breathe with me?” Then breathe slowly yourself, with a long out-breath.
4. Count out loud softly, or trace your hand together for five-finger breathing.
5. Give simple choices: “Would you like to sit down? Some water?”

Helpful

• “I’m here. Take your time.”
• “Let’s slow our breathing down together.”
• “Breathe out like you’re blowing on hot soup.”
• “You got through this before. You can get through it now.”

Less helpful

• “Calm down!” or “Just relax.”
• “You’re overreacting.”
• Telling them to take big, fast deep breaths, which can make dizziness worse
• Crowding them or touching them without asking

Helping someone through panic or anger can leave you shaky afterward. Take a few slow breaths for yourself, drink some water and talk to someone you trust. Supporting others is easier when your own tank isn’t empty.