This ‘frequently asked questions’ section explains the link between dysfunctional breathing and anxiety and panic disorders and how it may cause discomfort in yoga, Pilates etc. It is adapted from ‘Frequently asked questions” – p 183 of Relief from Anxiety and Panic.
Q: I have been told I have a brain chemistry imbalance. How could breathing exercises help?
A: Your brain chemistry does not go haywire for no reason. It is directly affected by the way you breathe. The carbon dioxide level in your blood is the primary determinant of your body’s chemical balance (pH). The bottom line is you are going to have much more normal and more stable brain chemistry if you gain control of your breathing.
Q: What is the connection between breathing and anxiety and panic attacks?
Acute hyperventilation or ‘over-breathing’ is an obvious feature during a panic attack. You dump out lots of carbon dioxide. While less noticeable, the chronic form of over-breathing is very common in people with anxiety and panic disorders. Research has found people with panic disorders breathe 12 L a minute at rest when it should be 5 L. Chronic over-breathing alters carbon dioxide levels and blood chemistry and contributes to hyper-arousal of your nervous system (fight-or-flight), with too much of the stress hormones adrenaline and cortisol being produced. Chronic over-breathing is like having your foot on the accelerator all the time. You are ‘primed’ and trigger-happy.
Q: How does breathing retraining help people with anxiety and panic attacks?
A: Breathing retraining aims to correct your baseline breathing pattern – bring your breathing and blood gas chemistry back to normal to prevent symptoms and attacks. It shows you how to breathe correctly all the time, to access the ‘parasympathetic’ or relaxation branch of your autonomic nervous system. Normal breathing and controlled breathing is very calming. It’s a natural sedative. Breathing retraining also shows you how to keep control of your breathing when you are under stress. It’s a wonderful tool to have to stay calm, relaxed and in control in stressful situations and to get off to sleep.
Q: Is breathing retraining any use when my nose is nearly always blocked?
A: Yes. Noses are often blocked because of irritation, dehydration and inflammation – all side-effects of chronic over-breathing, the faulty breathing habit most often seen in people with anxiety. When you learn to breathe correctly, airway irritation reduces. In over 20 years of breathing retraining, I have rarely seen a nose that won’t at least partially clear within the first five minutes of beginning to change a poor breathing pattern.
Q: I get panicky when I shut my mouth – is breathing retraining even possible for me?
A: Many people cannot tolerate ‘forcing’ nose breathing by trying to keep their mouth closed. They become claustrophobic or feel uncomfortable, as though they are suffocating. The BreatheAbility style of breathing retraining taught here gradually ‘reconditions’ you, so you can achieve comfortable nose breathing at your own pace. The initial step may be to breathe more gently through your mouth or to adjust your posture. (See Chapters 5, 13, and 14.)
Q: If breathing retraining is so good, why did my doctor only recommend medication/psychotherapy/counselling to me?
A: There is a general lack of knowledge about breathing pattern dysfunction. Most doctors are not well informed about the principles of breathing retraining, and observation and assessment of a patient’s habitual breathing pattern is not part of standard medical diagnosis. Most doctors have simply not considered breathing retraining as an option for their patients. Has your doctor ever assessed your baseline breathing pattern? Breathing retraining is a logical, scientific and conservative approach to the management of breathing-related disorders. Your doctor should be no more reluctant to suggest you improve your breathing habits than to recommend other self-help approaches such as meditation, yoga, avoiding alcohol, losing weight, and getting regular exercise.
Q: How long does it take to feel a difference with breathing retraining?
A: People usually notice benefits such as being more relaxed, having a lower heart rate, less nasal congestion, and quieter and easier breathing within hours (or even just minutes). Better sleep is often reported right from the first night. ‘The best sleep in decades’ is a frequent comment.
Q: I learnt breathing exercises (e.g. in yoga, Pilates, counselling) and felt dizzy/breathless/tired/anxious afterwards. Why would breathing retraining exercises be any different?
A: If the breathing exercises you learnt involved big, deep in-breaths with full exhales, particularly if by mouth, then likely you caused a shortfall in carbon dioxide in your blood. This can result in blood vessels narrowing and reducing the amount of oxygen that gets through to your brain and muscle cells. Thus dizziness, anxiety, panic, breathlessness, and fatigue may occur. The difference with a breathing retraining program as described in this book is that you are taught to breathe normally – at the correct rate and volume – so that you keep your blood chemistry in balance. This is essential in allowing the oxygen in your blood to actually get to the cells where it is needed. This is vastly different from a focus on getting as much oxygen into your lungs as possible.
Q: Does it take a lot of time? I don’t have time to do breathing exercises.
A: Why not? You are breathing all the time, aren’t you? You can make changes in your breathing any time in the day – while you watch television, walk to the car, stand in a queue, sit on a plane or a train. This is one of the advantages for busy people of breathing retraining over other exercise programs. Breath awareness and breath management can be applied during any activity. If you can do this for just a few days, you will be a changed person. You have around 16,000 opportunities a day to make a difference.
Q: Do I have to stop other treatments?
A: No, you can practise breathing correctly while you continue to use medications and appliances, attend counselling sessions and so on. In fact, improving your breathing can help you get more from other therapies. Ultimately though, if you return your breathing to normal, your requirement for other treatments may change and then you can discuss your situation with your doctor.