Why is it hard to breathe when you have anxiety?

Ms. Julie A. Fast
Mental Health
I asked my coauthor Dr. John Preston for a physiological explanation of why people have a hard time breathing when they are anxious. 
I learned a lot from his answer. I hope you will too!

When there is significant anxiety, people tend to engage in one of two types of breathing:
  • rapid shallow breathing
  • sighing.
Both super saturate the blood with oxygen.
Early humans did this on purpose, and then when they started to run away or fight for their lives, there was a huge amount of oxygen available to sustain a fight or flight response.
Most people who experience intense anxiety do not have to run from something or fight physically...and yet like their fight or flight ancestors, they have high oxygen levels in their blood also accompanied by lower levels of carbon dioxide.
Under these anxiety circumstances, oxygen binds more strongly to hemoglobin and is not released as readily in the brain, this creates a situation where the brain registers, "I am not getting enough oxygen!" Despite the fact that the blood supply is super saturated with oxygen.
This excess oxygen in the blood causes the following effects: lightheadedness, dizziness, sometimes visual changes (e.g. tunnel vision) and often pronounced shortness of breath which causes the person to reflexively breathe MORE...this does not help! It simply makes matters worse and can lead to hyperventilation.
Appropriate breathing during or after an episode of intense anxiety can significantly reduce distress by directly normalizing this balance of oxygen and carbon dioxide in the blood stream. This can be accomplished by breathing back and forth into a paper bag (lunch sized bag) or by taking normal breaths (not deep and not shallow) for several minutes.
Thank you John! I remember having a panic attack when I lived in Japan. I thought I couldn’t breathe and felt like I was going to pass out. I said to my partner Ivan. “I need a paper bag!” He ran off and came back with a shopping bag!
I am taking a breath right now.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.