Breathing Exercises for Panic Attacks and Anxiety

March 28, 2021, Publisher: Breath Hub

A panic attack is a common anxiety disorder. Recent studies show a correlation between panic attacks and breathing patterns and that relaxing breathing exercises help treat panic attacks.

What is a panic attack?

A panic attack is an anxiety disorder where you experience an intense episode of fear, thinking something terrible will happen. It usually happens suddenly, and severe physical symptoms may accompany these intense waves of worry.

How do panic attacks start?

Panic attacks are connected to the sympathetic nervous system in charge of the ‘fight or flight’ response that increases energy and prepares the body for action in dangerous situations. This response, also known as ‘acute stress reaction’, is a physiological mechanism that helps to keep the organism alive when faced with a powerful and sudden threat. But a high level of stress can also cause the sympathetic nervous system to send wrong messages and trigger the acute stress reaction.

Attacks can be triggered in worrisome situations or environments, but they can just as likely happen in a comfortable and safe environment—even during sleep.

What are the symptoms of a panic attack?

Shortness of breath is the most common symptom of an attack. One may also struggle to breathe in or out or hyperventilate. This can result in an increase in heart rate, as well as dizziness and numbness in the hands and feet.

Attacks can be quite tiring on the mind and the body depending on their frequency. They can cause discomfort and distress throughout the day, make it hard for you to fall asleep, and reduce your sleep quality.

How does breathing affect panic attacks?

Breathing exercises are an effective way of helping yourself through an attack. Techniques can help bring anxiety under control, reduce stress level, and relax the body and the mind.  

The 2011 article “Do Unexpected Panic Attacks Occur Spontaneously?” reveals remarkable findings from scientific research in which forty-three people suffering from panic attacks participated. According to the article, breathing pattern starts to change, and heart rate starts to increase sixty minutes prior to an attack and does not return to normal until ten minutes after it is over. When patients try to normalise their breathing patterns upon feeling an attack approaching, their symptoms are eased, and even the attack itself is sometimes prevented.  

Given the connection between attacks and respiration, relaxing breathing exercises offer convenient techniques that can at least help ease the symptoms. But it should be kept in mind that healing or preventing panic attacks by breathwork may not be possible for everyone.

Breathing practices help you return to your normal breathing during an attack and ease physical symptoms that have been triggered by a change in breathing patterns. It can reverse the brain’s conditioned reactions to stress. Moreover, relaxing breathing exercises during the day and before going to bed help to stay calmer and improve sleep.

Which breathing exercises are helpful against panic attacks and anxiety?

There are many effective breathing exercises for panic attacks and anxiety. The first is diaphragmatic breathing an effective practice that eases panic attack symptoms to a great extent. The 2018 article ‘Breathing Exercise - A Commanding Tool for Self-help Management During Panic Attacks’ underlines the importance of deep diaphragmatic breathing in easing the symptoms of panic attacks. According to the article, switching to diaphragmatic breathing during an attack helps relieve pressure from the lungs, balances blood pressure, increases the volume of breaths, improves the oxygen-carbon dioxide balance, and prevents dizziness.

Another effective practice for panic attacks is Sama Vritti pranayama, also known as box breathing. This technique makes use of breath holds and helps normalise the release of hormones associated with anxiety attacks, namely the cortisol, serotonin and oxytocin balance. This technique balances the energy in the body, calms and clears the mind, regulates blood pressure, and improves focus and emotional control.

How to practise Sama Vritti (equal breathing)

In Sanskrit, ‘Sama’ means equal, and ‘Vritti’ means flow or direction. The technique harmonises the four components of breathing—inhalation (puraka), exhalation (rechaka), internal retention (antara kumbhaka), and external retention (bahya kumbhaka). During the practice, these four phases are rhythmically repeated.

Each step is practised for a count of four. The most important thing is to repeat the same count on each step. As breathing patterns differ from person to person, you can experiment with a different count that suits you the best.

To begin the Sama Vritti technique, sit upright in a comfortable position, or lie down. Breathe in slowly through the nose for a count of 4, hold for 4, breathe out slowly through the nose for a count of 4 and hold for 4. Focus on breathing through your diaphragm.

Deep diaphragmatic breathing helps to stimulate the vagus nerve and triggers the parasympathetic nervous system. And so, the brain receives the message that everything is alright and takes the body out of the fight or flight state, transitioning into a sense of peace and calm.

You can use these techniques not only during an attack but also to remain calm when you feel an attack approaching. You can keep practising until you feel better.