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Anxiety, panic attacks and bad breathing, a modern day syndrome

My first taste of anxiety came when I was 15 years old and I was getting ready to compete in a local horse show. I'd woken up on the morning of the show and felt like I wanted to throw up. My Dad took one look at me and said "you're not sick, you've got anxiety". Dad was a seasoned anxiety sufferer so had seen my symptoms and spotted it a mile off. I couldn't understand it, having competed in a number of horse shows before this one, it didn't make sense in my head that I would suddenly suffer from an anxiety attack when it had never happened previously. 


After that morning, the anxiety kept a very quiet front until I reached the age of 23 where it blew it's lid like a volcano. I suffered a full blown panic attack and I actually thought I was dying. I was on holiday in Hawaii visiting my aunty at the time and I was rushed to the doctor because all of a sudden I just couldn't breathe. I thought I was having an asthma attack but the doctor assured me I wasn't and that it was a panic attack. She gave me some ventolin to placate my fears (warning me that this would probably exacerbate the problem) along with a paper bag and sent me back to my aunty's house. I spent the next 24 hours breathing into a paper bag, my symptoms getting worse by the hour and pacing up and down the small cottage that my aunty inhabited. Over the next 48 hours I ended up in the Honolulu hospital twice with two different diagnoses (first one a lung infection, second one anxiety and panic attack) and came out feeling like I was never going to make it back home. Luckily thanks to some pretty heavy sedatives, an awesome Air New Zealand crew and my Mum, I made it back to NZ.



When I Got Home...


Once I got home I thought I would feel better, however I still couldn't breathe properly, my heart was constantly racing and I was suffering severe panic attacks several times a day that saw me having to take a huge amount of time off work. At one point I couldn't leave the house and had become severely agoraphobic. Over the course of the next eight months my breathing went from bad to worse. I underwent every heart and lung test you could imagine, had numerous blood tests, and got a new diagnosis every week. Finally, as a last resort, my doctor diagnosed anxiety and depression. She referred me to a breathing physiotherapist who told me I had hyperventilation syndrome (HVS) or what's known as a breathing pattern disorder. That physio, Rosemary was her name, changed my life.


At my first appointment, Rosemary explained what HVS was, why it was happening and what I could do to make myself better. I had been breathing badly for years it turned out (probably from when I was in my teenage years) and the combination of working a stressful job with no time off for two years, paying two mortgages, trying to run a property development business and living in a city I disliked, had taken its toll. My poor body didn't know what to do when I went on holiday and when I asked it to relax it totally freaked out. I had become a severe upper chest breather over the years and by the time I went to Rosemary my diaphragm muscles were so weak I couldn't even take a deep belly breath. I was constantly living in fight or flight mode. After months of hard work I finally got my diaphragm working again and learnt to manage my panic attacks. Although I haven't had a full-blown panic attack for a long time, I'm still a habitual bad breather and I still suffer with anxiety. I have to work on my mental wellbeing every single day.


It is estimated that HVS affects between 6% and 10% of the general population (1)



The Power of Breathing


Breathing really is the key to life. You cannot last more than a few minutes without needing oxygen, inhaled into our lungs providing all of the trillions of cells in our body with the fuel they need to do their job of keeping us alive. Breathing, specifically diaphragmatic breathing is one of the easiest and cheapest things you can do to reduce the effect of stress on your life. By using our diaphragm and focusing on low, slow deep breathing for just 5 or 10 minutes at a time, you can switch the body from the stressed, fight or flight mode of the sympathetic nervous system to the relaxed, rest and digest mode of the parasympathetic system.


Whenever you feel yourself getting overwhelmed, anxious or stressed, stop what you are doing and put your hands on your belly. Take a deep breath in through your nose and fill your lungs from the bottom - your hands should rise as you do this. Don't overdo the breath, allow yourself to hold it at slightly at the top and then exhale through your nose again, pushing the air all the way out, letting your shoulders drop and your hands go down as your belly falls. Make sure your shoulders aren't hunched up - you can use your exhale to help drop your shoulders at the same time. Inhaling and exhaling through your nose creates a bit of resistance and slows the breath down which is good for over-breathers and hyperventilators who tend to breathe at a faster rate. The more you can do this exercise throughout the day, the more you will switch your body back into parasympathetic mode and train your body to breathe using your diaphragm and not your upper chest.


There are so many benefits to diaphragmatic breathing. Multiple studies have shown that it is beneficial regardless of whether you are healthy or have an illness. In healthy people benefits include reduced cortisol levels (cortisol is a hormone that is produced in response to stress), increased attention spans, increased heart rate variability, increased relaxation and being better able to manage stress (2,3). Diaphragmatic breathing is also beneficial for managing symptoms in chronic disease with recent studies showing benefits for people who suffer from gastroesophageal reflux disease (GERD) and reflux symptoms, respiratory diseases such as COPD and even patients with heart failure (4,5,6).


So, the next time you are feeling overwhelmed, stressed, anxious or have brain fog, do some diaphragmatic breathing for 5 minutes and see how you feel. I assure you, your body and your mind will appreciate it!



References:


1. Chaitow, L., Gilbert, C., & Morrison, D. (2014). Recognizing and treating breathing disorders: a multidisciplinary approach. Elsevier Health Sciences.


2. Ma X, Yue Z-Q, Gong Z-Q, Zhang H, Duan N-Y, Shi Y-T, Wei G-X, Li Y-F. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Frontiers in Psychology 2017;8. doi: 10.3389/fpsyg.2017.00874.


3. Hunt M, Rushton J, Shenberger E, Murayama S. Positive Effects of Diaphragmatic Breathing on Physiological Stress Reactivity in Varsity Athletes. Journal of Clinical Sport Psychology 2018;12(1):27-38. doi: 10.1123/jcsp.2016-0041.


4. Ong AM-L, Chua LT-T, Khor CJ-L, Asokkumar R, S/O Namasivayam V, Wang Y-T. Diaphragmatic Breathing Reduces Belching and Proton Pump Inhibitor Refractory Gastroesophageal Reflux Symptoms. Clinical Gastroenterology and Hepatology 2018;16(3):407-16.e2. doi: 10.1016/j.cgh.2017.10.038.


5. Mendes LPS, Moraes KS, Hoffman M, Vieira DSR, Ribeiro-Samora GA, Lage SM, Britto RR, Parreira VF. Effects of Diaphragmatic Breathing With and Without Pursed-Lips Breathing in Subjects With COPD.(Report). Respiratory Care 2019;64(2):136. doi: 10.4187/respcare.06319.


6. Lage SM, Britto RR, Brandão DC, Pereira DAG, Andrade ADd, Parreira VF. Can diaphragmatic breathing modify chest wall volumes during inspiratory loaded breathing in patients with heart failure? Brazilian journal of physical therapy 2018;22(6):452-8. doi: 10.1016/j.bjpt.2018.04.005.

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Well explained and written self revelation. I’m proud of you.

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