INSTRUCTIONS

"I can't catch my breath!" It's probably the most common of all the panic symptoms. Your breathing feels labored, you strain to get air, you fear you're not going to get it - and the harder you try, the worse it feels!

In this section, with the help of a brief video clip, I'm going to show you how you can solve this problem. As is true with all the material at this site, I will assume that you have already been evaluated by a physician who ruled out any physical disorders. If you haven't had such a physical go back to "First Steps" and start there!

When you feel short of breath, it doesn't mean you're not getting enough air. In fact, people will often say "I can't catch my breath", and this shows that they're getting air, because we talk by making air vibrate. If you're talking, you're breathing! It's not a dangerous symptom.

But it does get people very scared, and it does lead to other symptoms of a panic attack (chest pain and/or heaviness; lightheadedness; rapid heartbeat; and numbness or tingling in the extremities), so it's worth your while to learn how to correct this.

You've probably already had it told to you, and you've probably also read it as well, that what you need to do is "take a deep breath". And if you're like most people, that advice hasn't helped you much. It's good advice, but it's incomplete. It doesn't tell you how to take a deep breath. I'm going to tell (and show) you how.

When you feel like you can't catch your breath, it's because you forgot to do something. Do you have any idea what you forgot to do?

Think about this for a few moments, then click on the button when you're ready to move on.

Did you figure it out? What you forgot to do is exhale. That's right. Before you can take a deep breath, you have to give one away. Why? Because, when you've been breathing in a short, shallow manner (from your chest), if you try and take a deep inhale, you just can't do it. All you can do is take a more labored, shallow breath from your chest. That will give you all the air you need, but it won't feel good.

Go ahead, try that now and see what I mean. Breathe very shallowly a few times, then try to take a deep breath. When you breathe in this shallow manner, you get all the air you need to live, but you can also get other symptoms which add to your panic attack.

You get chest pain or heaviness, because you've tightened the muscles of your chest to an uncomfortable degree. (The chest pain people feel in a panic attack isn't from the heart, it's from the muscles of the chest). You feel lightheaded or dizzy, because shallow breathing can produce the same sensations as hyperventilation. And you also get a more rapid heartbeat, and maybe numbness or tingling in the extremities as well.

All from breathing short and shallow!

One of the very first things I ask my clients with panic disorder to do is to learn and practice deep breathing (also known as diaphragmatic breathing, or belly breathing). I urge you to learn it as well. Print out and review these instructions. Then have a look at the video clip, in which I demonstrate this exercise. (Yes, that is me doing the belly breathing, but it was right after Thanksgiving!).

• Place one hand just above your belt line, and the other on your chest, right over the breastbone. You can use your hands as a simple biofeedback device. Your hands will tell you what part of your body, and what muscles, you are using to breathe.
• Open your mouth and sigh, as if someone had just told you something really annoying. As you do, let your shoulders and the muscles of your upper body relax down with the exhalation. The point of the sigh is not to completely empty your lungs - it's to relax the muscles of your upper body.
• Pause, for a few seconds.
• Close your mouth. Inhale SLOWLY through your nose by pushing your stomach out. The movement of your stomach precedes the inhalation by just the tiniest fraction of a second, because it's this motion which is pulling the air in. When you've inhaled as much air as you can comfortably (without throwing your upper body into it), just stop. You're finished with that inhale.

Let Your Hands Be Your Guide!

Your hands will tell you if you're doing this correctly or not. Where is the muscular movement of the breathing? You want it to occur at your stomach; your upper body should be relatively still. If you feel movement in your chest, or notice your head and shoulders moving upwards, start again at Step 1, and practice getting the motion down to your stomach.

• Pause. How long? You decide. I'm not going to give you a specific count, because everybody counts at a different rate, and everybody has different size lungs. Pause briefly for whatever time feels comfortable. However, be aware that when you breathe this way, you are taking larger breaths than you're used to. For this reason, it's necessary to breathe more slowly than you are used to. If you breathe at the same rate you use with your small, shallow breaths, you will probably feel a little lightheaded from overbreathing. It's not harmful. If that happens, it's a signal to slow down. Follow it!
• Open your mouth. Exhale through your mouth by pulling your stomach in.
• Pause.
• Continue with Steps 4-7. Before you try this, take a look at the video clip. Then try the exercise for a couple of minutes.

After you've tried the exercise, continue on to Troubleshooting for further discussion of this technique.

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This page was last modified on 12-9-2004.