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Imagine this: It is past midnight, and you are in bed gasping for air, wondering why you are having this issue. Is it because something is physically wrong with you? Is it just a bad dream? Or are you dealing with anxiety? Without apparent reason, you will only feel the issue worsening even more.

While shortness of breath can be an indicator of many physical illnesses, anxiety is also one of the potential causes. But how to tell if shortness of breath is from anxiety or something else? This article will help you understand how to connect the two problems and what to do about their management.

When an individual feels anxious, they become restless, irritable, and unable to concentrate on anything. In some cases, anxiety may mimic the symptoms of a panic attack, including sweating, chest pain, increased heart rate, and the most dreadful of all: shortness of breath.

Both anxiety and panic share strong associations with fear. They can quickly induce several physiological and behavioural changes to prepare an individual for defence against a perceived threat. The human brain is trained to react to fearful or dangerous situations by activating the fight-or-flight response. As a part of this response, the heart rate increases to pump more blood to the organs, and the lungs start working faster to provide muscles with more oxygen. Owing to the latter, the person experiencing anxiety often struggles to catch their breath.

When a person visits a doctor with this symptom, they may first rule out all physical causes, such as heart issues or asthma. If no medical reason is found, the onus is on anxiety entirely.

When an anxious person becomes short of breath, it can be hard to tell if this symptom is due to anxiety or another health issue. Finding out the cause can be particularly challenging when the symptom is severe enough to disturb their quality of life. 

Shortness of breath does hit people with anxiety, but not everyone with anxiety disorder experiences this symptom. One way to find out if anxiety is the culprit behind it is by looking at the other psychological symptoms that anxiety commonly triggers, along with shortness of breath. These symptoms include:

  • Increased heart rate
  • Sweating
  • Dizziness
  • Dry mouth
  • Nausea
  • Sweating
  • Chills
  • Increased muscle tension
  • Shakiness or tremors
  • Chest pain
  • Excessive jitteriness
  • Irritability or frustration
  • A choking sensation
  • Confusion
  • Poor concentration
  • Frightening memories, mental images, or thoughts
  • Agitation
  • Fear of losing control
  • Difficulty speaking

Most doctors establish the diagnosis of anxiety using the criteria described in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. While shortness of breath is not a part of these criteria, it can occur with anxiety. In general, if your shortness of breath is accompanied by at least some of the symptoms described above, it most likely stems from anxiety.

That said, keep in mind that you still need to get yourself checked by a doctor to establish a definitive cause and rule out other possibilities. Some potential causes of shortness of breath, apart from anxiety, like asthma, can be life-threatening. So do not wait to seek help and get in touch with a doctor. Only a doctor can help you decide whether your shortness of breath is due to anxious thoughts or another illness.

The best way to manage shortness of breath due to anxiety is by connecting with a mental health professional. A professional can help you overcome your high anxiety levels through medications, therapy, and self-care tips.

Medication

To temporarily relieve shortness of breath and other anxiety symptoms, a psychiatrist may prescribe certain medications, such as alprazolam, diazepam, lorazepam, and clonazepam. Owing to their quick mechanism o action, they may provide relief from breathing difficulties in as little as 30 minutes.

However, remember that these medications may also have certain side effects and can potentially lead to physical dependence. Moreover, combining them with alcohol or other drugs may lead to complications like an overdose. Hence, it is imperative to follow the doctor’s instructions while using them.

Alternatively, a psychiatrist may suggest using selective serotonin reuptake inhibitors (SSRIs) as a safer class of antidepressant medication to manage anxiety symptoms.

Cognitive Behavioral Therapy

Cognitive behavioural therapy or CBT can particularly benefit people with anxiety. It works by assisting people in changing the way they think about and respond to specific situations, especially those that trigger anxiety. CBT can help many realise how their anxieties are based on false alarms of fear and encourage them to cope with these triggers instead of avoiding them.

Psychodynamic Psychotherapy

As an effective treatment for anxiety symptoms, psychodynamic psychotherapy focuses on the role of relationship and personal conflicts and their association with anxiety. It harnesses the patient-therapist relationship and uses it for personal reflection, adoption of new behaviours, and acceptance of complicated feelings.

Deep Breathing

Sufficient evidence suggests the role of deep breathing in calming down anxiety and its symptoms, including shortness of breath. Deep breathing stimulates the vagus nerve, which in turn, activates the parasympathetic system. The parasympathetic system works opposite the fight-or-flight response and introduces relaxation and calmness in the body.

Follow the steps mentioned below to practice deep breathing:

  • Sit up with your back against a wall or lie on the ground
  • As you close your eyes to relax the body, loosen your jaw, soften your brow, and roll your shoulders down
  • Put your right hand on the lower part of your belly and your left hand on your heart
  • Imagine having a balloon below your right hand and pretending that you are trying to fill it up. Take a deep breath through your nose, hold it until you mentally count to four, then slowly exhale as you further count to 8
  • Repeat the steps mentioned above a couple of times

Grounding Exercises

In many people, shortness of breath occurs due to an anxious thought spiral or irrational thoughts. If this is the reason in your case, try seeking help from grounding exercises. Whenever you feel like your breath is about to stop, go outside for a walk to divert your mind. Even if you cannot manage to be outdoors whenever you are having an anxiety attack, consider following the technique indoors with the following steps: 

  • Observe five things that are in your sight
  • Name four things you can physically touch
  • Notice three things that you can hear
  • Pay attention to two things you can smell
  • Focus on one thing that you can taste

Temperature Change

If nothing else works for you, consider shocking or resetting your nervous system with a sudden temperature change. For this purpose, try hopping into a cold shower, holding an ice cube, or submerging your face in an ice-filled bowl for a few seconds.

Progressive Muscle Relaxation

Research has proven the efficacy of progressive muscle relaxation, especially when you can’t get a satisfying breath due to anxiety. The technique involves tensing certain body parts, holding that tension for up to five rounds of breath, and then releasing it.

As a tip, begin with the lower half of your body and then slowly climb up in the following order: feet, legs, butt, stomach, arms and hands, shoulder and neck, and face.

Exercise

By engaging in physical activity, you can improve oxygen and blood circulation throughout the body, which may also help with your rising anxiety levels. To gain this benefit, consider trying the following exercises:

  • Jumping jacks
  • Jumping rope
  • Yoga

If possible, try engaging in high-intensity exercises as they are generally more beneficial for anxiety and shortness of breath than low-intensity alternatives.

With so much going on in life, you can easily brush off the self-help techniques unless you are knee-deep in a crisis. But just like any disaster-preparedness plan, it becomes easier to get through tough moments when you have practised your defence mechanisms a few times.

Consider learning and practising the following tips to prevent getting short of breath due to uncontrolled anxiety:

Meditation

Meditation helps you detach from anxiety-provoking thoughts and allow you to focus on the present moment. If possible, consider spending some time every morning to observe your thoughts in a peaceful corner of your accommodation to keep your anxiety symptoms well-managed.

Journaling

In most people, anxiety is a signal that indicates that their life needs some kind of adjustment. Journaling about anxious feelings and thoughts can help them identify the problematic area and address it.

Limiting Social Media

Research suggests that watching up to 2 hours of the COVID-19 news daily can significantly contribute to anxiety, stress, and depression. Similarly, spending too much time on other social media platforms can also contribute to these issues. If you feel like excessive use of social media is contributing to high anxiety levels and the consequent shortness of breath, consider limiting it. One way to do this is by setting a 30-minute-long time every time you start scrolling. As soon as the timer rings, shut down whatever you are doing and engage in some other activity.

Lifestyle Adjustments

You can make many tiny tweaks in your daily life to increase the element of relaxation, calmness, and happiness. These include:

  • Getting 6 to 8 hours of sleep every night
  • Spending time with loved ones
  • Working out at least five times a week
  • Engaging in hobbies, you enjoy the most
  • Following a nutrient-dense diet plan

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