Helpful Handouts, Uncategorized

Breathing Protocol

The vast majority of people who experience a panic attack do so, in large part, because of inefficient breathing, either by hyperventilating (80-85%) or by holding their breath. In both cases, the affected person is unaware of their breathing pattern, but acutely aware of the outcome.

Ideally, when you inhale, your stomach and shoulder muscles will be relaxed and allow your diaphragm (a dome-shaped sheath of smooth muscled beneath your lungs) to fully flatten downward. In this process, you would notice a light bulging of your stomach when you inhale. As the diaphragm relaxes and you exhale, a flattening of your stomach will be evident. This process is reversed as a person becomes increasingly anxious and begins to “chest breath”. The following procedure is recommended to anyone experiencing difficulty with panic attacks, even if a breathing dysfunction is not part of the problem.

  1. Take in a deep breath through your nose, then hold it for a count of three. With a gentle “sigh”, let your breath escape through your mouth. At the end of the exhalation, tighten your stomach slightly to squeeze out a bit more air. Then, relaxing your shoulders and stomach, close your mouth and let air flow in through your nose. With your finger tips resting lightly on your stomach, notice the slight outward movement. If you don’t get it the fist time, be patient and try again. This first step is vital is switching you from “chest” to “abdominal” breathing.
  2. Continue to breathe at your normal depth and rate. As you inhale say “one” to yourself, and as you exhale say “relax”. You are counting to match your normal breathing. Keep counting up to “ten” then count backwards to “one”. Remember to say “relax” each time that you exhale. (You may notice yourself becoming somewhat anxious or slightly short of breath as you focus your attention on your breathing. With practice, this will diminish.) Practice this skill five times each day for 5 minutes each time. Be diligent! This is a vital skill you can easily master.
  3. When you feel comfortable with 1 & 2, you are ready to slow your rate of breathing. Now, you will match your breathing to your count. Count “one” and then inhale. Say “relax” and then exhale. As you master this procedure, gradually slow your count with the goal of 10 – 14 breaths per minute. Practice this with the same frequency that you used in #2.

The regular use of the techniques will gradually lower your arousal level, making you less susceptible to panic attacks. In addition, use the technique to prevent or reduce the intensity of a panic attack.


7.12.12, Mental Health. Behavioral Health Education

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