Being anxious can make breathlessness feel worse. Not being able to catch your breath can be very frightening. Learning to relax and slow down can help to build your confidence and make you worry less. By understanding how anxiety affects your body you will be able to deal with it more easily. 

Understanding your anxiety

The first step to beating anxiety is to understand it. Everyone feels anxious at some time or another. It is a normal reaction to feelings of fear and stress. Anxiety can affect your body in many ways. The physical sensations are not harmful, but they can be unpleasant and frightening, particularly if you do not know what is causing them. It is useful to be able to recognize these sensations so you can learn to work through them. You might want to tick on the following list the ones that you have.

Common physical sensations of anxiety 

  • Pain or tightness in your chest
  • Fast, shallow breathing
  • Fast or pounding heart beat
  • Feeling dizzy or faint
  • Tense or aching muscles
  • Headaches
  • Sweating
  • Stomach churning
  • Needing to go to the toilet
  • Trembling
  • Pins and needles or numbness

Even when these sensations are caused by medical problems, they can be made worse by anxiety.  The good news is that you can learn ways of resisting these changes.

How can anxiety make my breathlessness worse?

When you are anxious, you do not think as clearly. This makes it harder to plan things. When you do not plan, you tend not to do things at a steady rate and are more likely to get breathless. Thinking less clearly makes it harder to spot the usual triggers that cause breathlessness. It can also make you delay doing things to reduce your breathlessness.

Being anxious often makes you tense up your muscles and you may not realize you are doing this. Tension in the muscles around your chest can make breathing feel much more difficult.

The higher your levels of anxiety, the more you tend to focus on not being able to breathe. This, in turn, makes breathing seem much harder.

Anxiety makes you breathe faster and less deeply. When you are feeling anxious, you might think that it will get worse and worse. But anxiety does go away on its own, unless you keep it going by anxious thinking. 

What can I do to help myself? 

Firstly, know what makes you breathless

Sometimes it is obvious what has made you breathless, such as going up the stairs too fast. Try to work out all the solutions you can think of for a problem and decide which you would like to try. So if you get breathless when you go upstairs, see if you can find ways of doing it differently, such as walking more slowly or pausing halfway up.

If the first solution does not work, try another one. In this case, a better solution might be to build up your fitness so you find it easier to go upstairs. Sometimes, there may not seem to be any reason why you are breathless. It may be something else, such as a thought, that has made you feel anxious. Notice your thoughts – and manage them. How you think about a situation can affect how you feel and what action you take. Many people have very frightening thoughts when they are breathless, such as ‘I am going to die’ or ‘I am not getting enough oxygen’. This is an example of what we call ‘emotional reasoning’ – thinking that, if something feels very bad, it must be dangerous.If you have had thoughts like this, the fact you are alive and reading this now is evidence that they were not true. 

It is important to know what you need to do to deal with your breathlessness, but also to deal with frightening thoughts. Gently remind yourself: ‘This is frightening but I’ve got through it before.’ Some thoughts will not help you. For example, if you think: ‘I cannot cope with getting breathless’, you might not do any activity which makes you get out of breath. This will leave you less fit and less confident.It is more helpful to think: "It is not nice to be breathless, but if I keep active I will get more confident about handling it. I will also get fitter, so I will not get breathless so easily.”

Another example of an unhelpful thought is: ‘I cannot breathe. I must use my inhaler right now.’ You might then feel panicky, use your inhaler in a rush and breathe rapidly and shallowly, so you do not get the full benefit from the inhaler. A more helpful thought would be: ‘I need to use my inhaler. I am going to get it out calmly and take a nice slow, gentle breath in.’ This will help you to stay calm and confident that you can control your breathlessness. 

Distraction can help

You might be able to distract yourself by getting up and doing something else or talking to someone about a different subject. It can also help to occupy your mind. For example, try thinking of girls’ names or a country beginning with every letter of the alphabet, or make a list of your top ten films of all time. If you worry a lot, it can help to sit down with a pen and paper for about 20 minutes a day to focus on your worries. This means that, for the rest of the day,you do not need to think about them.

Balance your awareness

Being aware of your body can help you to make wise choices, but being over aware can make it hard for you to focus on other things. This can mean you miss out on fully enjoying the good things in life. Being over-aware can also cause you unnecessary worry and distress, which can make your symptoms feel worse. It can help to put your feet flat on the ground and simply notice how it feels. You can also try focusing on what you can see and hear in the world around you. 

Learn to relax

Learning how to relax your mind and body can make you less likely to have a stress response and so make it easier to breathe. You may have been shown exercises to help with your breathing. This one aims to help you relax.Breathe out first, then just let your body breathe in. Breathe as deeply down into your belly as you can, doing this as gently as possible. Breathe out first, then just let your body breathe in gently through your nose, counting’one… two… three’. Breathe as deeply down into your belly as you can, and do this as gently as possible. Pause a second, then breathe out through your mouth, counting ’one… two… three… four. The counting protects you from fast, panicky breathing. Make sure you breathe out for one beat longer than you breathe in.

Be physically active

Being physically active also helps to relax your mind and body.

Reduce your stress levels

Take time to do the things you enjoy doing and which help you to relax your mind and body. Many people find that yoga helps make them feel less anxious in the long term. Spending time with pets or people whose company you enjoy can be very soothing. Think about how you can make looking after yourself a priority. Learn not to take on too much and to say ‘no’ to the things you do not have time for. 

Build your confidence

It is important to be sensible but not too cautious. Doing the things which are most important to you will help you feel more independent and happier. If something seems impossible right now, try breaking it down into smaller steps. Think about what help you might need or how you might do it. It can help to slow down and do things at a relaxed pace, even if this is not what you are used to. 

Know how to explain your situation 

Many people feel awkward or embarrassed about getting breathless in public. But you can build your confidence with practice. The more confident you get, the less breathless you will be. You may worry about not having enough breath to explain what is happening. It can help to plan ahead what to say. For example, ‘I have a lung problem’, or even just pointing to your chest to say that is where the problem is. 

Include your family and friends

Your family and friends may feel scared when you are not able to catch your breath.They might not know what to do. It is good to plan ahead for this and to talk through what they can do to help.It is useful to be able to ask for help. It is good, too, to build your confidence and do what you can for yourself. 

Seek professional help

If there is anything you are unsure about, ask your doctor or visit to a psychiatrist . Doctors may be busy, but your appointment is your time to get the information you need. Before you take an appointment, it can help to write down any questions you would like to ask. In the appointment, it can be useful to make notes of the important things the doctor says, or to take someone with you to help you remember what was said. You might be worried that the doctor will give you bad news, but the more you know about your condition, the more you can do to deal with it.