Why Panic Attacks Cause Shortness of Breath

During a panic attack or sudden anxiety episode, the fight-or-flight response is activated, which can lead to an intense cascade of uncomfortable symptoms, including shortness of breath and hyperventilating. Whether you have had a single panic attack or have been diagnosed with panic disorder, experiencing shortness of breath can feel incredibly unsettling and frightening.

Better understanding shortness of breath and its link to panic attacks and anxiety may help you or a loved one find appropriate resources, support, and strategies that aim to reduce and/or eliminate symptoms.

Characteristics

When experiencing a change in your breathing pattern during a panic attack, you may feel as if:

• You are gasping for air
• Your breathing feels shallow and restricted
• Your breathing pace is quicker than usual
• You can’t slow your rapid breathing down
• You feel as if you are choking or being suffocated

In addition to experiencing shortness of breath and/or hyperventilation, you may feel faint, dizzy, and lightheaded. You may also experience other symptoms of a panic attack or panic disorder during this time.

Shortness of Breath vs. Hyperventilating

Shortness of breath, also referred to as dyspnea, and hyperventilation, also known as overbreathing, are intimately connected to each other. When you feel shortness of breath, you may breathe faster, which can lead to hyperventilation—and, in turn, hyperventilation can trigger or worsen shortness of breath. Hyperventilation:

• Can intensify feelings of panic, stress, and anxiety
• Can decrease the carbon dioxide in your blood
• Can lead to faintness, nausea, numbness or tingling, and dry mouth
• Can lead to feeling restricted and tight in your chest
• Can lead to feeling confused and out of it
• Can disrupt your sleep

What Causes Shortness of Breath

Breathing can be a good marker for an individual’s internal state, so it makes sense that if an individual is experiencing panic, anxiety, and/or high levels of stress, their breathing will reflect that. According to research,1 changes in breathing can trigger a panic attack, increase levels of anxiety, and intensify a panic attack that has already begun. Studies indicate that:2

• Shortness of breath is linked to the body’s fight or flight response as the body attempts to take in more oxygen and prepares to defend itself.
• Shortness of breath in the context of panic attacks and panic disorder have a genetic and/or hormonal component.

Can Anxiety Cause Shortness of Breath?

Anxiety can both cause and exacerbate shortness of breath. Symptoms of anxiety can include feeling short of breath, air hungry, and a smothering feeling. In turn, feeling short of breath can also increase your anxiety. In terms of panic attacks, shortness of breath may take place prior to the onset of a panic attack, or increase during one.

Treatment

If you or a loved one are experiencing panic attacks, know that there are many treatment options available. Because the root cause of panic attacks and panic disorder will vary from individual to individual, it’s best to try multiple treatment options or combinations to figure out which one is the best fit.

Medication

Medication may be effective for some individuals in treating panic attacks and panic disorder. Medication may help reduce overall anxiety, decrease the frequency and intensity of panic attacks, and reduce the anxiety associated with panic attacks. Medication options3 that have proven efficacy in treating panic attacks and panic disorder in some individuals include:

• Tranylcypromine
• Paroxetine
• Clonazepam
• Alprazolam
• Escitalopram

Psychotherapy

Psychotherapy may be used in conjunction with medication, or on its own. Which route someone opts to try in terms of treatment may depend on the intensity and frequency of their symptoms as well as their personal preferences. Psychotherapy may address individual, couples, and family issues that have been impacted by panic attacks and panic disorder. Therapeutic techniques used to treat panic attacks and panic disorder include:

• Cognitive behavioral therapy
• Cognitive behavior modification
• Rational emotive behavior therapy
• Practicing mindfulness
• Transcranial magnetic stimulation4

Coping

Experiencing shortness of breath during a panic attack can feel stressful, isolating, and scary. Because panic attacks can begin without a known trigger, it’s important to have a tool kit of techniques to stop or manage a panic attack. If you are having difficulty with daily activities and/or are having thoughts of harming yourself or others, it’s important to connect with a professional immediately.

• During the start of a panic attack, recite a mantra to yourself that you can repeat (for example: “This will pass” or “I’m going to be okay”).
• Practice a relaxation technique when you are not having a panic attack. Practicing in a more relaxed state may help you feel better prepared to use your strategy when you feel a panic attack beginning.
• Begin practicing mindfulness meditation to help you gain better insight into your thoughts in a non-judgmental way.
• Track your symptoms with a panic attack diary to better understand your unique panic attack experience.
• During a panic attack, try to reconnect to your body and surroundings by doing an exercise of threes. Count three things you see around you, three things you feel, three things you can hear, and three things you can smell.
• After a panic attack, call a supportive friend or loved one to talk through your experience.
• Consider calling your therapist or doctor if this particular panic attack was especially intense or if the frequency of your panic attacks is increasing.