Panic disorder can be a debilitating condition. It can be made worse by the fact that many people think it is all in the sufferer’s head. They can come on suddenly and be hard to resolve. However, there is a real physiological basis for panic attack, and understanding this can help turn it around.

Panic attacks can come with a range of symptoms:

  • Feelings of fear and panic
  • Sweating
  • Chest pain or discomfort
  • Having a tight chest or the sensation of choking
  • Nausea
  • Numb or tingling fingers
  • Trembling or shaking
  • Pounding heart
  • Feeling dizzy, lightheaded or faint
  • Feeling short of breath

Most of the symptoms of panic attack are real, physical symptoms – the sufferer really is nauseous, really is light-headed, and really does have numb and/or tingling fingers. They haven’t dreamed these things up and there is a real physiological cause for these symptoms. That cause is related to the levels of certain substances in the body – oxygen and carbon dioxide, and changes to the levels of these substances happen because of changes to breathing. Some doctors call panic attack acute hyperventilation syndrome, and the symptoms are identical.

So what happens in a panic attack or during acute hyperventilation? To understand that we need to understand something about the air we breathe. About 21% of the air we breathe is oxygen, and approximately 0.03% of it is carbon dioxide. However, in normal breathing the amount of oxygen in the lungs is 18% and the amount of carbon dioxide is 5.5%. A quick bit of arithmetic shows us that the difference between the oxygen levels in the atmosphere and in the lung is not really that much different: about 1.15 times more oxygen in the atmosphere. However the difference between the two carbon dioxide levels is huge: about 183 times more in the lungs than in the atmosphere. So if a person breathes more air than they need, it is the carbon dioxide level that is most affected. Over-breathing causes carbon dioxide to be lost from the lungs.

If carbon dioxide was just a waste gas, as most people erroneously think, then lower levels of it would be no problem. But what most people don’t know is that carbon dioxide is critical to human life and essential for the normal functioning of many bodily systems. Some of the functions of carbon dioxide are:

  • Relaxing smooth muscle
  • Relaxing and opening up blood vessels
  • Relaxing and opening up the airways
  • Activating the para-sympathetic nervous system – which soothes us, makes us feel relaxed and counteracts the actions of adrenaline and other stress hormones
  • Improving oxygenation of cells and tissues, including the brain.

Putting all this together we can see that the symptoms that are suffered during a panic attack can all be attributed to lowered levels of carbon dioxide:

  • Sweating, pounding of the heart, trembling and shaking are all caused by a surge of stress hormones such as adrenalin – unchecked by the calming parasympathetic nervous system which is normally governed by healthy levels of carbon dioxide.
  • Chest pain (in a healthy person without coronary artery disease) can be caused by spasm of the coronary arteries. As one of the functions of carbon dioxide is to relax arteries, spasm of coronary arteries can happen when carbon dioxide levels are too low
  • Light-headedness and numbness or tingling of fingers are both symptoms of not enough oxygen. Now it is a bit confusing that a condition characterised by over-breathing would cause a lack of oxygen! However, low carbon dioxide levels prevent oxygen from entering the cell. This is because oxygen is only released from haemoglobin in the presence of carbon dioxide. If carbon dioxide levels are too low, oxygen stays tightly bonded to the haemoglobin and keeps circulating in the blood, while the cells are starved. (This is known as the Bohr Effect, or the oxyhaemoglobin dissociation curve). Which is exactly why the sufferer feels lightheaded and confused – they don’t have enough oxygen in their brain tissue, and the lack of oxygen in the extremities causes numbness and tingling of the fingers.

So as you can see, there is a real reason why all these seemingly unrelated symptoms happen together when someone is anxious and having a panic attack and over-breathing. The old-fashioned treatment was to get the sufferer to breathe into a paper bag. And why does this work? It slows down the breathing rate and causes the person to rebreathe their own carbon dioxide. As their blood level of carbon dioxide rises they feel calmer and more in control.

Panic attack and acute hyperventilation are very obvious conditions – not easily missed and not easily forgotten after seeing someone go through the distress of an attack. However what is often missed and misdiagnosed is chronic hyperventilation and its associated symptoms. It is just the baby cousin of acute hyperventilation. And just like acute hyperventilation the symptoms of chronic hyperventilation are varied and many. However because the over-breathing isn’t as obvious it is often missed.

Both acute and chronic hyperventilation are caused by dysfunctional breathing patterns. They can both be eliminated with breathing retraining under the care of a breathing practitioner. Breathing retraining can help by:

  • Testing for hypocapnia (low carbon dioxide levels) through the use of capnography (a simple test that analyses the air you exhale)
  • Identifying dysfunctional breathing patterns
  • Identifying your triggers for dysfunctional breathing
  • Learning how to manage your triggers through healthy breathing
  • Breathing exercises to normalise chronically low carbon dioxide levels
  • Learning new breathing habits

Contact Buteyko Vitality for more information.