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Panic Disorder and Breathing Techniques: Calming the Nervous System

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Panic Disorder and Breathing Techniques: Calming the Nervous System

Panic disorder is a debilitating mental health condition characterized by recurrent and unexpected panic attacks. These attacks are often accompanied by intense physical symptoms such as rapid heartbeat, shortness of breath, dizziness, and chest pain. While panic disorder can be challenging to manage, there are various techniques that can help individuals calm their nervous system and reduce the frequency and severity of panic attacks. One such technique is focused on regulating breathing patterns. By learning and practicing specific breathing techniques, individuals with panic disorder can gain a sense of control over their symptoms and promote relaxation. In this comprehensive guide, we will explore the relationship between panic disorder and breathing techniques, and provide valuable insights on how to effectively calm the nervous system.

The Physiology of Panic Attacks

To understand the role of breathing techniques in managing panic disorder, it is essential to first grasp the physiology of panic attacks. Panic attacks are the result of the body’s natural response to perceived threats, known as the fight-or-flight response. When faced with a threat, the body releases stress hormones, such as adrenaline, which trigger a cascade of physiological changes. These changes include increased heart rate, rapid breathing, and heightened alertness. While this response is adaptive in dangerous situations, individuals with panic disorder experience these symptoms in the absence of any real threat, leading to intense feelings of fear and distress.

The Connection Between Breathing and Panic Attacks

Breathing plays a crucial role in the development and maintenance of panic attacks. During a panic attack, individuals often experience rapid and shallow breathing, known as hyperventilation. This type of breathing disrupts the balance of oxygen and carbon dioxide in the body, leading to a range of physical symptoms such as lightheadedness, tingling sensations, and chest discomfort. Additionally, hyperventilation can further activate the body’s stress response, exacerbating the intensity of panic attacks. By learning to regulate their breathing patterns, individuals with panic disorder can interrupt this cycle and reduce the severity of their symptoms.

Diaphragmatic Breathing: A Foundation for Calming the Nervous System

One of the most effective breathing techniques for managing panic disorder is diaphragmatic breathing, also known as belly breathing or deep breathing. Diaphragmatic breathing involves engaging the diaphragm, a dome-shaped muscle located below the lungs, to facilitate slow, deep breaths. This technique helps individuals shift from shallow chest breathing to a more relaxed and efficient breathing pattern. By engaging the diaphragm, diaphragmatic breathing promotes the intake of more oxygen and the release of carbon dioxide, restoring the body’s natural balance and reducing the symptoms of panic attacks.

To practice diaphragmatic breathing, follow these steps:

  1. Find a comfortable position, either sitting or lying down.
  2. Place one hand on your chest and the other on your abdomen, just below your ribcage.
  3. Take a slow, deep breath in through your nose, allowing your abdomen to rise as you fill your lungs with air.
  4. Exhale slowly through your mouth, feeling your abdomen fall as you release the air.
  5. Continue this pattern of slow, deep breaths, focusing on the movement of your abdomen.

Box breathing: Regulating the Breath and Calming the Mind

Another effective breathing technique for managing panic disorder is box breathing, also known as square breathing or four-square breathing. Box breathing involves inhaling, holding the breath, exhaling, and holding the breath again, each for an equal count of time. This technique helps regulate the breath and promote a sense of calmness and relaxation. By focusing on the breath and the counting pattern, individuals can redirect their attention away from anxious thoughts and reduce the intensity of panic attacks.

To practice box breathing, follow these steps:

  1. Find a quiet and comfortable place to sit or lie down.
  2. Close your eyes and take a moment to relax your body and mind.
  3. Inhale slowly and deeply through your nose, counting to four in your mind.
  4. Hold your breath for a count of four.
  5. Exhale slowly and completely through your mouth, counting to four.
  6. Hold your breath again for a count of four.
  7. Repeat this pattern for several minutes, focusing on the counting and the sensation of your breath.

Progressive Muscle Relaxation: Combining Breathing and Muscle Relaxation

Progressive muscle relaxation is a technique that combines deep breathing with the systematic tensing and relaxing of different muscle groups. This technique helps individuals release physical tension and promote a state of deep relaxation. By incorporating deep breathing into the practice, individuals with panic disorder can enhance the effectiveness of progressive muscle relaxation and further calm their nervous system.

To practice progressive muscle relaxation, follow these steps:

  1. Find a quiet and comfortable space where you can sit or lie down.
  2. Close your eyes and take a few deep breaths to center yourself.
  3. Starting from your toes, tense the muscles in that area as tightly as you can, holding for a few seconds.
  4. Release the tension and allow the muscles to relax completely, noticing the sensation of relaxation.
  5. Move up to the next muscle group, such as your calves or thighs, and repeat the process of tensing and relaxing.
  6. Continue this pattern, working your way up through your body, including your abdomen, chest, arms, and face.
  7. Throughout the practice, maintain slow and deep breathing, syncing your breath with the tensing and relaxing of each muscle group.

Mindfulness Meditation: Cultivating Present-Moment Awareness

Mindfulness meditation is a powerful technique for managing panic disorder and promoting overall well-being. This practice involves intentionally focusing one’s attention on the present moment, without judgment or attachment to thoughts or sensations. By cultivating present-moment awareness, individuals can reduce the impact of anxious thoughts and physical symptoms associated with panic attacks. Breathing is often used as an anchor in mindfulness meditation, allowing individuals to ground themselves in the present moment and observe their thoughts and sensations with a sense of curiosity and acceptance.

To practice mindfulness meditation, follow these steps:

  1. Find a quiet and comfortable space where you can sit or lie down.
  2. Close your eyes and take a few deep breaths to settle into the present moment.
  3. Direct your attention to your breath, noticing the sensation of the breath entering and leaving your body.
  4. As thoughts or sensations arise, simply observe them without judgment, and gently redirect your attention back to the breath.
  5. Continue this practice for a predetermined amount of time, starting with just a few minutes and gradually increasing the duration as you become more comfortable.
  6. Remember that the goal of mindfulness meditation is not to eliminate thoughts or achieve a particular state, but rather to cultivate a non-reactive and accepting awareness of the present moment.


In conclusion, breathing techniques can be powerful tools for individuals with panic disorder to calm their nervous system and reduce the frequency and intensity of panic attacks. By understanding the physiology of panic attacks and the connection between breathing and anxiety symptoms, individuals can gain a sense of control over their condition. Techniques such as diaphragmatic breathing, box breathing, progressive muscle relaxation, and mindfulness meditation can all contribute to managing panic disorder and promoting overall well-being. By incorporating these techniques into their daily routine and practicing them regularly, individuals can develop a greater sense of calmness and resilience in the face of panic attacks. Remember, managing panic disorder is a journey, and it may take time and practice to find the techniques that work best for you.