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Hyperventilation

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Hyperventilation forms part of the panic attack symptoms experienced by 50 to 60% of all sufferers and is 7 times more likely in women than in men, meaning that nearly all women get hyperventilation amongst their collection of panic attack symptoms.

Hyperventilation is when we breathe fast and deeply, but with panic attacks a better definition is ‘when we unconsciously breath faster and/or deeper than necessary, as a result of a psychological trigger.’

At first blush, this might seem incorrect. If you have experienced this horrible symptom you will almost certainly be thinking “I wasn’t getting enough air, so it was definitely not deeper than necessary with me!”

People think and it is often said, that “hyperventilation occurs during panic attacks due to the change in the heart rate coupled with the heightened fear and anxiety experienced during the attack.” The theory being that the blood becomes oxygen starved and therefore hyperventilation occurs.

This might or might not be true to an extent, but we don’t totally buy into this explanation, because the bloodstream is nearly always at 100% oxygen saturation.

In the case of a panic attack, we believe hyperventilation is more likely to be the result of an initial “psychological stress response,” which is then accelerated by the “psychological response to that psychological response” (the fear of the fear) putting the nervous system into overdrive.

The type of hyperventilation associated with panic attacks is sometimes referred to by doctors as 'psychogenic dyspnoea' or 'behavioural breathlessness.' If you ever hear this term being used by your doctor or medical professional, what they are really saying is that your hyperventilation is a consequence of perceived breathlessness rather than the cause of it.


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Panic attack induced hyperventilation is so distressing that people often feel like they are having some kind of serious physical illness which when coupled with the other panic attack symptoms such as palpitations, might feel like a severe heart attack. Whilst the doctor might tell you, “Its OK, it’s only a panic attack” (in a way only doctors can say it!) the truth is that it is a really frightening experience. And this fear is the danger, because being frightened makes us hyperventilate even more and this creates a vicious circle which is hard to break.

A consequence of hyperventilation is that the blood becoming depleted in carbon dioxide, a condition known as ‘respiratory alkalosis.’ This depletion of carbon dioxide changes the bloods ph making it more alkaline. Carbon dioxide is a very weak acid, but due to the large quantities we produce naturally on a daily basis; it forms a major contributor to the acid base balance of our blood.

When blood becomes more alkaline it contributes to many of the other panic attack symptoms such as weakness, dizziness, tingling, sweating and a feeling of choking or suffocation, it can also bring on ringing in the ears (tinnitus).

A secondary problem with a change in blood ph is that it can cause something called ‘hypocalcaemia’ - a change in the balance of ionised / unionised calcium in the bloodstream, of which muscle spasms in the hands and face is often a symptom.

A measure sufferers often use to try and address this loss of carbon dioxide is to breath into a paper bag. This allows you to re-breath some of the carbon dioxide you are exhaling in order to keep the carbon dioxide level of the blood from falling too low.

One point of caution here though; you should only do this if you are certain that your hyperventilation is the result of a panic attack as it could be a dangerous thing to do if it is the result of a physical disease. Medical advice should be sought if you experience hyperventilation frequently just in case it’s something more serious.

Perhaps the biggest piece of advice is that whilst hyperventilation is extremely frightening, the best thing you can do is relax.
OK, we know, how the hell...!!!   But the truth is if you are one of the few who can master this, you will have conquered hyperventilation!


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