Help for anxiety and panic attacks
The Buteyko Breathing Method can bring considerable relief for individuals who suffer from anxiety and panic attacks because the type of breathing taught and some of the Buteyko exercises can elicit the ‘relaxation response’. In order to understand this, it is first necessary to have an understanding of the ‘stress response’ (also known as the ‘fight-or-flight’ response) accompanied by an understanding of the ‘relaxation response’.
A primitive response
When we are under stress, our bodies respond with the fight-or-flight response, also known as the stress response. This response was critical to the survival of our cavemen ancestors when faced with a life or death encounter with a hungry saber-toothed tiger. The stress response prepared the caveman’s body for action – to either fight or run away.
The primitive fight-or-flight response is still with us today and produces the same physiological changes in the body. Unlike our cavemen ancestors, we rarely face life-threatening situations. However, experts estimate that in modern society, most of us experience between 40 and 50 stress responses per day. The stressors that trigger the stress response nowadays are unlikely to be man-eating tigers. They are more likely to be difficulties at work, financial problems, being stuck in traffic, or a tight deadline that has to be met.
Whenever we are confronted by a threat, whether physical or psychological, real or imagined, the primitive brain (the hypothalamus) is activated to produce the stress response. Unfortunately, psychological stress in modern times tends to be chronic rather than acute. When our stress mechanisms are chronically activated, the responses that were originally designed to protect us can become harmful, even lethal.
The ability to respond to stress and the ability to relax are equally important in being able to function effectively in the modern world, while remaining healthy. In an ideal world, we would respond to challenges or difficult situations, fast and efficiently and then relax. Unfortunately, many people are better at getting ‘pumped up’ than at relaxing afterwards.
Physiology of the stress response
When a stressor is perceived, nerve impulses from the hypothalamus activate the sympathetic-adrenal-medullary system. This results in an increase in the secretion of adrenaline and noradrenaline from the adrenal medulla. These stress hormones mimic the action of the sympathetic branch of the autonomic nervous system and initiate a heightened pattern of physiological activities. The hypothalamus also releases corticotrophin-releasing factor (CRF). This stimulates the anterior pituitary to secrete adrenocorticotrophic hormone (ACTH). ACTH acts on the adrenal cortex causing it to release corticosteroids. Cortisol is the most important of the corticosteroids in relation to the physiology of the stress response.
The stress response involves the following physiological changes:
- Heart rate accelerates and blood pressure rises
- Glucose and fats are released from the liver
- Breathing becomes faster
- The muscles become tense in preparation for strenuous activity
- Blood coagulability increases
- Perspiration increases
- Saliva dries up and digestion ceases
- The pupils dilate and all the senses are heighted
- The bowel and bladder muscles may become loose
The relaxation response
The relaxation response is a physiological response that is the opposite of the stress response. It has been described as an antidote to stress. The term ‘relaxation response’ was coined by Dr. Herbert Benson, a Mind/Body Medicine Professor at Harvard Medical School.
Dr. Benson conducted a series of studies on practitioners of transcendental meditation and found that when practicing, they showed decreases in metabolism, heart rate, blood pressure, breathing rate, blood lactate, and muscle tension. In addition, normal waking brain wave patterns shifted to predominantly slower patterns. This series of physiological changes, which Benson named the ‘relaxation response’, occur when the mind and body become tranquil. The relaxation response is quite different to sleep and has been described as a wakeful hypometabolic state.
The relaxation response can occur naturally, for example, when lying on a sandy beach soaking up the sun. Normally, however, the relaxation response has to be brought about voluntarily and by intention. A large number of techniques can be used to elicit the response, including diaphragmatic breathing, meditation, yoga, repetitive prayer, autogenic training, progressive muscular relaxation, visual imagery, and qigong.
“The time to relax is when you don’t have time for it.”
– Sydney J. Harris
Regular elicitation of the relaxation response can help counteract the harmful effects of long-term daily stress and result in the alleviation of many stress-related disorders. Research has demonstrated that in people who have practized eliciting the relaxation response, the body is less responsive to stress hormones, even during the times of the day when they are not eliciting the response. Relaxation response-based approaches, generally used in conjunction with nutritional, exercise and stress management interventions, have been demonstrated to be effective in the treatment of hypertension, cardiac arrhythmias, insomnia, chronic pain, premenstrual syndrome, infertility, anxiety and mild or moderate depression.
Buteyko Breathing expert Patrick McKeown had made the following important points in relation to panic attacks and breathing:
“There is much documented research to demonstrate that people who are prone to panic attacks and anxiety tend to have dysfunctional breathing patterns, including breathing irregularity and sighing frequently.”
“Professor Donald Klein from the Department of Psychiatry at Columbia University College claims that the feeling of suffocation caused by over-breathing provokes a very strong reaction in people who are susceptible to panic attacks, sending them into a state of panic and hyperventilation.”
“Evidence also shows that the practice of reduced breathing exercises which modify carbon dioxide tolerance are therapeutic to those who suffer from anxiety, panic attacks and depression.”
“The technique of observing and slowing down the breath has been shown to calm the mind and improve resilience in stressful situations.”
“Practicing breathing exercises that create a slight accumulation of carbon dioxide conditions the brain to tolerate higher concentrations of the gas. Gently subjecting the body to the feeling of air hunger for short periods of time will also reduce the body’s fear response, reducing the risk of panic and hyperventilation. After all, the sensation of air hunger is a natural occurrence that we experience several times a day, especially during physical exercise, and there is no need for the body to respond to the feeling with panic.”
“While many breathing techniques aim to slow down breathing, the Buteyko Method is the only breathing exercise to my knowledge that intentionally reduces breathing volume in order to create a tolerable need for air. In essence, the theory works like a vaccine – reducing breathing to create an air hunger is similar to giving the body a very small, controlled dose of symptoms, which can be a useful strategy to overcome the fear of the sensations that accompany a full-blown panic attack.”
“In addition to addressing hyperventilation over the long term, it is also very important to learn to control breathing during the early stages of an attack. A central feature of a panic attack is that the symptoms are cyclical, feeding back in on themselves and perpetuating the attack. If symptoms continue for several minutes, the increase to breathing volume serves to disturb blood gases, reducing the delivery of oxygen to the brain and causing the attack to become even more intense. Practicing many small breath holds of 3-5 seconds each, or cupping the hands over the face to re-breathe exhaled carbon dioxide are two effective strategies to employ at the first signs of symptoms. The sooner you take control of your breathing, the better chance you have of stopping the attack before it takes hold.”
“Given the sensitive nature of panic disorders, breathing exercises should be introduced very gently. It’s essential to avoid creating too strong of an air shortage during reduced breathing – or even during measurement of the Control Pause – as this could bring about sensations similar to the beginning of a panic attack.”