Breathing Exercises For Panic Attacks

Breathing Exercises For Panic Attacks

An estimated 40 million Americans live with anxiety disorders, including 6 million with a panic disorder diagnosis and 7.7 million affected by post-traumatic stress disorder (PTSD). Panic attacks can happen to anyone, anywhere, at any time. And they are more common than you think. As many as 25% of people have one at some point in their lives (Kessler et al., 2006).

What is a panic attack?

The word “panic” may sound like something that’s all in your head. Yet when it comes to panic attacks (sometimes known as anxiety attacks), the symptoms are mostly physical. They include:

  • Chest tightness
  • Chest pain
  • Shortness of breath
  • Shaking
  • Dizziness
  • Sweating

What causes anxiety and panic attacks

Sometimes panic attacks can happen when you’re under stress. Other times they may be triggered by a specific situation like an argument or social setting that doesn’t feel safe. But not always. “Panic attacks can seem to come out of the blue without any clear trigger,” says Cuyler.  “Panic can run in families and there are likely genetic factors at play.”

For some people, breathing in too much air which lowers exhaled carbon dioxide levels can trigger panic attacks. And the trait seems to be linked in families, though it doesn’t cause panic attacks for everyone (van Beek & Griez, 2000). That’s why many experts believe learning to breathe in a way which won’t trigger panic attacks can be a powerful tool to prevent them.

The role of stress in the modern world

The first accounts of the effects of stress on breathing were documented during the 1870s by military doctor De Costa after he observed an array of symptoms amongst soldiers returning from the front line. These soldiers had endured heavy stress over many months which altered their breathing habits and caused a biochemical change, resulting in symptoms such as:

  • Fatigue upon exertion
  • Breathlessness
  • Palpitations
  • Excessive sweating
  • Chest pain


Even when the soldiers returned to civilian life they faced a long and arduous process to regain their health. In 1937, scientists Kerr and colleagues coined the term hyperventilation syndrome to describe the main cause of these symptoms. 

In other words: over-breathing.


The effects of panic attacks

Fear of panic attacks, or trying to avoid them, takes a toll on your whole life. Many people who experience panic attacks start to avoid certain things. For example, you might avoid driving or going to big box stores because you’re afraid of having a panic attack there. You might skip class because you’re afraid of being called on. You might avoid elevators because you’re afraid of having a panic attack inside, and not being able to escape.

Panic attacks—and the ways people cope—cause challenges with relationships, work, school, and more. Problems linked with panic attacks include:

  • Frequent health concerns and trips to the doctor
  • Depression, anxiety, and other mental health issues
  • Increased risk of suicide or thoughts of suicide
  • Alcohol and substance misuse
  • Changes in relationships with family or friends


What you can do if you have panic attacks

The connection between panic disorder and frequent emergency department visits has been known for decades

In a report on the most frequent reasons for people visiting the Emergency Department in New York City from 2018, Respiratory issues along with nonspecific chest pain take the 2nd and 3rd place on the list. 

It’s important to say that whilst panic attacks are very common, if you are experiencing symptoms like shortness if breath or chest pains, you should always seek the advice of a medical professional to be on the safe side.


How breathing affects anxiety: Too much of a good thing?

Scientists have studied these differences in breathing for decades and have learned that they are linked to anxiety attacks and symptoms of anxiety. People who suffer from these conditions often breathe too fast and take in too much air—even when not doing a demanding activity that needs more oxygen. 

If you were simply sitting down or driving a car, but breathing enough to go for a light jog. Other signs you may be overbreathing are frequent sighing and yawning, cold hands and feet, and an inability to sit still and switch off. These habits cause you to take in too much air. (Yes, there’s such a thing!) In some people, it also sets the stage for panic attacks or symptoms of anxiety.

The vital role of Carbon Dioxide (Co2)

A metaphor for how the brain reads its internal processes incorrectly in the ‘’Faulty suffocation alarm’’. Inside your hypothalamus, the part of your brain responsible for maintaining homeostasis or balance, there is a certain ‘setpoint’ for tolerating carbon dioxide (Co2). When your brain reads an amount of Co2 present that exceeds its current setpoint, it thinks you are drowning or running and triggers you to gasp for air. Except there is actually plenty of oxygen available, and oftentimes in the modern world, we are not in situations of high physical exertion for which this response was designed. 

It’s as if the thermostat in your house (the amygdala in your brain) is set to 24 degrees celsius, but someone left the windows wide open on a cool day (you are overbreathing). The brain will fire up all its resources to balance out the temperature in the house (you will start breathing more and producing more adrenaline). 

But now there is a mismatch between internal processes, and the external environment, and over time it ends up confusing the brain and sending incorrect signals to your body and back, causing you to breathe more and more shallowly. 

So are there any alternative ways to relieve symptoms of a panic attack?

So, what can you do about it? Simply paying attention to your breathing isn’t enough. The first step to overcoming panic disorder with breathwork is to learn how to breathe better—both during the day and at night— to take in the right amount of air, and stop overbreathing and shallow breathing in its tracks. The next step is practice— the harness conscious breathing exercises and their effects on physical and mental health. 

Breakthrough research on breathing exercises for panic attacks and anxiety

Recent research has identified a treatable, shared underlying physiological factor for both anxiety disorders and panic disorder: hypersensitivity to carbon dioxide. 

The research is clear, people with these conditions breathe differently than others. And this is no longer just an interesting observation, it’s a groundbreaking discovery that has the potential to change our system or care for good. 

Based on this simple principle, that overbreathing and panic attacks go hand in hand, we can start working on treatments that normalise breathing rates and in turn balance Co2 levels and reduce or eliminate panic attacks and symptoms of anxiety. 

The best breathing exercises to help with panic attacks

There are a variety of breathing exercises you can use both during and before a panic attack to slow down your breathing, and calm down. 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. Early on, breathing techniques for panic attacks can also cause lightheadedness. If this happens to you, breathe normally for several minutes between cycles of breathing exercises. Gradually decrease the number of normal breaths until you can perform the breathing exercises as recommended.

Here’s a few difference exercises you can try for panic and anxiety attacks (in no particular order):

1. Breathing into a paper bag

There is a simple technique that’s been used in hospitals and by first responders for many decades which allows the body to find balance and the symptoms to fade away, it works by recycling and rebreathing the excess exhaled carbon dioxide, and therefore normalising the breathing rate, returning to homeostasis. 

  • Take 6 to 12 easy, natural breaths, with a small paper bag held over your mouth and nose. Then remove the bag from your nose and mouth and take easy, natural breaths through the nose where possible.
  • Next, attempt to make your breath lower and slower with each cycle. Try diaphragmatic breathing by bringing your breath lower into your body.
  • Alternate these techniques until your hyperventilation stops.


Follow these precautions when using the paper bag method:

  • Do not use a plastic bag.
  • Do not hold the bag for the person who is hyperventilating. Allow the person to hold the bag over his or her own mouth and nose.


Note, if you don’t have a paper bag handy, cupping the hands across the face to re-breathe exhaled carbon dioxide is also an effective strategy to employ at the first signs of symptoms. 

2. Nasal Breathing 

Another simple but effective method for slowing down your breathing in times of need is to switch to nasal breathing. 

Begin with focusing on switching to nasal breathing and becoming mindful of  the habit of sighing. You can stop a sigh by swallowing or holding your breath anytime you feel one coming. If you miss a sigh, then simply exhale through your nose and hold your breath for three to five seconds to compensate afterward. 

3. The Buteyko Method

While many breathing techniques aim to slow down breathing, the Buteyko Method intentionally increases the amount of Co2 in the blood and lungs temporarily, in order to retrain the breathing centres in the brain.

Once you can comfortably maintain nasal breathing for 5 minutes at a time, begin to incorporate gentle relaxation and reduced breathing exercises. 

  • Start by creating a mild feeling of air hunger for very short periods of thirty seconds at a time, practising ten times throughout the day. 
  • As you become more comfortable with the sensation of air hunger, lengthen the duration of the exercise from thirty seconds to up to two minutes. 
  • The most important point to remember is that your breathing volume reduces through relaxation. 
  • During each reduced breathing exercise, pay attention to whether you are tensing your body, or restricting your breathing by force. 
  • If so, abandon the exercise for a minute or so and focus on bringing a feeling of relaxation to your body, gently and gradually allowing your breathing to become quieter and calmer. 
  • Some people find it uncomfortable to observe their breathing, as the attention causes breathing rate to increase and become erratic. If you find this happening, concentrate on practising Many Small Breath Holds and relaxation.


The technique can provide instant relief, but mostly works in the long term to reduce the symptoms and onset of anxiety and panic attacks. It should be noted that this practice doesn’t always provide instant relief, in fact it can feel contradictory to slow the breathing down significantly, but over time this type of exposure can be a useful strategy to overcome the fear and sensations that accompany a panic attack.

For a technique that provides instant relief I recommend the many small breath holds exercise. 

4. Many small Breath Holds

In addition to addressing hyperventilation over the long term, it is also very important to learn safe and effective strategies that can help you stay in control of your breathing during the early stages of a panic attack. 

Practising many small breath holds of 3-5 seconds each, or cupping the hands across the face to re-breathe exhaled carbon dioxide are two effective strategies to employ at the first signs of symptoms. 

5. Alternate Nostril Breathing

Alternate nostril breathing is an effective way to slow breathing during a panic attack. It can also temporarily decrease blood pressure.4

  • Sit in a comfortable position.
  • Place your right thumb on your right nostril and your right ring and pinky finger on your left nostril.
  • Close your right nostril with your thumb and breathe out through your left nostril.
  • Breathe in through your left nostril.
  • Release your right nostril and close your left nostril with your right ring and pinky finger.
  • Breathe out through your right nostril.
  • Breathe in through your right nostril.
  • Close your right nostril and breathe out through your left nostril.
  • Continue this pattern for several breaths.

6. 4-7-8 Breathing

Dr. Andrew Weil developed the 4-7-8 breathing technique to help ease anxiety and help with stress-related health issues. Perform this exercise while seated in a comfortable position.2

  • Touch the tip of your tongue to the roof of your mouth, just behind your upper teeth. Keep your tongue in this position throughout the exercise.
  • Breathe out through your mouth, emptying all the air from your lungs. Make a “whoosh” sound as you exhale.
  • Close your mouth and breathe in through your nose for a count of 4.
  • Hold your breath and count to 7.
  • Breathe out through your mouth for a count of 8, making a “whoosh” sound as you exhale.
  • Repeat this cycle for three to four breaths. Over time, work your way up to eight breaths—this is the maximum recommended by the creator of this breathing technique.


Alternative Ways to Treat Panic Attacks

In addition to harnessing breathing exercises, there are many other strategies you can use to decrease your symptoms during a panic attack and regain composure in times of need. 

1. Learn effective approaches to self manage anxiety

Breathing exercises have been shown to reduce anxiety and proven as an effective method for managing stress and mental health. By learning to use breathing exercises both when in need, and as a preventive measure, we can overcome the grip of anxiety which often preludes panic attacks and gain more control over our experience. 

Breathwork Studies: Efficacy In Anxiety And Stress Reduction

2. Relaxation Methods 

Muscle tension often occurs during a panic attack. Progressive muscle relaxation is a technique you can use to help reduce symptoms of stress and anxiety. This technique involves tensing and relaxing muscles throughout the body in a specific order, from the top down or the bottom up.

Building resilience with breathwork

3. Mindfulness Techniques

When you start to have a panic attack, take a break from whatever you are doing. Remind yourself that your body and brain are overreacting to the actual circumstances of your situation.

Recognize irrational thoughts that might be contributing to your panic attack. For example, your racing heartbeat might make you think you will die. However, focusing on your breath and practising calming techniques in these moments can help your heartbeat slow down.

4. Come to your senses (a grounding technique)

Grounding techniques can help shift your focus back to the present during high anxiety, such as a panic attack.

The 54321 grounding exercise is one way to engage all five senses. Look around your environment and find:

  • Five things you can see
  • Four things you can feel
  • Three things you can hear
  • Two things you can smell
  • One thing you can taste

5. Preventing Panic Attacks

Panic attacks can’t always be prevented. Most occur without a clear trigger, and they can even happen while you’re relaxing or after falling asleep.

However, for some people, tracking symptoms can help identify potential triggers. Keep a journal and write down the environment where your attacks occurred, the circumstances, and what you felt.



Panic attacks are sudden, often unexpected episodes of intense fear accompanied by many uncomfortable physical and emotional symptoms. Breathing exercises can help calm your mind and reduce these symptoms during a panic attack. Examples include 4-7-8 breathing, the Buteyko method, and alternate nostril breathing.

Other techniques, such as progressive muscle relaxation and grounding techniques, can also be used during panic attacks. If you suspect you are having a panic attack but have not been given a diagnosis, seek medical attention to rule out serious medical causes of your symptoms, such as a heart attack.

Johannes’s inspiring life journey is punctuated by seeking the positives in every situation, a thirst for self-discovery and a love for unconventional experiences. Despite a challenging childhood, he discovered something unexpected that would alter the direction of his life forever – controlled breathing. Breathwork immediately resonated with Johannes, and he relentlessly cultivated knowledge on the subject from brilliant minds such as Wim Hof, Laird Hamilton etc and acquired more than ten breathwork certifications. His holistic wellness brand, Breathless Expeditions, has led the breathwork movement in Australia and inspired thousands of people across the globe since 2018. With world-renowned clientele such as David Goggins, Ludovico Einaudi, A-League Sports Teams, and some of Australia’s largest companies including PwC’s The Outside event flipping professional development, team building and life reslience experiences on its head, the future is brighter than ever for Johannes and Breathless. For additional inspiration visit his youtube channel.

Breathless Journal