Anxiety, Panic Disorder & PTSD: Factors in Hyperventilation

What are some correlations between respiratory distress and living with anxiety, panic disorder or PTSD? Anxiety, panic disorder and PTSD are all forms of psychological disorders. Anxiety can be a factor in speeding up the heart rate which can cause heavy breathing, also known as hyperventilating. Respiratory changes are associated with anxiety disorders, particularly panic disorder (Freire, S32). Anxiety has a type of reaction where it affects the mind and body. Anxiety disorders are associated with respiratory abnormalities (Wollburg, 81). Panic disorder is associated with hyperventilation (Tolin, 51). PTSD, known as Posttraumatic Stress Disorder is the result of a terrifying, shocking or disastrous event that has happened in one’s life. PTSD is known to have many effects on a person’s lower respiratory system. Therefore, if a person is struggling to catch their breath, they can possibly be under acute stress, or have anxiety due to the situation at hand. Not everyone suffers from stress, anxiety or PTSD, but those who do often suffer the effects of erratic breathing. Often times, there are many factors for those who commonly struggle. Stress, Anxiety and PTSD are just a few psychological disorders that contribute to hyperventilation disorder. They are just a few that relate to both psychological and physiological understanding, effecting the mind and body at the same time.

Breathing is the most fundamental physiological functions of the human body (Paulus, 315). In order to breathe, the body naturally inhales oxygen and exhales carbon dioxide into the environment. The average human adult takes 12- 20 breathes per minute. Anything less than twelve breath’s or more than twenty-five breath’s is considered abnormal. Hyperventilation is studied to be anywhere between twenty-five and forty breathes per minute. If the human body is not producing enough carbon dioxide in the blood stream due to the excessive amount of breathing being done, that can be the cause of hyperventilating. The low carbon dioxide levels, contribute to the bodies blood vessels not producing enough blood to the brain.  That is why stress disorders and hyperventilation are so common and happen coincidently. People who have symptoms of hyperventilation, experience heavy breathing, where they tend to exhale more oxygen than they inhale, making it hard to catch their breath. Respiratory changes are associated with anxiety, particularly with panic attacks and panic disorder (Freire, 533). Emotions such as anxiety can profoundly influence the subjective experience by amplifying particular afferent sensory components of breathing (Paulus, 316). Although hyperventilating is not life threatening, it can lead to an experience of not being able to breath enough air and can result in a loss of consciousness. Some side affects of hyperventilation can be anxiousness, tensing up, or nervousness. Changes in breathing can be both, the consequence of an increased level of anxiety as well as the source of threat experienced by the individual, which, in turn, leads to increased anxiety (Paulus, 315). More often than not, hyperventilating is a negative feature of high stress, anxiety, PTSD, phobias and more.

Anxiety and panic disorder are closely related in the fact that it can cause subjects to worry, and be fearful. This is why they are more common, than not. The difference in anxiety and panic disorder is that anxiety does not normally have an exact source for the onset of emotions and cannot be controlled, whereas, panic disorder is often times sought from a specific event or feeling, often times trying to avoid the reason for the attack. People who suffer from anxiety disorders often times think of problems to be bigger than they really are. This irrational thought process is referred to as “making a mountain out of a mole hill.”  They get tightness in their chest, shortness of breathing and feel heart attack like symptoms, often times thinking their increased heart rate is an actual heart-attack, and not just a normal feeling of a faster heart palpitation, when under stress. The onset of the attack can be unknown and last anywhere from minutes, to a half an hour. Behaviorists believe that anxious behavioral reactions are learned (Ciccarelli, 551). This was Paplov’s idea that classic conditioning is learning to elicit an involuntary, reflex-like, response to a stimulus other than the original, natural stimulus that normally produces the response (Ciccarelli, 177). This would mean that people who suffer from anxiety or have panic disorders, are taught to have this reaction, or type of ideology by past events.

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Several anxiety disorders have been associated with altered breathing, perception of breathing, and response to manipulations of breathing (Paulus, 315). There is depression, phobias, anxiety, stress, panic disorder, PTSD, and many others, that are some of the disorders that can be the cause irregular breathing. These feelings of anxiety cannot be identified all the time, and at times cannot be controlled, even if sought to do so. Heart rate variability has been identified variously as a marker for anxiety disorders broadly for panic disorders and for cardiovascular morbidity and mortality (Fisher, 80). After the heart rate is elevated, it makes for regulating heart rate, hard to control. Often times, anxiety and stress contribute severely to panic disorder, causing one to lose breath and have irregular heart palpitations. The level of heart beats per minute can detect an attack before it happens. Often times, psychological therapy or medicine are the solution for preventing future attacks These conditions are similar to what someone suffering from PTSD may feel.

PTSD, Posttraumatic Stress Disorder is an intense psychological distress, marked by horrifying memories, recurring fears, and feelings of helplessness that develop after a psychologically traumatic event, such as combat, rape, criminal assault, life-threatening accident, or natural disaster. (Venes, 02/2013, p. 1878). PTSD is an amplified state of acute stress disorder (ASD), usually lasting longer than one month. Where as PTSD can last up to years and is normally a symptom much later on and not immediate like ASD (Ciccarelli, 551). PTSD is often found later than usual, when a person recalls a specific event in time and reacts to it. It can cause nightmares, erratic thinking, heavy breathing and hyperventilating.  It is thought that anxiety sensitivity can lead to the development of PTSD and difficulties with the respiratory system. Individuals high in anxiety sensitivity may be more likely to react with prolonged anxiety to traumatic exposure and to be hypersensitive to the physiological changes that accompany anxious arousal and respiratory symptoms (Maheffey, 72). Post-traumatic victims often have a psychological melt down leading to them unable to breathe and often times hyperventilating. It is often time’s that people with these medical issues, have a reasoning for the elevated heart palpitations. In PTSD patients, they can suffer from war, a tragic event, a bad storm, a car crash, their parent leaving them, an animal attack. Many different scenarios can alter ones thinking, causing the hyperventilating to happen. Trauma exposed patients, or people with hyperventilation disorder, cannot calm themselves down and need assistance in doing so. This means the patients can be at a higher risk for respiratory symptoms. PTSD, anxiety and panic disorder are all disorders, mental and physical, that can lead to harm on the body such as hyperventilation.

There are some intriguing initial findings of altered breathing perception, difference breathing patterns, and changes in the neural signature related to individuals with high anxiety or anxiety disorders (Paulus, 318). The association and communication between the mind and brain is fundamental to the human body. Changes in breathing can be a condition in those who often experience panic disorder, anxiety attacks or any form of PTSD. These psychological disorders can all be studied in neurobiology, physiology, and psychology. The amount of scientific structure between these subjects is an unwavering amount. Hyperventilation can be caused by many stressors. In conclusion, Anxiety, panic disorder PTSD and hyperventilating can have long term effects on one’s life. These psychological disorders can cause distress, social distress and even more, effect the everyday life, such as health.

References

• Ciccarelli, S. K., White, J. N. (01/2014). Psychology, 4th Edition. [VitalSource]. Retrieved from https://online.vitalsource.com/#/books/9781269745734/
• Fisher, A. J., & Woodward, S. H. (2014). Cardiac stability at differing levels of temporal analysis in panic disorder, post-traumatic stress disorder, and healthy controls. Psychophysiology, 51(1), 80–87. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=92866325&site=ehost-live
• Freire, R. C., Nascimento, I., Martins Valença, A., Leão Lopes, F., André Mezzasalma, M., Leão de Melo Neto, V., … Egidio Nardi, A. (2013). The panic disorder respiratory ratio: a dimensional approach to the respiratory subtype. Revista Brasileira de Psiquiatria, 35(1), 57–62. https://doi.org/10.1016/j.rbp.2012.02.008
• Mahaffey, B. L., Gonzalez, A., Farris, S. G., Zvolensky, M. J., Bromet, E. J., Luft, B. J., & Kotov, R. (2017). Understanding the Connection Between Posttraumatic Stress Symptoms and Respiratory Problems: Contributions of Anxiety Sensitivity. Journal of Traumatic Stress, 30(1), 71–79. https://doi.org/10.1002/jts.22159
• Paulus, M. P. (2013). The Breathing Conundrum-Interoceptive Sensitivity and Anxiety. Depression & Anxiety (1091-4269), 30(4), 315–320. https://doi.org/10.1002/da.22076
• Tolin, D., McGrath, P., Hale, L., Weiner, D., & Gueorguieva, R. (2017). A Multisite Benchmarking Trial of Capnometry Guided Respiratory Intervention for Panic Disorder in Naturalistic Treatment Settings. Applied Psychophysiology & Biofeedback, 42(1), 51–58. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=121699688&site=ehost-live
• Wollburg, E., Roth, W. T., & Sunyoung Kim. (2011). Effects of Breathing Training on Voluntary Hypo- and Hyperventilation in Patients with Panic Disorder and Episodic Anxiety. Applied Psychophysiology & Biofeedback, 36(2), 81–91. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=60279072&site=ehost-live
• Venes, D.  (02/2013). Taber’s Cyclopedic Medical Dictionary, 22nd Edition [VitalSource Bookshelf version].  Retrieved from vbk://9780803639096