Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Is There Any Correlation Between Breathing Difficulty And Panic Attacks?
Question: Miss me???? Update. Last month was uncovering bits and pieces. We have gad. Stress anxiety all creating inflammation. Oops that's old news. Seems I have a tad bit central obesity. It's not helping pushing up on diaphragm
Still in Nebraska
Still sending out job apps
Still suffering with the same old same old.
Have uncovered the breathing episodes most remembering were tied to bouts of panic shortly before. This added to prior long term gad made it big problem
Off to band. Talk later
Still in Nebraska
Still sending out job apps
Still suffering with the same old same old.
Have uncovered the breathing episodes most remembering were tied to bouts of panic shortly before. This added to prior long term gad made it big problem
Off to band. Talk later
Brief Answer:
Private Consultation
Detailed Answer:
Hello XXXXXXX of course I missed you. I hope things are going well. I notice you have been talking quite a bit with pulmonologists. What are they saying? I worry this may be you focusing again too much on worrying your breathing is a physical problem rather than an anxiety-predominant problem. I think we have established anxiety is the driving factor here, although it is possible you may have very (very) mild asthma. I think focusing on CBT should be your most important focus.
Any panic attacks in the last couple of weeks? How has the anxiety been on a scale of 1 to 10, 10 being the worst ever?
I hope band practice goes well!
Dr. Sheppe
Private Consultation
Detailed Answer:
Hello XXXXXXX of course I missed you. I hope things are going well. I notice you have been talking quite a bit with pulmonologists. What are they saying? I worry this may be you focusing again too much on worrying your breathing is a physical problem rather than an anxiety-predominant problem. I think we have established anxiety is the driving factor here, although it is possible you may have very (very) mild asthma. I think focusing on CBT should be your most important focus.
Any panic attacks in the last couple of weeks? How has the anxiety been on a scale of 1 to 10, 10 being the worst ever?
I hope band practice goes well!
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Raju A.T
Worry is my middle name it seems. Never used to be. I was always calm and relaxed when I smoked. When I quit I started getting more anxious than normal.
I am doing different things in my daily life to try to relax more. I have been skipping lunch to leave building and go to a quiet, shady place and take a power nap or just close the eyes. Most of the time it re-energizes
If I was to quantify different sensations that I trigger from panic, I seem to get one that hits two. I have a inhaling sense that has an obstructive stopping point and tightness in chest when I try to breath in when exerting self.
You can put your input to it. Bhavsar has said he feels that first I am very anxious. No disagreement there. That I have let the stress act to inflame airways as asthma does when stress acts on asthma That the small airways are constricted tight and will stay that way until I relax. This means to stop looking for more answers to affirm or deny all other dr's opinions. That the body must desensitize itself
Ok. Band practice was ok I recently bought a new combo amp. Used it for first time on Sunday. Was not happy so I need to drive 100 miles to nearest guitar center store and return it. Time to find a better unit
My next thread or info I compose will be a list of triggers or events that I can relate to anxious moments. You can see if you agree that they are triggers I will probably send as a upload report
I am doing different things in my daily life to try to relax more. I have been skipping lunch to leave building and go to a quiet, shady place and take a power nap or just close the eyes. Most of the time it re-energizes
If I was to quantify different sensations that I trigger from panic, I seem to get one that hits two. I have a inhaling sense that has an obstructive stopping point and tightness in chest when I try to breath in when exerting self.
You can put your input to it. Bhavsar has said he feels that first I am very anxious. No disagreement there. That I have let the stress act to inflame airways as asthma does when stress acts on asthma That the small airways are constricted tight and will stay that way until I relax. This means to stop looking for more answers to affirm or deny all other dr's opinions. That the body must desensitize itself
Ok. Band practice was ok I recently bought a new combo amp. Used it for first time on Sunday. Was not happy so I need to drive 100 miles to nearest guitar center store and return it. Time to find a better unit
My next thread or info I compose will be a list of triggers or events that I can relate to anxious moments. You can see if you agree that they are triggers I will probably send as a upload report
Brief Answer:
Private Followup
Detailed Answer:
I do not believe your PFTs indicate significant asthma. They in fact barely qualify you for asthma at all. Airway inflammation is not causing the symptoms that trouble you (shortness of breath, a feeling of obstruction, a feeling of not being able to get a full breath) -- these symptoms are caused by chemical reactions in the brain related to anxiety, rather than a physical problem. Focusing on modifying these chemical reactions in the brain through psychotherapy (and medication such as Lexapro) is the solution to helping you feel better.
I'm glad you're finding ways to relax. This is very important and you're doing an excellent job doing this. Going to a quiet place during the day to recharge sounds like an excellent idea. Maybe make your own lunch and take it with you!
Glad to hear about band practice as well. I hope it was relaxing and enjoyable. Driving to replace the amp may not be, but at least in the end you will have a better amp!
I like the idea of going over a list of triggers together. I think this will be helpful to analyze and think about.
Dr. Sheppe
Private Followup
Detailed Answer:
I do not believe your PFTs indicate significant asthma. They in fact barely qualify you for asthma at all. Airway inflammation is not causing the symptoms that trouble you (shortness of breath, a feeling of obstruction, a feeling of not being able to get a full breath) -- these symptoms are caused by chemical reactions in the brain related to anxiety, rather than a physical problem. Focusing on modifying these chemical reactions in the brain through psychotherapy (and medication such as Lexapro) is the solution to helping you feel better.
I'm glad you're finding ways to relax. This is very important and you're doing an excellent job doing this. Going to a quiet place during the day to recharge sounds like an excellent idea. Maybe make your own lunch and take it with you!
Glad to hear about band practice as well. I hope it was relaxing and enjoyable. Driving to replace the amp may not be, but at least in the end you will have a better amp!
I like the idea of going over a list of triggers together. I think this will be helpful to analyze and think about.
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Ok I will be brief as I work on the list. First I am sorry for giving you the idea I am thinking of asthma, I am not. Dr B has indicated that he does no believe in asthma for my case at all. He thinks that the small airways are constricted by inflammation due to stress mediators. The inflammation is all I was talking of.
Now I am willing to be open to your explanation of brain released chemical reactions. But first indicate the chemicals and what they are doing
Now I will get back to my slow progressing list
Now I am willing to be open to your explanation of brain released chemical reactions. But first indicate the chemicals and what they are doing
Now I will get back to my slow progressing list
Brief Answer:
Followup
Detailed Answer:
Small airway inflammation is how asthma is defined. What PFTs measure are small airway inflammation, and your PFTs show very minimal (if any at all) evidence of this. So I do not believe small airway inflammation is contributing here. Moreover, the degree of small airway inflammation that we might be able to see on your PFTs would simply not be severe enough to cause the degree of respiratory distress you are experiencing. Thus we look to another cause, which is anxiety, which is well-known for causing a false sensation of inability to breathe. This is what we are treating.
What happens in a simple sense is the brain plays tricks on you. The amygdala, or fear center of the brain, misinterprets minor stressors as highly dangerous, and creates in your mind through various neurotransmitters (serotonin primarily) the sensation that you cannot breathe, even though there is nothing wrong with your lungs. Through medication, we can change serotonin levels in the brain. This is what Lexapro does. Through psychotherapy, we can activate the frontal lobes of the brain (the rational part) to inhibit the actions of the amygdala. This is what we are doing with CBT. Focusing on the lungs will not help you, in my opinion. We have no evidence there is anything wrong with your lungs that would cause the sensations you describe. We need to focus on the brain. And I think this is helping you improve already.
Dr. Sheppe
Followup
Detailed Answer:
Small airway inflammation is how asthma is defined. What PFTs measure are small airway inflammation, and your PFTs show very minimal (if any at all) evidence of this. So I do not believe small airway inflammation is contributing here. Moreover, the degree of small airway inflammation that we might be able to see on your PFTs would simply not be severe enough to cause the degree of respiratory distress you are experiencing. Thus we look to another cause, which is anxiety, which is well-known for causing a false sensation of inability to breathe. This is what we are treating.
What happens in a simple sense is the brain plays tricks on you. The amygdala, or fear center of the brain, misinterprets minor stressors as highly dangerous, and creates in your mind through various neurotransmitters (serotonin primarily) the sensation that you cannot breathe, even though there is nothing wrong with your lungs. Through medication, we can change serotonin levels in the brain. This is what Lexapro does. Through psychotherapy, we can activate the frontal lobes of the brain (the rational part) to inhibit the actions of the amygdala. This is what we are doing with CBT. Focusing on the lungs will not help you, in my opinion. We have no evidence there is anything wrong with your lungs that would cause the sensations you describe. We need to focus on the brain. And I think this is helping you improve already.
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
I am still here just busy with job project. Keeping thread open. When free time opens I will continue. Things are fine fir moment
Brief Answer:
Private Followup
Detailed Answer:
Great! I'm glad to hear things are going well. What did you think of my explanation about the brain? I'm happy to explain more. One more followup question in this one before the end of the month.
Dr. Sheppe
Private Followup
Detailed Answer:
Great! I'm glad to hear things are going well. What did you think of my explanation about the brain? I'm happy to explain more. One more followup question in this one before the end of the month.
Dr. Sheppe
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
