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Why Am I Feeling Shortness Of Breath And Worse, Not Able To Take In A Comfortable Full Breath?

Posted on Tue, 7 Jan 2025

Question: Hello, doctor. I have suffered with anxiety and panic attacks most of my adult life and have been on various meds. Usually, I can handle the symptoms of sweating, trembling like shaking inside, nervousness on and on. A few weeks ago, however, a new symptom arose that borders unbearable which is shortness of breath and worse, not able to take in a comfortable full breath. I am still pursuing medical tests to rule other reasons out, but my sense is this is all anxiety related. Problem is it's 24/7, even on meds and trying to sleep or watch tv. I have tried some breathing exercises geared for anxiety and none seem to help. Just wondering if u had any suggestions or advice. Thank you

Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)

Brief Answer:
Consultation

Detailed Answer:
Hello,

First of all I like to inform you that breathlessness is very common among the individuals with anxiety disorder and can be disabling to a great extent.

My experience with various patients with similar problems and available literature suggests use of benzodiazepines for the breathlessness. However considering the fact that it is 24 X 7 and there is no time when the breathlessness is under control I feel we need to revise the existing treatment for time being.

At the same time we need to explore the non pharmacological options for betterment of condition. In my personal experience I found the mindfullness meditation most useful. In addition the deep breathing exercise is of good use and helps the individual to a great extent.

I like to add that non pharmacological approaches yield results after a lag and we need to have confidence in any practiced method before considering it useless or non helpful.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Ashok Kumar Choudhary (1 hour later)

Hi, Dr. XXXXXXX and thanks for your reply. Over the years, I have tried xanax and klonopin in low doses, at times concurrent and they do relax. Meditation as well as u suggest. With this breathing issue, however, is a mystery. When I am racing around the house (with heart rate up as it usually is), I am not as aware of breathing issue as when I do try to relax (as to watch tv or try to fall asleep). It's in this relaxed state where this breathing issue comes so much more to the forefront of consciousness and am totally at a loss as to finding a solution.

Answered by Dr. Dr. Ashok Kumar Choudhary (9 hours later)

Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

In view of the additional information shared by you, it is almost clear that the breathlessness issue, currently faced by you is related to anxiety. This is because all other breathlessness problems increase with physical activity and only anxiety related breathlessness eases with physical activity.

Since you have tried almost all relevant medications the other option which needs exploration is cognitive behavior therapy or CBT. CBT likely to help you to distract yourself from the problematic breathless and relieve the distress caused by it.

I hope this helps you further.
Thanks and regards.

Above answer was peer-reviewed by : Dr. Dr. Yogesh D

Follow up: Dr. Dr. Ashok Kumar Choudhary (3 hours later)

Thank u and will definitely look into CBT. Having suffered w/anxiety, depression, and even 2 facial neuralgias for many years now (with the root of the problem for me is being a people pleaser and lived solely for others; long story), I honestly feel on the verge of a nervous breakdown. Anyway, would this CBT also help alleviate some of this inner shaking/rapid heart rate? (These two symptoms are constant and seem to be imbedded.)

Answered by Dr. Dr. Ashok Kumar Choudhary (15 hours later)

Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

In regard to CBT, I like to make it clear that it is more effective for psychological symptoms of anxiety in compare to physical symptoms. However there will be definite effect on physical symptoms of anxiety but to a limited extent. Generally medications such as b blockers are helpful for inner shaking and increased heart rate.

I hope this helps you further.
Thanks again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ashok Kumar Choudhary (3 hours later)

Thank u for your help. Both my family doctor and/or neurologist will prescribe any med to try to help me. Could u please provide the name of two or three b blockers that I could suggest to them to get their opinion and the property of their effectiveness.

Follow up: Dr. Dr. Ashok Kumar Choudhary (16 minutes later)

To save u a long answer (and I appreciate your help), just googled beta blockers and learned a lot. Got the name of two u may recommend - Atenolol or Propranolol. (ones usually used for anxiety). Would either of these two be something I could try and I did see where a side effect is "shortness of breath". In any event, would like to try this for physical symptoms. Could u tell me the lowest dose available on each? Thanks so much.

Answered by Dr. Dr. Ashok Kumar Choudhary (26 hours later)

Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

Generally the propranolol is better for most patients and dose ranges from 10-240 mg per day. For most patients I prefer to start with 20 mg (with long acting properties) in morning and get evident response. In case it does not work the increment in dose is done by 10 mg every second or third day.

I hope this helps you further.
Thanks again.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar