My 6 top tips for controlling anxiety and breathlessness

One of the themes of last week was breathlessness and the affect that anxiety has upon it. Breathlessness can be seriously debilitating and also difficult to control, which in itself leads to feelings of anxiety.

When we feel anxious the body starts to prepare its self for flight or fight, in both cases the body requires more oxygen to supply the muscles with. The Adrenal glands release adrenaline and this hormone has the action of increasing your respiratory rate, among others in preparation for flight and fight. As you can see when you are already breathless the last thing you need is for your body to increasing your respiratory rate!

So what techniques can you use to try and control the anxiety related to breathlessness?

Breathing Exercises

Breathing techniques are a really useful tool in the armoury against breathlessness and there are several different things you can try out. The breathing rectangle is a great one as it helps you to focus your mind on something other than not being able to catch your breath. If you imagine that the long edge is the breath out and the short edge is your breath in and work your way round focusing on a slower longer breath out. The theory behind this is that when you are breathless that you never fully breath out as you are taking short in and out breaths and therefore can’t take on fresh oxygen. Think of a sponge already saturated with water, if you only squeezed a corner out you can never get a full sponge of fresh water. The same applies to your lungs. I also find that the act of concentrating on the rectangle helps you to recover quicker and it focuses you on something other than the feeling of panic. Pursed lip breathing is also a good way to help reduce the effect of being short of breath as it increases the pressure on the airways on the breath out and helps you recover faster, this can also be used in conjunction with the breathing rectangle.


Its really important to talk to someone about your anxiety as you won’t be the only person to feel this way. There are many support groups such as Breath Easy groups around the country and also a support line available at the British Lung Foundation. 03000 030 555 or email You can search the BLF website to see if there are groups local to you,

Keeping active

Its essential to make sure you keep active. It’s very tempting when you feel breathless to avoid doing the things that make you short of puff but this will only reduce your fitness further and make you more breathless. When you exercise its ok to become moderately breathless and is actually good for your lungs. There is strong evidence that exercise is also good for your over all mood which can help to reduce feelings of anxiety.

Keep a diary

I talk a lot about diaries as they are a great tool to help you reflect on your symptoms both for good and bad days. It can also make it easier if you have to go to your GP, to help you pin point the things that affect you most.

Visual imagery and relaxation

Visual imagery doesn’t work for everyone, some people just don’t have a mind for pictures. If you do however it can be a very effective way of helping you to relax. Get in a relaxed position either sitting or lying down, concentrate on diaphragmatic breathing and work your way through a scene that you find relaxing. Imagine every little detail, from the sight, sounds, smells and touch. Practice it until you can recall it at will and then when you feel anxious you can work your way through the scene again helping to settle your anxiety.


This is a form of meditation that involves observing what is happening around you and within you in a non-judgemental way. There are many books, groups, online courses or apps that will help you practice this technique if you want to try it out.

Practice these techniques when you are not breathless, that way when you have an attack it’s a familiar process and therefore easier. Try to spend at least ten minutes each day practising your breathing exercises and you will be sure to notice a big improvement in your ability to control anxiety and breathlessness.

These are my top tips to help you cope but what’s your top tip for anxiety control?

#BLF #breathlessness #respiratoryphysio

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