Do you remember, the 13 symptoms of panic in last month’s blog and how they make us catastrophise (make something catastrophic out of something minor?) Well, when we get some of the frightening symptoms of panic what we might do is begin to breathe more quickly (hyperventilate). This is just nature’s way of preparing us for fight or flight. Unfortunately, we cannot run away from a panic attack so we tend to repeatedly hyperventilate – prepare for fight/flight even when we’re not aware of doing so.

Hyperventilation (taking too much oxygen in by breathing quickly) upsets the balance of oxygen and carbon dioxide in our body. This results in feelings of:

  • Weakness/ faintness
  • Dizziness
  • Numbness and tingling in our arms or feet
  • Chest pain
  • Palpitations
  • Breathlessness

Do those symptoms sound familiar? Yes, they are all panic symptoms – and hyperventilation makes them worse – not better. Then when we breathe faster and experience even more panic symptoms what do we tend to do? Yes – we try to take in even more air by hyperventilating faster. Before we know it, the symptoms increase even more and we become terrified. Yet they’re only based on fast breathing and catastrophising them (thinking we’re having a heart attack for example when the pounding heart and chest pains are only being caused by hyperventilation). This is because we don’t understand that really, hyperventilating is causing them and it’s happening because something has frightened us, and hyperventilating is therefore preparing us for fight or flight. (Always check with your Doc that your heart is ok to begin with of course.)

How to correct hyperventilation?

Paced Breathing:

Breathe in SLOWLY through your nose for 3 seconds and out for five, for a period of 10 minutes. That’s it. Simple – but please do it SLOWLY. The oxygen/ carbon dioxide levels will return to normal and so will the panic symptoms that are being cause by it.

What to do about what originally frightened us?

There are many reasons for panic attacks. A good therapist will establish the origin of the fear and then rationalise it e.g. we may have a panic attack at the thought of going to our manager for an appraisal. The therapist will discuss how likely it is that the appraisal will be bad. If our work so far is pretty good and few or no concerns have been voiced, then it’s likely the appraisal will be fine and that this is anticipatory anxiety.

If our work has been criticised quite a lot; we don’t like it and are maybe unhappy there anyway, and our manager is likely to tell us that s/he has concerns about it, then it would be unethical for a therapist to reassure us that everything will be ok.

A therapist should help us look at the reality – how we can prepare for such a situation e.g. by asking the manager for guidance and assistance in going forward (if the worker/manager relationship is reasonable), by discussing a transfer to an area of work that we prefer or, if we can’t transfer in this particular workplace, even perhaps a change of job (at worst).

That will be a decision for each client to make. The therapist is there only to reduce our panic and distress, clarify as many options as possible if the dreaded situation is a reality, and help us prepare for the consequences of our decision so that we can begin to move on.

If you have panic attacks and you’d like help with them, you’re welcome to email me in confidence at

Anne Kelly is a psychologist and CBT therapist. She has trained several hundred CBT therapists to professional level.