Several things can be done to control hyperventilation, each of which may be helpful for different individuals.
A hyperventilation test (described above) may be helpful in establishing the role of hyperventilation in producing some of the symptoms associated with panic. If overbreathing provokes anxiety, then control of hyperventilation may prevent or relieve those symptoms. Knowing that hyperventilation symptoms can be very distressing but are not harmful provides some comfort even while these symptoms are occurring.
Specific techniques to gain control of overbreathing are also available:
1. Cover your mouth and nose with a small paper bag and breathe into and out of it. This technique causes some rebreathing of the carbon dioxide that you have just exhaled.
2. Slow your breathing rate by using a clock to breathe (for example, breathe just once every five seconds, or 12 times a minute). This technique can bring runaway breathing under control.
3. Consciously take smaller breaths; this will reduce the volume of air being moved with each breath.
4. Try belly breathing (breathing mainly with the diaphragm and not with the chest) to control hyperventilation. One technique for learning belly breathing is to spread your hands and fingers around your ribcage and then breathe, as much as possible, by merely moving your belly in and out and keeping your ribcage nearly still. As your belly moves in and out, it reflects the movements of the diaphragm, which provides ample ventilation for a person at rest.
5. Rehearse the words “slow and shallow” to the point at which they become a reflex thought when symptoms of hyperventilation appear.
All of these methods decrease overbreathing and help to restore the blood electrolytes (carbon dioxide, bicarbonate, calcium, and phosphorus) to normal levels. As the ventilation of the lungs and the blood’s electrolytes return to normal, the symptoms of hyperventilation disappear.
Practicing methods to control overbreathing provides many who suffer panics with something useful to do when panic occurs. There is some evidence that combining these methods with exposure therapy improves results in people who hyperventilate as part of their panic or other Anxiety Disorder. However, it does not appear that methods to control overbreathing are sufficient by themselves to overcome Anxiety Disorders. Exposure therapy—and, in some patients, medications—are usually necessary.
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