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Hyperventilation Symptoms: How they may lead to panic, anxiety, or substance use

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 Hyperventilation Symptoms: 

How they may lead to panic, anxiety, or substance use

by Julie Myers, PsyD, MSCP

Licensed Clinical Psychologist in San Diego;

Many people with panic/anxiety symptoms are hypervigilant to internal body sensations, such as the subtle changes brought about by an increase in breathing rate.  Mild anxiety or fear may trigger faster breathing in order to prepare the body for fight-or-flight via the sympathetic nervous system.

Faster breathing increases the amount of oxygen in the blood stream.  Unless the body steps-up activity to use this oxygen, the oxygen level can build up while the carbon dioxide (CO2) level decreases.   A decrease in CO2 causes the blood to become more alkaline, which causes the hemoglobin in the blood (which carries the oxygen to the body) to bind more tightly to the oxygen, refusing to disperse the oxygen to the tissues and organs.   This overbreathing is called hyperventilation.

Decreased oxygen availability in the tissues and brain may cause feelings of dizziness, light headedness, confusion, breathlessness, blurred vision, and feelings of unreality.  It also decreases blood in the extremities (which causing them to become cold and/or tingling), and causes sweating, muscles tension, and an increase in heart rate.

Individual react to these symptoms in different ways.  For some, these subtle changes may lead to a full-blown panic attack, which is a period of intense fear and arousal, where the person may feel like they are dying or going crazy.  Panic attacks may decrease a person’s willingness to engage in important activities, such as driving, because of the fear of having another attack.

Other individuals may attempt to reduce these symptoms by using alcohol or drugs.   Alcohol and many drugs (particularly those considered “downers”) can bring immediate relief of anxiety/panic symptoms.  The alcohol/drugs may slow down breathing, reduce sympathetic nervous system arousal, and bring fast relief.  However, relief is only temporary and usually results in an increase in anxiety once the drugs/alcohol wear off.

Different therapies are available to treat symptoms of panic/anxiety resulting from hyperventilation:

  1. Breath retraining techniques can help to decrease symptoms.  Retraining involves teaching the person to breathe more slowly, smoothly, and with a relaxed diaphragm.  Such breathing reduces the sympathetic nervous symptom response, hence reducing anxiety.  Training can be accomplished by psychophysiological techniques and/or with biofeedback.
  2. Interoceptive exposure, which teaches a person to recognize and tolerate normal bodily sensations such as overbreathing.
  3. Cognitive Behavioral Therapy (CBT) can help individuals recognize the thoughts, emotions, and behaviors involved in anxious reactions.
  4. Exposure to feared situations, either gradually or by “flooding”.
  5. Medications, such as SSRIs.
  6. Reduction of or abstinence from alcohol and other drugs.

What is Biofeedback?

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What is Biofeedback?

by Julie Myers, PsyD, MSCP

Licensed Clinical Psychologist in San Diego;


Biofeedback is a therapeutic technique that uses technology/computers  to help you become more aware of the subtle changes that occur in your body. Once you are more aware of them, you can control them better.

How does Biofeedback work?

Many physiological processes in your body are hard to detect, but computerized monitoring allows you to notice them better. The monitored information is then “fed” back to you in an understandable form. By being able to see this information on a computer monitor, you can learn how to control the processes better.

Why would I care about controlling my physiological processes?

Most people know that we control our body by using our mind. For example, if we are agitated, we can use our brains to calm our body. But did you know that many nerves that control our behavior actually go from the body to the brain? If you can create a calm body, you can create a calm state-of-mind.

What will biofeedback help me with?

Biofeedback has been used for stress and anxiety disorders (including muscle tension and panic), TMJ, low back pain, chronic pain anywhere in the body, migraine headaches, breathing disorders, Raynaud’s Syndrome, IBS, hypertension and addiction (when you are calmer cravings tend to diminish). There are also many additional health benefits from biofeedback.

What physical processes does biofeedback monitor?

The most common physiological processes monitored are heart rate, respiration (breathing), sweating, peripheral temperature, blood pressure and muscle tension.

How does receiving feedback about physiological processes help me control them?

If you shot a basketball in the general direction of the basket, but could not see the basket itself, your shooting would not improve. When you set the goal of relaxing, and then get feedback about exactly what is happening in your body, you will get better at relaxing.

How fast does Biofeedback work?

As with any therapy, the results will vary depending on your condition. Although lasting results may take 10 sessions or more, some people see results in 3-4 sessions. As with learning any skill, how fast you improve will depend on how much you practice.

What is a typical biofeedback session like?

Your biofeedback therapist usually begins treatment with a comprehensive assessment of your physiological processes and your awareness of them. Then you will jointly design a biofeedback training program to improve your capacity for self-regulation, based on your needs and goals. Electrodes are “pasted” to you so that you can get feedback on the computer monitor. The paste is easily wiped off. The electrodes do not transmit any electricity to you. You therapist will guide you through the entire process. Near the end of each session you will discuss the progress made, and the next steps to take. If you rent or purchase small practice equipment and use it at home you will make faster progress.


This sounds like meditation.

You’re right! There are many similarities between meditation, yoga, self-hypnosis, and biofeedback. However, biofeedback can help you achieve awareness of physiological processes much more quickly than other techniques. If you already use other techniques, you can master them faster!

Reference: Julie Myers, Psy.D. is a licensed clinical psychologist in San Diego.  She is Board Certified in Biofeedback.

Written by Julie Myers, PsyD, MSCP

July 28, 2011 at 2:50 pm

What’s Your Caffeine IQ?

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What’s Your Caffeine IQ?

by Julie Myers, PsyD, MSCP

Licensed Clinical Psychologist in San Diego;


Caffeine Facts

For most people, moderate caffeine (200 – 300 mg, or about 2-3 cups of coffee a day) aren’t harmful.  But heavy caffeine use (more than 500 mg) can cause insomnia, nervousness, restlessness, irritability, nausea or other gastrointestinal problems, fast or irregular heartbeat, muscle tremors, headaches, and anxiety.

Some people are more sensitive to caffeine than are others.  Even one cup of tea may prompt unwanted anxiety, restlessness, irritability, and sleep problems. Research suggests that men may be more susceptible to caffeine than women.

Caffeine can interfere with sleep.  Sleep loss is cumulative, and even small nightly decreases can add up and disturb your daytime alertness and performance.  Caffeine keeps you from falling asleep at night, increases the number of times you wake during the night, and interfere with deep, restful sleep. Try to avoid caffeinated beverages eight hours before bedtime.

Reducing Your Intake

Too abrupt a decrease in caffeine can cause withdrawal symptoms that include headaches, fatigue, irritability and nervousness. Fortunately, these symptoms resolve after a few days. Try these simple tips:

  • Keep track of how much caffeine you use daily
  • Cut back gradually to lessen withdrawal effects.
  • Substitute decaffeinated beverages.  Try drinking half decaf.
  • Lower the caffeine content by brewing tea for less time or drinking weaker coffee
  • Read labels to check for caffeine content



1       Mayo Clinic Staff,, Nutrition and healthy eating. “Caffeine: How much is too much?”, March 5, 2010