Autonomic Nervous System and Panic Disorder: Insights and Solutions

Autonomic Nervous System and Panic Disorder Issues

Hello Dr.
Jiang: I have been suffering from respiratory compulsions for many years (since transitioning from elementary school to junior high).
I have developed a habit of controlling my breathing.
This condition has led to high blood pressure and palpitations (my heartbeat feels very strong, and I can feel it at all times, even causing my body to shake; my blood pressure often exceeds 140, which is considered hypertension).
I frequently experience headaches and tension in my head.
During my military service, the military doctor mentioned that this situation seems to be related to autonomic nervous system dysregulation and anxiety.
However, the results from my physical examinations indicated that my heart appeared to be fine.

Could you please advise me on any breathing techniques that could help me regulate my breathing? I have researched that extending the exhalation time can stimulate the parasympathetic nervous system, which slows my heart rate and lowers my blood pressure, and it seems to be effective.
Therefore, whenever I measure my blood pressure, I take slow, deep breaths to ensure the reading is normal.

I would like to ask if my habit of consciously controlling my breathing, which leads to a stronger and faster heartbeat and higher blood pressure, will cause my heart to age more quickly in the future.
Will my heart be damaged? Are my blood vessels and organs being harmed due to high blood pressure? I remember that every organ in the body has its lifespan and usage limits; if my heart beats too fast or too forcefully, it increases its usage, potentially reducing its lifespan and accelerating aging.
Could respiratory compulsions therefore shorten my lifespan? This habit has persisted for about 20 years.
Thank you.

A-Pang, 30~39 year old female. Ask Date: 2019/05/08

Dr. Jiang Junyi reply Neurology

Hello, based on your description, there are many factors that can cause elevated blood pressure symptoms, such as metabolic syndrome (hypertension, hyperglycemia, hyperlipidemia, and obesity), autonomic nervous system dysfunction (excessive stress), and medications (such as the antihistamines you are taking, especially if they contain vasoconstrictors).
Regarding the autonomic nervous system, many hospitals now have autonomic nervous system testing devices, which can be combined with psychological therapy.
If your blood pressure is elevated, it is recommended to start with dietary improvements (the "DASH diet" is suggested) and engage in moderate exercise.
It is advisable to discuss testing and treatment with an internist or family medicine physician (at least to assess for metabolic syndrome and other potential causes of hypertension).
Wishing you good health and peace.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2019/05/08

More Info

Hello, thank you for your detailed inquiry regarding your experiences with obsessive-compulsive breathing patterns, anxiety, and the implications for your cardiovascular health. It seems that you are dealing with a complex interplay of the autonomic nervous system (ANS), anxiety disorders, and their physiological effects on your body, particularly your heart and blood pressure.

The autonomic nervous system is divided into two main branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The SNS is often described as the "fight or flight" system, responsible for preparing the body for stressful situations by increasing heart rate, blood pressure, and respiration. In contrast, the PNS is known as the "rest and digest" system, which promotes relaxation and recovery by slowing the heart rate and lowering blood pressure.

Your experience with panic disorder and obsessive-compulsive breathing can indeed lead to dysregulation of the autonomic nervous system. When you engage in forced breathing patterns, it can trigger the sympathetic nervous system, leading to increased heart rate and elevated blood pressure, as you have described. This can create a feedback loop where anxiety exacerbates your symptoms, leading to further distress and physical symptoms like headaches and a feeling of tightness in your head.

Regarding your concern about the long-term effects of these patterns on your heart and overall health, it is important to understand that chronic stress and sustained high blood pressure can indeed have detrimental effects on cardiovascular health. Over time, elevated blood pressure can lead to damage to the blood vessels, heart, and other organs, potentially increasing the risk of heart disease, stroke, and other serious health issues. However, the body is resilient, and with appropriate interventions, many of these risks can be mitigated.

You mentioned that you have found some relief by extending your exhalation, which is a technique that can stimulate the parasympathetic nervous system and promote relaxation. This is a valid approach, as controlled breathing techniques, such as diaphragmatic breathing or paced breathing, can help regulate your heart rate and blood pressure. Here are a few techniques you might find beneficial:
1. Diaphragmatic Breathing: Sit or lie down comfortably. Place one hand on your chest and the other on your abdomen. Inhale deeply through your nose, allowing your abdomen to rise while keeping your chest still. Exhale slowly through your mouth, feeling your abdomen fall. Aim for a longer exhalation than inhalation (e.g., inhale for 4 counts, exhale for 6 counts).

2. Box Breathing: Inhale for 4 counts, hold your breath for 4 counts, exhale for 4 counts, and hold again for 4 counts. Repeat this cycle several times. This technique can help calm the nervous system and reduce anxiety.

3. 4-7-8 Breathing: Inhale through your nose for 4 counts, hold your breath for 7 counts, and exhale through your mouth for 8 counts. This method can help promote relaxation and improve sleep quality.

4. Mindfulness and Meditation: Incorporating mindfulness practices can help you become more aware of your breathing patterns and reduce anxiety. Techniques such as guided meditation or yoga can be particularly effective.

As for your concern about the longevity of your heart and overall health, it is crucial to address these breathing patterns and the underlying anxiety. While chronic stress and high blood pressure can contribute to cardiovascular issues, adopting healthy coping strategies, engaging in regular physical activity, maintaining a balanced diet, and seeking professional help for anxiety can significantly improve your overall health and potentially extend your lifespan.

If you have not already, I recommend discussing your symptoms and concerns with a healthcare professional who specializes in anxiety disorders or a cardiologist. They can provide personalized guidance and may suggest further evaluation or treatment options tailored to your needs.

In summary, while your concerns about the effects of your breathing patterns on your heart and health are valid, there are effective strategies to manage anxiety and improve your autonomic regulation. With the right approach, you can work towards a healthier and more balanced life. Thank you for sharing your experiences, and I wish you the best on your journey toward better health.

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