Breathlessness: Anxiety, Oxygen Deprivation, and Neurological Concerns

Many symptoms

Since last month, I have been feeling like I'm lacking oxygen, which has led me to constantly take deep breaths.
I can't seem to stop this habit; whenever I try to breathe normally, I feel uncomfortable and can't maintain it for even a second.
I quickly went to the hospital for an examination.
The doctor explained that I might be experiencing heightened sensitivity due to recent stress, and it's possible that I have mild obsessive-compulsive disorder.
For the past month, I have been gasping for air every moment, which has resulted in headaches and persistent dizziness with bright lights.
Sometimes, my gums feel numb like my feet.

What's increasingly concerning is that my respiratory function seems to be deteriorating.
I don't even feel my breathing; after holding my breath for a while, regardless of how long it is, I don't feel the urge to breathe until I nearly faint.
I am truly frightened.
Even worse, I sometimes forget to breathe while sleeping, as if I'm holding my breath, leading to severe oxygen deprivation that wakes me up suddenly.
I have gotten up seven or eight times in one night, and sometimes I can't even sleep because I wake up as soon as I start to doze off.

The doctor mentioned that this could lead to memory decline, chronic fatigue, decreased cognitive function, and depression.
He advised me to rest for a few days.
I am very worried because I don't know if the memory issues will recover and whether these symptoms are due to brain damage.
I wonder if this excessive breathing and occasional hypoxia could gradually cause damage to brain neurons, leading to the death of some cells.
How could I forget to breathe? I kindly ask for your medical insights on these concerns.
Thank you.

m h, 20~29 year old female. Ask Date: 2001/11/18

Dr. Huang Yingzhe reply Neurology

Dear online user, thank you for reaching out to Taiwan e-Hospital.
Based on the symptoms you described, such as continuous hyperventilation leading to headaches, dizziness, numbness in the teeth, and ultimately an unconscious urge to hold your breath until you feel faint, as well as interruptions in your breathing during sleep, it appears that you are currently experiencing a state of anxiety.

Hyperventilation can lead to a deficiency of carbon dioxide in the body, which, in severe cases, may result in respiratory alkalosis and abnormal sensations throughout the nervous system.
These symptoms are generally temporary and do not cause permanent functional impairment.

As a general recommendation, you can manage hyperventilation by using a plastic bag, approximately the size of your head (ensure it is intact and does not leak), to seal your mouth and nose and breathe into it a few times until your urgent breathing subsides.
If this approach does not resolve your issue, I recommend consulting a psychiatrist for a more detailed evaluation and treatment.
I believe you will see improvement.
Sincerely,
Dr.
Chang Hsun-Cheng,
Attending Psychiatrist, Tainan Hospital, Department of Health

Reply Date: 2001/11/18

More Info

Breathlessness can be a distressing experience, particularly when it is intertwined with anxiety and concerns about oxygen deprivation. Your symptoms, including the sensation of not being able to breathe properly, frequent deep breaths, dizziness, and feelings of confusion, are indeed concerning and can significantly impact your quality of life. It is essential to understand the interplay between anxiety, breathing patterns, and potential neurological implications.

Firstly, it is important to recognize that breathlessness can often be exacerbated by anxiety. When individuals experience heightened anxiety, they may become hyper-aware of their breathing, leading to a cycle of over-breathing or hyperventilation. This can result in a range of physical symptoms, including dizziness, tingling sensations in the extremities, and even feelings of faintness. The body's response to anxiety can trigger a fight-or-flight reaction, which can further intensify the perception of breathlessness.
In your case, the persistent focus on your breathing and the resultant anxiety may have led to a form of obsessive-compulsive behavior surrounding your respiratory patterns. This is not uncommon in individuals with anxiety disorders, where the fear of not breathing properly can lead to compulsive behaviors aimed at controlling or monitoring breathing. It is crucial to understand that while these feelings can be very real and distressing, they are often not indicative of a physical problem with your lungs or heart.

Regarding your concerns about oxygen deprivation and potential neurological damage, it is reassuring to note that while chronic anxiety can lead to cognitive difficulties, the brain is remarkably resilient. Short-term episodes of breathlessness or hyperventilation are unlikely to cause permanent damage to brain cells. However, chronic stress and anxiety can lead to cognitive decline over time, primarily due to the effects of stress hormones on the brain. It is essential to address these symptoms early to prevent them from becoming a chronic issue.

To manage your symptoms effectively, consider the following strategies:
1. Breathing Techniques: Learning and practicing controlled breathing techniques can help regulate your breathing patterns. Techniques such as diaphragmatic breathing or pursed-lip breathing can be beneficial. These methods encourage slower, deeper breaths, which can alleviate feelings of breathlessness.

2. Mindfulness and Relaxation: Engaging in mindfulness practices, such as meditation or yoga, can help reduce anxiety and improve your overall sense of well-being. These practices encourage a focus on the present moment and can help you detach from the overwhelming feelings associated with breathlessness.

3. Cognitive Behavioral Therapy (CBT): Seeking therapy, particularly CBT, can be highly effective in addressing the underlying anxiety and obsessive thoughts related to your breathing. A therapist can help you develop coping strategies and challenge negative thought patterns.

4. Physical Activity: Regular physical activity can improve your overall lung function and reduce anxiety. Start with gentle exercises, such as walking or stretching, and gradually increase the intensity as you feel more comfortable.

5. Consultation with Healthcare Professionals: It is crucial to maintain open communication with your healthcare provider. If your symptoms persist or worsen, further evaluation may be necessary to rule out any underlying medical conditions.

In conclusion, while your symptoms are understandably distressing, they are often rooted in anxiety rather than a physical respiratory issue. By implementing relaxation techniques, seeking therapy, and maintaining a healthy lifestyle, you can effectively manage your symptoms and improve your quality of life. Remember, it is essential to address both the physical and psychological aspects of your experience to achieve the best outcomes.

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