British Lung Foundation
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A Strategy for Dealing With Stress

At some point, all of us get into some sort of a stressful situation. Maybe we've done too much too quickly, or had a shock of some sort. We end up with low oxygen levels, panting and panicky, and our heart rate goes up. We're in trouble.

First thing to do is STOP. Whatever it is we're doing STOP... NOW.... Find somewhere to sit (best option), or at least something to lean on. Take your rescue drugs (for me Ventolin and Atrovent). Start pursed lips breathing (most 'old hands' will do this automatically). Concentrate on blowing out more air than you breathe in. If you have a pulse/oximeter, use it. After about five minutes, if you are still struggling to get to regular breathing, repeat the rescue inhalers. All rescue drugs are safe for repeated use if needed. If another five minutes passes and you are not on the road to recovery, GET SOMEONE TO CALL AN AMBULANCE!!!! It could be that you need nebulised drugs and oxygen to get you to stabilise. If your breathing is still ragged and you are struggling, you do need help. There is nothing to gain by being a hero.

That's the breathing side dealt with, what's the heart doing meanwhile? Probably going like the clappers. I know that if I get into trouble, my heart rate goes up, a lot. My normal PR (Pulse Rate) at rest is about 105. A short walk will take it up to 120. Doing pulmonary exercises can take my PR up to just over 130. A panic attack? 150/160. Serious, and not good.

How to deal with this? Use a relaxation technique. The benefits of doing this was shown to me and others on the course when I attended a Pulmonary Rehabilitation course about two years ago. It was used as part of the exercise programme as a part of the finishing set. We all said that we felt the benefit. One the Occupational Therapists would lead this by reading a script about five minutes long, usually describing a gentle journey through a tranquil landscape. We would sit, close our eyes, a try to imagine ourselves following this journey. We all learned from this that we COULD in some way control our heart rate, and slow it down quicker than a 'normal' recovery. What made this work was the rhythm of the words, changing from fairly fast gradually to a good bit slower, along with a change in how the view was described. Clever writing! But, for me, this had a flaw, the scripts were too long, too much to remember when in a difficult situation. So I came up with a slightly different way of doing it, which did not need me to recall a long script. Here it is.

Imagine a ball. It's about the size of a football. It's red. It's bouncing. One bounce for each of your heart beats. Feel your heart beat. Match the bounce. A low bounce is faster than a high bounce. When you have got the bounce right (with practise, you will do that in a few seconds), change the colour of the ball to orange, and make the bounce of the ball a little higher to slow it down a fraction. Be careful not to slow the ball too much, or you will lose the synchronisation with your heart beat. At the same time, do pursed lips breathing. In a few seconds (10 to 20) you should feel that your heart has slowed a little. Change the colour of the ball again, to yellow. Make the bounce a little higher again to slow it again. When you get your heart beat to match the bounce again, change the colour again, and so on. I find that I can usually slow my heart rate down by about 5 beats per minute using this, so from about 140 down to 110 takes 6 or 7 minutes, which I think is pretty good going. The colours. I go through the colours of the rainbow Red to Violet, because it's easy to remember, and using the same sequence gives a comparison to previous times so you know how it's going THIS TIME. If your recovery is much longer than usual, it's often an indication of something wrong that needs to be seen to. The ball. Not important, just something comfortable that you can bounce in your mind.

Remember, Red ... Orange ... Yellow ... Green ... Blue ... Indigo ... Violet.

When you have gone through the colours, if it's not enough, start again.

Like many other exercises for helping out when we're not so good, this needs to be practised when we're OK, and on an even keel.

I hope that some of you might get something useful out of this. I know it works for me.

breathe easy


17 Replies

Excellent - knowledge shared is what this site is great for. For me, if I get a panic over breathing, advice given by a wise physio was simply to think of a family member who was dear to you, this fools the brain into forgetting that it is panicking. :) xx


good advice, the same strategy works for moderate pain too


I remember when I had my ears pierced, the first one really hurt, when he done the other one I couldn't feel the first one any more, lol, wouldn't recommend causing yourself pain to ease your breath


Thank you, will try to remember this :) xx


Thanks John.



Thanks for your advice and scrobbitys..I will try to remember what to do if I get into another panic as I did yesterday evening when I couldn't reach my inhaler

Meditation classes have calmed me down a lot, but still get the occasional "blip"... just got a book and cd on Zen meditation... instructions and 40 minutes of silence!


Interesting reading, John. Also made a note on Zen meditaton to find out what it is. Need something with this heat.


many thanks, this is just the kind of advice I need as i suffer badly with such attacks. I have not managed to find a way of preventing them - any suggestions ?


I'm not sure there is fool proof method of preventing them but I have found that they lessen in frequency the better you are able to deal with them, almost like subconsciously there is no point in having one if you can rid them quickly. :) xx


thanks scrobbity,i guess i will have to practice the breathing technique and try to gain confidence.


I think that is the key word - confidence. What they teach at Pulmonary Rehab classes is that shortness of breath won't kill you and that you should be able to control it sufficiently to allow you to do things that otherwise you thought were beyond your reach. I started off by making sure I did three things every day that challenged me and by the end of the week, instead of automatically saying 'no' to invitations I said 'yes' and just got on with it. When the breathing is relatively good, I even park a bit further away from my intended destination to push myself a bit. Having said that, there are definitely days where no matter what I try it doesn't work, so just say 'stuff it - I'll have a not doing anything day' LOL :) xx


Good post with great advice :) Thanks johnwr :)

Sandra x x x


Hello John wr,

Wonderful and a great instructional post. Will try some of your suggestions.



johnwr has done some great blogs in the past too, one of his:-!/#blf/p...

is what brought me to this forum last year and helped me greatly. Click on his name to see all his blogs. Libby

1 like

Nice informative post. I can control my breathing to a certain extent, but if my heart plays up I have been told to dial 999 immediately.



Great post,always look forward to yours,very informative,as always xxx


thank you for your advice re panic attacks .I'm new to the site and found your old post this morning. ichyfeet


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