Breathlessness - difference between anxiety and lungs causes

Hi,

Ive got asthma and possibly pulmonary eosinophilia - have been very breathless for the last few weeks but lung function tests were not too bad. Have been told that I don't have chest infection , also had echo heart test which was ok.

Just wondering - if it could be caused by anxiety and how can I recognise?

The main symptom-I cannot take deep breaths and also cannot breath in the stuffy office/rooms

20 Replies

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  • Hi

    Apart from aniexty you may have problems with triggers, as well as aniexty I have issues with household products, perfumes, and airfresheners especially Air wick automatic fresheners.

    Aniexty is the fear of xxxxxxx. If you are thinking the worse then this can lead to panic attack.

    You need to write down the situation your in, the environment and any thoughts you're having.

    Explain this to your respitory nurse and I am sure a solution will be found either by breathing exercises or medication.

    I have benefited from lorazepam half tablet twice daily, not suited for all but your GP can advice on any medication that suits you.

  • I've been wondering the same lately. Iam naturally anxious and always had trouble breathing with my daily panic attacks. Since my xray and scans showed emphysema I'am never too sure if if it's caused by anxiety or if it's a symptom of my lung issues.

    Perhaps a way to know if its anxiety-related or lung issues is to check when you exercise, run or make extra efforts: I would think that if you get respiratory issues and feel unusually SOB after exercising or making extra efforts then it could be lung related but if you feel "fine" and only get moderately breathless due to exercising then it could just be anxiety related ?

    But I see what you mean, it can be hard to differenciate between anxiety and real respiratory issues....

  • Hi

    I've posted some of this earlier but have extracted the main bit about anxiety for you. I get very anxious especially when confronted with a new situation outside my comfort zone.

    I had a long chat with my respiratory nurse yesterday about this anxiety, and she agrees with me that it's caused by the extra adrenaline in our bodies from being SOB, but also from some of the inhalers.

    Once the negative thoughts begin it's hard to be positive and convince self that you can cope. However much you "talk" to yourself and work out coping strategies, your body isn't listening

    Bless her, she's prescribed diazepam to take when I get very anxious, so am not on it all the time, just on the day when I have to face an unknown and am excessively anxious

    Hope this helps

  • Hi, is diazepam sedative and addictive ?

  • Yes, it is a sedative, and can be addictive if taken over a long period of time without proper reviews. I wouldn't take it regularly unless very ill with anxiety all the time. I've been prescribed the lowest dose - 2mg - and told to take one tablet on days when I'm facing something that's making me anxious. Judging by my usual routine that will be one a month at the most!

  • It is hard to diagnose anxiety induced breathlessness. After a stressful moment the breathing should return to normal. If not there are breathing controls you could learn to help with that. And also relaxation techniques. All available on the Internet. The best test for dysfunctional breathing is a cardio-pulmonary-exercise test. But your doctors may be reluctant to set that up unless they were also looking for other cardio-pulmonary problems. What you can do is simply know your own body and its reactions. If good breathing and relaxation techniques don't bring about an easing in your breathlessness then it is reasonable to assume that there is a physical cause. The classic signs of dysfunctional breathing are a feeling of not being able to inhale properly, sometimes characterised as "air hunger", frequent sighing, palpitations, tingling in the lips and fingers. If it really is problem for you then a few sessions with a respiratory physio should help.

    Sorry about the lecture. Having been frequently told I have dysfunctional breathing it is something that I have investigated. As it happens I don't.

    It is route that doctors take too quickly.

    All the best

    K x

  • Hi Kate, Thank you for the 'lecture' - it was very useful.

    Nobody really mentioned anxiety to me - I am just at my wits end!

    I do have issues with inhaling, recently went on Buteyko course - it didn't help! The breathlessness is getting worse every day - I haven't been to work for a couple of months as I feel very breathless in the stuffy office. It usually not too bad when I wake up but its getting worse within an hour or so .

    Had quite high blood eosinophils but they are not too bad now, lung function didn't deteriorate , CT showed air trapping which is , according to my consultant, a sign of eosinophilic asthma but shouldn't cause severe breathlessness , I asked him about respiratory physio a few times but he just dismissed it.

    I am on seretide, keep taking prednisone ( 2 weeks courses) but they don't help. Tried Spiriva, montelukast but they didn't help either

    Feeling breathless all day- every day and no explanation whatsoever!

    My next appointment with the pulmonary consultant is in 3 months time and up to then I am on my own.

    I had a pulmonary exercise test with inconclusive results ( they promised to send it to another consultant to interpret but it never happened) , also had laryngoscopy which was ok.

  • Hi , I went on a Buteyko breathing course many years ago...it did help me but I had recurring chest infections ...antibiotics and steroids frequently so it wasn't the cure all I hoped.

    I have no infection now so I actually started Buteyko exercises again this morning.

    Some Buteyko teachers are better than others...it's a lot of money to spend if the course is not helpful. My eldest daughter has found an excellent teacher in London who concentrates on gentle breathing.

    Have you tried the pursed lip breathing technique which can help some people with air trapping.....you can find it on you tube.

    There are videos there too which illustrate gentle diaphragm ...belly breathing ....not tight upper chest inhalation.

    I wonder if a change of inhaler would help you...I have had problems with some.

  • Hi Knitter, I keep asking about different inhalers - but always get a reply - 'they are all the same!'

  • Hey thanks for that reply, it's useful. The "air hunger' you describe with frequent sighing is exactly what Iam feeling everyday at the moment. It could be because I quit smoking. Also I was doing meditation almost everyday for a year and stopped a month ago after I was told about copd, I know this is probably when I need the meditation the most but at the moment Iam so "wired" it's impossible for me to sit down and relax like I use to when meditating. I manage some days to continue with deep belly breathing but find it a lot harder to relax nowadays. Thanks for the tips !

  • Hi if you have copd then that alone can be a reason for breathlessness. Anxiety can make it worse though. x

  • Hmmmm...

    I am concerned about some of the things you have mentioned. I am not a doctor and just make it up as I go along but I do very much identify with people who are breathless and are getting nowhere. It is taken huge determination and gentle pushing (friends have said that I am too gentle) to get where I am. If I had accepted what doctors have said to over the past six years I would be a gibbering wreak. Do you feel that the air trapping is permanent and irreversible, i.e. it does not respond to bronchodilators? If so then they need to think again about dx. Buteyko breathing helps some but is not the universal panacea that is claimed.

    Did it all happen quickly? If so again that should trigger certain concerns in the doctors minds. Very few lung conditions are like that. COPD and long term damage from Asthma develop slowly.

    Sorry to go on, but unusual lung conditions have become a bit of an obsession of mine.

    Please keep in touch, I REALLY want know how things go.

    Kate xxx

  • Hi Kate, I really appreciate your interest, nobody else, including 4 respiratory consultants that I saw in the last few years, seems to be terribly interested ! Just came back from my GP and he said, ' No chest infection, don't have a clue' .My respiratory problems started as chronic cough about 6 years ago, the cough lasted for 3.5 years, then became manageable on seretide, but then the shortness of breath started 2 years ago , and it got progressively worse - I haven't been able to walk for more than a couple of hundred meters for a couple of years now, but at least I used to drive to work , now I cannot stay in the office either ( even in the meeting rooms with air conditioning and fan) . I had lung functions, 4 CTs , laryngoscopy, gastro reflux Bravo test, just don't know who else can I ask!

    Asked my consultant about unexplained breathlessness service in Royal Brompton and he said they would do the same tests .

    I am not under stress really, the only stress I am getting is from the condition itself. I never was diagnosed with copd, only with eosinophilic asthma - at some point my eosinophils reached 28% but they are not too bad now,

  • Hmmmm.... Can I ask if you are/were a smoker?

    I believe the RB doctors who do unexplained breathlessness are good. I was told that Dr Mike Polkey would sort out anything! But I don't know if he's still there.

    Has anyone mentioned Small Airways Disease? That fits with the air trapping. What are your Spirometry readings and PFTs coming up with? SAD are very difficult to dx. PFTs can be normal with SAD. And any Spirometry abnormalities indicate that the disease is 'advanced and widespread.'

    Keep the info coming. I thrive on it!

    All the best

    Kate xx

  • No, never smoked. The PFT are normal and my peak flow doesn't change, also I am not responsive to salbutamol.

    Prednisone used to help at the beginning , but doesn't help anymore.

    Seretide probably slightly helps - I was told that I cannot stop taking it but at some point I thought that it could cause the breathlessness so stopped for a week and the cough came back. Not sure if I need the LABA (salmetrol) component of seretide as it just causes extreme hoarseness -I also tried to take flixotide separately -the steroid component of seretide.

    At some point I ordered peptest (reflux test) over the internet and it showed significant reflux but my consultants don't accept this test,, so I had the more acceptable , mainstream Bravo test and it didn't show any reflux - but it cannot measure the' silent' reflux which usually causes the breathlessness

    Also feel breathless when talking - haven't seen my friends for a while!

    xx

  • Hi again, could you go back to your Buteyko teacher and tell them of the problems you are having.....they should help you....aftercare is part of the course.

    I have had problems with Serevent in the past...the LABA element of Seretide.

    Have you tried Bricanyl instead of Ventolin...my daughter finds it more effective...but I don't.

    It's strange that you have been told that Seretide is the same as other inhalers....they are different drugs, and we are all genetically different ...what suits one may not suit another.

    I try and meditate to calm myself....if I am too wired listening to music can help or a bit of yoga .

    There is a website called normal breathing ,, which explains the effect of disordered breathing or hyperventilation on the body.

    Please contact your Buteyko teacher again for advice...I am going to do my breathing exercises now with the help of an ancient cassette tape.

    Best wishes

  • Hi knitter, I wonder if buteyko exercises can cause more breathlessness - I just feel much worse since I started them a month and a half ago. I was recommended to do relaxed breathing -60 min reduced breathing a day with extended pauses, which exercises do you do?

    Xx

  • Hi again, just a few thoughts when I was doing my Buteyko.......have you had any allergy tests...skin or blood ones.

    I find birch pollen makes me worse, and we had a silver birch in the front garden. My daughters are allergic to dogs, cats, small mammals, and one to grass pollen and horses.

    I have been prescribed antihistamines for when the pollen count is high.

    There was no sign of infection in your sputum when it was tested was there. I used to have a long term infection which hopefully now is gone.

    I hope you find some answers soon ..take care.

  • Hi. how are you, yes, had allergy tests, seem to be fine. I never had a sputum test - nobody offered!

  • The weather recently has been bad for people with lung disease. The combination of humidity and high pollen has wiped me out and I'm struggling more than usual.

    I also find that if I get anxious (maybe about being SOB or facing an event outside my comfort zone) that I get SOB faster than usual

    I had a long chat with my respiratory nurse yesterday about this anxiety, and she agrees with me that it's caused by the extra adrenaline in our bodies from being SOB, but also from some of the inhalers.

    Once the negative thoughts begin it's hard to be positive and convince self that you can cope. However much you "talk" to yourself and work out coping strategies, your body isn't listening

    Bless her, she's prescribed diazepam to take when I get very anxious, so am not on it all the time, just on the day when I have to face an unknown, and am excessively anxious

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