So I've been having moderate to severe panic attacks for around 5 years now. They come and go, but recently I've been going through a rough patch. It seems like I can go a few months really calm, and then get hit hard with heightened anxiety and nocturnal and regular panic attacks for weeks at a time. When it first started years ago, I'd get attacks multiple times a day especially when eating and even went to the ER. I took some heart tests with my doctor and he ruled out any problems with that. So back to the topic, I initially only thought panic was a fight or flight response by some trigger that wasn't there, which would explain all the physiological changes. It can literally tire you out like you actually did fight or flee. Doing some research recently, I've come across a lot of new info regarding breathing and just wanted to know which was sound and which was bunk scientifically speaking. There's a school of thought that says if we breathe in too much air it raises our anxiety, causing too much oxygen in the blood and not enough carbon dioxide. This explains hyperventilation, because we breathe out way too much CO2 and in too much oxygen. This is why people say to breathe through a paper bag, to replenish your CO2. They propose nasal breathing 24/7 and to breathe slower as it helps regulate our oxygen and gives CO2 a chance to accumulate in our blood. It could result in acidosis however, but I've heard there were tons of benefits to nasal breathing. On the other hand, I've also heard the complete opposite. I've just read studies that say acidosis itself can cause anxiety and that if you're predisposed to anxiety just the presence of certain amounts of CO2 in the air can induce panic attacks. This would suggest nasal or slower breathing to produce CO2 in the body would be detrimental. I've been trying the nasal breathing method these past couple of weeks and I'm wondering if maybe that's why my anxiety has been through the roof and having nocturnal panic attacks every night and some during the day. I don't want to give up nasal breathing as it seems to have a ton of other benefits (like air filtration, nitric oxide production etc) I'd just like to know what scientific consensus has to say about this. Should I try to breathe slowly and through my nose to increase CO2, or more naturally including with mouth for higher oxygen levels? Thanks!
Here’s what I mean.
First study:
Brainstem response to hypercapnia: a symptom provocation study into the pathophysiology of panic disorder - PubMed.
So this study seems to show that breathing with 100% oxygen was fine, but in those susceptible to panic, attacks set in once CO2 was added. Meaning we should avoid this hypercapnic state?
Second study:
This study shows the opposite and states that panic disorders settled down with increased CO2.
Does anyone have any thoughts? I feel I’m missing something obvious.