Anyone who’s experienced anxiety knows the feeling: a sudden tightness in the chest, a racing heart, a sense of being unable to take a full breath. This phenomenon, commonly referred to as “air hunger,” is an all-too-familiar symptom for those living with anxiety and panic attacks. The sensation of being unable to breathe, though incredibly distressing, is often more psychological than physical. Yet, understanding why it happens and learning how to manage it can make a world of difference for those navigating this anxious breathlessness.
What Is Air Hunger?
For many people with anxiety, air hunger is an intense and often frightening experience. Heather Ann Voyer, who was diagnosed with anxiety in her mid-20s, describes it as an overwhelming feeling of not being able to catch her breath. Over the years, she has encountered episodes of rapid heartbeat, muscle tension, and the kind of breathlessness that sends panic spiraling out of control. “When I can’t breathe, I panic,” Voyer says. “It’s like pressure in my chest, my heart flutters, and my fingers go tingly from hyperventilating.”
Air hunger, while not a physical breathing problem like asthma or chronic obstructive pulmonary disease (COPD), can mimic the sensation of suffocation. Kim Nowak, a clinical therapist who has personally dealt with panic attacks, describes it as “breathing through a straw” or feeling the chest tighten. It’s a vicious cycle: the more you try to control the breath, the more panicked you become, which only worsens the sensation.
Why Does Air Hunger Happen?
Air hunger is closely tied to our body’s autonomic nervous system, which controls involuntary bodily functions, including breathing. During a panic attack, the sympathetic nervous system is activated, triggering the body’s fight-or-flight response. This response causes rapid, shallow breathing as the body prepares for danger. However, in a moment of panic, the danger is often perceived but not real, and the body’s natural response to stress can become overactive.
Jeffrey R. Strawn, a psychiatrist at UC Health, explains that during such episodes, the brain may misinterpret normal bodily sensations, such as increased heart rate or shallow breathing, as threatening. This heightened sensitivity is known as interoception, a heightened awareness of internal bodily sensations. When this process is dysregulated in those with anxiety, even normal, harmless changes in breath or heart rate can feel dangerously overwhelming, triggering a full-blown panic attack.
Coping with Air Hunger
The instinct when experiencing air hunger is often to breathe more rapidly, but this can make the situation worse. Instead, focusing on slower, controlled breathing can help activate the parasympathetic nervous system, the body’s natural “calming” response.
Strawn recommends a simple but effective technique called paced breathing: breathe in for a count of four, hold for four, and exhale for six to eight counts. Nowak adds that it’s important to focus on exhales that are longer or equal to inhales, which helps prevent hyperventilation.
In addition to breathing exercises, cognitive reframing can be a powerful tool. Nowak suggests that once a healthcare provider confirms that the breathing difficulties are linked to anxiety, shifting negative thoughts can help. Instead of thinking, “I can’t breathe,” she encourages reframing the thought to, “This is how I breathe when I’m anxious. It’s uncomfortable, but it won’t last forever and it’s not dangerous.” This change in perspective can reduce the intensity of the experience.
For Nowak, cognitive behavioral therapy (CBT) has been instrumental in her own healing journey. CBT helps individuals reframe their thoughts, manage their symptoms, and change how they relate to anxiety. As Nowak explains, “It’s about sitting with the anxiety and retraining your brain to understand that these symptoms, though uncomfortable, are not life-threatening.”
Grounding techniques, such as holding a cold object or naming objects in the room, can also help shift focus away from the breathlessness and distract from the anxiety spiral.
Medication and Managing Air Hunger
For some individuals, medication may be necessary to manage the underlying anxiety that causes air hunger. Strawn points out that people with panic disorder, especially those who experience prominent respiratory symptoms, may benefit from antidepressants. For others, particularly those whose panic attacks are more situational, benzodiazepines might be prescribed for immediate relief.
Recent research also suggests that people with panic disorder may be especially sensitive to inhaled carbon dioxide, which can trigger feelings of suffocation and panic. Understanding this sensitivity is key in selecting the right treatment.
Voyer, who has tried various medications to manage her anxiety, shares that finding the right regimen can be a trial-and-error process. “Coping skills are important to learn but difficult to implement unless you practice them outside of an anxiety attack,” she says. Alongside therapy, she relies on tools like meditation and having a Crisis Plan on hand — strategies that help her feel more grounded and prepared.
The Takeaway: Managing Breathlessness in Anxiety
While air hunger can be a deeply distressing symptom of anxiety, it is important to remember that it is not life-threatening. It’s a sign that the body’s natural response to stress is in overdrive. By using breathing techniques, reframing anxious thoughts, and seeking appropriate treatment, those who experience air hunger can regain a sense of control.
Living with anxiety doesn’t mean living with breathlessness. With the right strategies and support, you can learn to manage the physical symptoms, break the cycle of panic, and breathe more easily — both literally and figuratively.
