How Deep Breathing Can Worsen Trauma Responses

“Take a breath” is advice that’s often dispensed to those who experience trauma responses which can manifest as panic attacks, hypervigilance, and dissociation. Usually this is wonderful advice, as deep breathing practices have been shown to decrease your heart rate, which can quickly calm your body and mind. In addition, many people incorporate their breath into meditation, yoga, and mindfulness practices in order to manage their trauma responses.

Yet, breathing techniques are not a universal cure. Even if they work for you, they may not work in every situation and may not have the same level of effectiveness each time. Here are a few situations in which focusing on or changing your breathing may not be effective in a trauma response:

You’re having a panic attack. Panic attacks are notorious for stealing your breath. It’s common when having a panic attack to breathe heavily, which can cause hyperventilation – a state in which you exhale too much carbon dioxide. Hyperventilation creates a situation in which there is more oxygen and less carbon dioxide in your system, which can cause you to feel faint or lightheaded. In fact, taking more or deeper breaths when hyperventilating is counterproductive because in such a situation there is too much — not too little — oxygen in your system. As Dr. Julia Englund Strait (2021) writes, “Taking a deep breath, especially a quick one, is essentially extending and exacerbating the hyperventilation cycle. If you’re having a panic attack, or feel close to it, taking a big gulp of even more O2 is the very last thing you should do, because it will tip the scales again in favor of less CO2. With that big gulp of air, you’re pumping even more oxygen.” When you’re having a panic attack, deep breathing may not always be helpful.

Focusing on your body can feel unsafe. Many trauma survivors do not feel safe when focusing on their physical sensations. These survivors may have experienced medical trauma, sexual assaults, or dissociation, which causes them to feel that their bodies are not safe and so, when they focus on their bodies — by taking deep breaths, for example — their anxiety is intensified. If you do not feel safe connecting with your body, it’s best to focus on coping strategies that feel safer or easier to do when you’re feeling anxious. You can work on reconnecting and feeling safer in your body. Yet, it may not be best to do this work while you're experiencing an intense trauma response.

You’re judging yourself for not breathing correctly. Trauma survivors often struggle with feelings of shame and profound self-judgment. Imagine that you attempt to take a breath and begin experiencing thoughts such as “I’m not doing this right,” “I can’t do anything right,” and “I can’t cope with my trauma.” These self-judging thoughts can initiate or exacerbate the trauma response. As Strait writes, “Focus on the breath can be an anxiety trigger for some and lead to panic attacks, due to the judgments and thoughts that pile on as you think about how you should be able to do it, how you’re doing it wrong, how you can’t even do breathing right, and so on.” If you try to take a breath and instead experience racing, self-judging thoughts, you might want to try another coping strategy.

You can’t take a breath. You might not be able to take a breath for many reasons, such as medical issues, a lack of practice in breathing techniques, or not knowing which breathing techniques work best for you. Whatever the reason, you do not need to take a breath in order to manage your trauma responses. There are other coping strategies and interventions that you can try.

Instead of taking a deep breath, try sighing

The act of sighing might be more effective. Dr. Ni-Cheng Liang reported, “When we inhale, it’s a very active process. The diaphragm actually has to pull itself down and flatten in order for us to invoke an inhaled breath.” When you sigh, however, you “can actually control the out-breath and harness your own physiology to help exhale out all of our residual breathe.” This allows you to be able to take a deep breath automatically without the need to force it. Sighing might help you to engage in deep breathing without triggering additional trauma responses.

Should you take a breath? Maybe. There are many circumstances in which taking a breath might help you manage trauma responses. Yet, there are reasons why it might not work and might even intensify or prolong your trauma response.