Question: What's the purpose of breathing? It's to get what into the body and what out of the body?

Answer: The purpose is to get oxygen into the body and carbon dioxide out.

Question: Is it good to get as much carbon dioxide out as possible, or is it possible to breathe so fast that you get too much carbon dioxide out?

Answer: What we need is to have not too much, not too little, but just the right amount of carbon dioxide in our bodies. If we breathe too fast, and blow off too much carbon dioxide, that produces some uncomfortable symptoms.

Question: What are the symptoms that are produced by blowing off too much carbon dioxide and getting too low in carbon dioxide?

Answer: When we get too low in carbon dioxide, we can feel trembling in the hands, sweatiness, tingling or numbness in the hands, lightheadedness or dizziness, headache, tightness in the chest, chest pain, nausea, heart pounding, heart beating faster than usual, and anxiety. And most importantly for some people, getting too low in carbon dioxide produces a feeling that you are not getting enough air, that you are short of breath.

Question: What does the word hyperventilation mean?

Answer: Hyperventilation means that you are breathing faster than you need to and blowing off more carbon dioxide than is good for you.

Question: What's the vicious cycle of hyperventilation?

Answer: When being too low in carbon dioxide makes you feel like you don't have enough air, you breathe even faster. This blows off more carbon dioxide and makes the situation of being too low in carbon dioxide even worse.

Question: What's the relation between panic attacks and hyperventilation?

Answer: For very many people, and particularly for adolescents and young adults, hyperventilation is a major contributor, if not the sole cause, of bad panic attacks.

Question: Does this mean that if people can learn to slow down their breathing at the appropriate times, they can ward off hyperventilation symptoms and panic attacks?

Answer: Yes. I have seen many people accomplish this.

Question: What is the 5-in-and-5 out exercise?

Answer: This is the first of 3 exercises that are meant to help people slow down their breathing. They breathe in for 5 seconds and out for 5 seconds. This comes out to 6 breaths per minute. This is about half of the rate that we usually breathe, and it’s hard to hyperventilate at this rate.

Question: If you have something that displays seconds handy, what’s a good way of doing the 5-in-and-5-out exercise?

Answer: Start breathing in when the number of seconds ends in 0, and start breathing out when the number ends in 5.

Question: What are the other 2 exercises for?

Answer: They’re to teach your brain to recognize the difference between high carbon dioxide and low carbon dioxide, and to slow down your breathing when carbon dioxide is low.

Question: How do you do exercise 2?

Answer: You hold your breath for just long enough that it starts to feel uncomfortable. (This is the high carbon dioxide feeling.) You cure that by taking a couple of fast deep breaths.

Question: What are you supposed to notice when you do exercise 2?

Answer: Notice what the high carbon dioxide feeling is like. You’re going to want to notice that this is very different from the low carbon dioxide feeling you get from exercise 3.

Question: How do you do exercise 3?

Answer: You hyperventilate on purpose, for about 10 breaths as fast and deep as you can do them. Then notice a slight lightheaded feeling, or anything else that you feel. This is how a slightly low carbon dioxide feels. This is your signal to breathe more slowly. To cure this feeling, after having hyperventilated on purpose, take a very slow breath in and out, over about 30 or 40 seconds. This should get you back to feeling normal. It also teaches your brain to cure a low carbon dioxide feeling by breathing slowly rather than quickly.

Question: Which one of these exercises should you do if you feel a panic attack starting to happen?

Answer: The 5-in-and-5-out is the one to do in that case. For many people, this has nipped the panic attack in the bud.

Question: How often should you practice the three exercises?

Answer: At least once a day. After a while you can skip the hyperventilation on purpose and just do the other two. But until you’ve gotten the episodes to go away, it’s good to practice all three each day.