Ways to manage breathlessness and anxiety

Eating and cooking can be hard work when you are short of breath so try to:

  • Choose soft, moist foods that are easier to chew and swallow. Sauces and gravies can help.
  • Eat smaller meals with snacks or nourishing drinks between – here are some shopping list ideas [leaflet: High Energy High Protein diet shopping list ideas]
  • Sit upright when eating and drinking to ease the pressure on your lungs.
  • Take small mouthfuls and pause between each mouthful.
  • Sometimes fluids are easier – here are s a couple of quick tips by video    (see bottom  of page)
  • It’s ok to use convenience foods like ready meals if you’re not up to cooking a meal from scratch at the moment. This quick, nourishing meal uses just ingredients from your cupboards:
  • Oral hygiene is really important to reduce risk of getting infections- more information here: [ NB LINK NOT  YET  LIVE leaflet: oral hygiene and respiratory problems]

Breathing

  • Breathless is a normal sensation experienced by everybody. Due to Covid-19, you may feel this at rest, being active or when feeling anxious. It is important to understand as you recover from Covid-19, mild to moderate breathlessness when you are active is not a bad thing. If you exert yourself and become breathless regularly, as your muscles get stronger and you use oxygen more efficiently, you will start to feel less breathless overall.

  • When you are breathless, getting in to certain positions can help with your breathing control.
  • Sitting – Either try forward leaning (keeping your trunk straight) resting your hands / arms on your knees or on a table or sitting upright
  • Standing – Either try leaning forwards with your hands on your knees or a support e.g. chair, kitchen worktop or walking stick or leaning back on a wall
  • https://www.youtube.com/watch?v=dzPqZIzZSbo&t=1s
  • Try this Active Cycle of breathing  Technique
  • Deep Breaths

Sit in a relaxed position and take a slow deep breath in, filling your lungs with air to the bottom of your chest .

Hold the breath for as long as comfortably possible, normally a couple of seconds

Sniff in through the nose to fill the lungs with a little more air

Breathe out steadily and normally

Complete this three times

https://www.youtube.com/watch?v=37vDgmAs4R0

  • Huffing

Sit in a relaxed position and take in a medium sized breath

Open your mouth and force the air out, as if you were trying to steam up a mirror

Repeat two to three times; If you hear wet noises in your upper chest, try a cough to see if you can clear any sputum

  • Square Breathing

Focus on a square object .

As you breathe in through your nose, follow the line with your finger or eyes

When you reach the corner, breathe out through your mouth

Repeat focusing on the square.

Try to avoid using muscles around the ribs and neck area

Being anxious can affect your breathing in many different ways, some of which you may not be aware of.

Being short of breath, feeling like you can’t catch your breath, feeling like you can’t fill your lungs fully, getting breathless at rest, yawning or sighing a lot.

You may also experience symptoms that do not seem to relate to your breathing, such as dizzyness, poor concentration, pins and needles, fatigue and lethargy.

  • Diaphragmatic or tummy breathing can help control your breathing.

Find somewhere comfortable to sit with your back well supported.

Place one hand gently on your tummy below your ribs and one hand on your chest bone/sternum.

Make sure your breathing is as steady and relaxed as possible

You should feel your hand on your tummy rise and fall with each breath. Your hand on your chest bone/ sternum should have minimal movement.

Try to practice this 3-4 minutes 3-4 times a day

Breathless is a normal sensation experienced by everybody.

Due to Covid-19, you may feel this at rest, being active or when feeling anxious.It is important to understand as you recover from Covid-19, mild to moderate breathlessness when you are active is not a bad thing. If you exert yourself and become breathless regularly, as your muscles get stronger and you use oxygen more efficiently, you will start to feel less breathless overall.

  • What you can do; use the above control exercises, explore why you are anxious and practice relaxation techniques.

For more information, please refer to this very helpful guide:

www.kcl.ac.uk/ioppn/depts/pm/research/imparts/quick-links/self-help-materials/breathlessness-and-anxiety.pdf

Relaxation, Breathing exercises and mindfullness can all  help you  to manage:.

Relaxation:

It prevents build-up of muscle tension which can cause headaches, pain in the body, tightness in the chest and tiredness, It helps combat breathlessness, It helps you to feel calmer and more in control so that you can tackle situations where you might normally feel anxious or worried or irritable, It helps you sleep better, Relaxation is the opposite of anxiety:

Anxiety = Increase in  breathing rate, heart rate, tension in muscles, body and your muscles need for oxygen

Relaxation  = decrease in  breathing rate, heart rate, tension in muscles, body and your muscles need for oxygen

Learning to relax takes time and practice but you can use relaxation techniques to relax your mind and body in any situation. Try to find time to relax every day. It doesn’t have to be a full on relaxation exercise, just any activity that makes you feel more relaxed as we are all different.

Muscle Release: As being breathless can cause our muscles to tense, particularly those in our chest, the first thing to do when you feel very breathless is to reduce your muscle tension. One good way to do this is to:

STOP, DROP & FLOP

STOP stop doing whatever it is that is making you breathless.

DROP drop your shoulders and get into a good position for breathing. People often find leaning forward against something helps.

FLOP try to relax your body and go floppy, particularly the muscles around the back, the neck, the shoulders, the arms and the stomach. Shake out the tension.

People often find when they are breathless that their shoulders “hunch up”, which can make breathing less efficient (as the muscles around your lungs are tight and so your lungs have less space to expand). This means you are more likely to use your chest and not your diaphragm to breathe. Lower your shoulders and try to relax those shoulder muscles. Dropping your shoulders gives more space to the lungs.

When you’ve stopped, dropped and flopped, you may notice that your muscles feel less tense and more relaxed.

Relaxation Exercise:

  1. 1. Sit with your feet flat on the ground.
  2. Tightly clench your hands and your shoulders raised towards your ears.
  3. Hold that position to a count of 10.
  4. Relax and feel all the tension drain from your shoulders, arms and hands.
  5. Let your arms hang heavy and loose and enjoy that warm, relaxed glow – for another count of 10.
  6. Repeat the clenched hands and raised shoulders for another count of 10.
  7. Then relax everything and count to 10 again.
  8. Now pull your tummy muscles in very tight and hold yourself in like that for a count of 10.
  9. Relax and let your middle expand against your belt.
  10. Feel your body and your breathing relax.
  11. Sit quietly for a moment feeling the muscles in your shoulders, arms and abdomen completely relaxed and loose.

(Source: CBT for Chronic Illness and Palliative Care: A Workbook and Toolkit by Nigel Sage.)

Free relaxation tracks: https://www.moodcafe.co.uk/download-relaxation-exercises.aspx

This calming breathing technique for stress, anxiety and panic takes just a few minutes and can be done anywhere.

You will get the most benefit if you do it regularly, as part of your daily routine.

You can do it standing up, sitting in a chair that supports your back, or lying on a bed or yoga mat on the floor.

Make yourself as comfortable as you can. If you can, loosen any clothes that restrict your breathing.

If you’re lying down, place your arms a little bit away from your sides, with the palms up. Let your legs be straight, or bend your knees so your feet are flat on the floor.

If you’re sitting, place your arms on the chair arms.

If you’re sitting or standing, place both feet flat on the ground. Whatever position you’re in, place your feet roughly hip-width apart.

Let your breath flow as deep down into your belly as is comfortable, without forcing it.

Try breathing in through your nose and out through your mouth.

Breathe in gently and regularly. Some people find it helpful to count steadily from 1 to 5. You may not be able to reach 5 at first.

Then, without pausing or holding your breath, let it flow out gently, counting from 1 to 5 again, if you find this helpful.

Keep doing this for 3 to 5 minutes.

Source: https://www.nhs.uk/conditions/stress-anxiety-depression/ways-relieve-stress/

Brief Mindfulness: Take Ten Breaths

Practice it throughout the day, especially any time you find yourself getting caught up in your thoughts and feelings.

  • Take ten slow, deep breaths. Focus on breathing out as slowly as possible, until the lungs are completely empty – and then allow them to refill by themselves
  • Notice the sensations of your lungs emptying. Notice them refilling. Notice your ribcage rising and falling. Notice the gentle rise and fall of your shoulders
  • See if you can let your thoughts come and go, as if they are just passing cars, driving past your house.
  • Expand your awareness: notice your breathing and your body at the same time. Then also look around the room and notice what you can see, hear, touch, and feel.

Source: Russ Harris (2009) ACT Made Simple

Free Mindfulness Resources:

For more information, please refer to this very helpful guide:

www.kcl.ac.uk/ioppn/depts/pm/research/imparts/quick-links/self-help-materials/breathlessness-and-anxiety.pdf