MS and Panic Attacks: Using the Breath to Regain Control

😨 Understanding Panic Attacks in MS

A panic attack is an intense wave of fear or anxiety that comes on suddenly. It may include:

Racing heart
Shortness of breath
Chest tightness or pain
Dizziness or feeling faint
Sweating, trembling
Numbness or tingling
Sense of doom or losing control
Feeling like you’re going to die

Many of these symptoms overlap with MS itself—especially during flares, high stress, or fatigue—making it hard to tell whether you’re experiencing a neurological issue or a psychological one.

This confusion can fuel the panic even more.

🧠 Key insight: Panic attacks are not “just in your head”—they’re a sign your nervous system is overwhelmed and needs safety signals.

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🧠 Why People with MS Are Vulnerable to Panic

People with MS are more likely than the general population to experience panic attacks. Here's why:

1. Nervous System Dysregulation

MS is a disease of the central nervous system (CNS). Lesions in areas that control mood, emotion, or autonomic function can trigger exaggerated stress responses.

2. Health Anxiety and Uncertainty

Unpredictable symptoms, medical trauma, or fear of progression can create anticipatory anxiety—a perfect storm for panic to arise.

3. Sensory Sensitivity

Many MS patients report heightened sensory perception. A small shift in body sensation may be interpreted as dangerous, kicking off a cascade of fear.

4. Chronic Stress Load

Living with MS often means navigating doctors, medications, physical limits, and isolation—creating a nervous system under siege.

🌀 The Breath as a Tool for Panic Recovery

When panic strikes, the breath is often the first thing to change—it becomes shallow, rapid, or erratic. This tells the brain, “We’re in danger.”

But when you consciously control your breathing, you can send the opposite message:

“It’s okay. You’re safe. You’re in control.”

Breathwork helps by:

Activating the parasympathetic nervous system (rest-and-digest)
Stimulating the vagus nerve, reducing heart rate and blood pressure
Bringing awareness back to the body and present moment
Interrupting spiraling, catastrophic thoughts

And best of all—it’s free, discreet, and always available.

🧘 5 Breathwork Techniques to Calm Panic During MS Episodes

1. Extended Exhale Breathing

📌 Best for: When your heart is racing and you feel unsafe

This simple method helps shift you out of fight-or-flight mode by extending your exhale, which activates the vagus nerve.

How to do it:

Inhale gently for 4 seconds

Exhale slowly for 6–8 seconds (through pursed lips or humming)

Repeat for 2–5 minutes

Tip: Whisper “safe” or “calm” on each exhale to reinforce the signal.

2. Box Breathing (Square Breathing)

📌 Best for: Regaining focus and structure in chaos

Used by Navy SEALs, box breathing offers rhythmic grounding and emotional regulation.

How to do it:

Inhale for 4 seconds

Hold for 4 seconds

Exhale for 4 seconds

Hold for 4 seconds

Repeat the cycle for 3–5 minutes

Tip: Visualize a square with each breath cycle to anchor your mind.

3. Humming Breath (Bhramari)

📌 Best for: Calming a hyperactive mind and soothing the vagus nerve

The vibration from humming activates calming pathways and distracts from anxious thoughts.

How to do it:

Inhale through the nose

Close your lips and exhale while making a gentle humming sound

Focus on the vibration in your face and throat

Repeat for 5–10 rounds

Tip: Cover your ears lightly to enhance the internal vibration.

4. Hand-on-Heart Coherent Breathing

📌 Best for: Reconnecting to a feeling of safety and presence

Touch is grounding. Combining it with slow breath reinforces body-mind safety.

How to do it:

Place one hand on your heart, one on your belly

Breathe in for 5 seconds, out for 5 seconds

Feel the warmth of your hand and the movement of breath

Continue for 3–10 minutes

Tip: Silently repeat: “I am safe. I am grounded.”

5. Butterfly Tapping with Breath

📌 Best for: Emotional overload or disassociation

This combines bilateral stimulation (gentle tapping) with breath to re-integrate the body during a panic attack.

How to do it:

Cross your arms and rest hands on opposite shoulders

Gently tap left–right–left while breathing slowly (inhale 4, exhale 6)

Sync your tapping with your breath

Continue until you feel calmer

Tip: Say your name aloud to reorient yourself: “I’m Max. I’m here. I’m okay.”

🧭 A Grounding Sequence for Panic Attacks

Step 1: Sit or lie down. Bring your attention to your breath.
Step 2: Place one hand on your chest and the other on your belly.
Step 3: Begin extended exhales (4 in, 6–8 out).
Step 4: Add humming or tapping if helpful.
Step 5: Use grounding statements like:

“This is a panic attack. It will pass.”

“I’m safe in this moment.”

“I’ve survived this before—I can do it again.”

📅 Building a Breath-Based Recovery Practice

While breathwork helps in the moment, daily practice rewires your nervous system to be less reactive over time.

Try this daily:

Morning (3 minutes): Coherent breathing (5 in, 5 out) to set your tone

Afternoon (2 minutes): Hand-on-heart breath after stressful tasks

Evening (5 minutes): 4-7-8 breath to prepare for sleep

During flares or fatigue: Humming breath while resting

📓 Track your symptoms and panic episodes—you may notice fewer or shorter attacks over time.

❤️ When Panic Is Linked to MS Flare-Ups

Sometimes panic doesn’t come from mental stress—it’s triggered by physical MS symptoms like:

Neuropathic pain
Dizziness or balance issues
Bladder urgency
Sudden fatigue or weakness
Cognitive fog (“something feels off”)

In these cases:

Use breath to regulate your response, not eliminate the symptom
Combine breathwork with self-talk: “This is my MS, not an emergency.”
Pair with hydration, cooling, or medication if needed

The goal is not to “breathe it away,” but to prevent fear from escalating.

🧠 Breath and the Brain in Panic States

Science shows that slow breathing improves communication between brain regions involved in fear, regulation, and reasoning:

🧠 The amygdala (fear center) becomes less reactive

💡 The prefrontal cortex (logic/planning) becomes more active

🎛️ The insula (body awareness) becomes more balanced

These shifts don’t just feel good—they’re neurologically healing.

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🗣️ What to Say to Yourself During Panic

Your inner voice matters. During breathwork, use statements like:

“This will pass.”

“I’m safe. I’ve felt this before.”

“I can ride this wave without fighting it.”

“My breath is my anchor.”

“This isn’t forever—it’s just right now.”

💬 Repeating kind, grounding words while breathing reinforces nervous system safety.

📞 When to Seek Help

While breathwork is a powerful self-help tool, it is not a substitute for professional mental health support. Consider speaking with a therapist if:

Panic attacks happen multiple times a week
You avoid activities due to fear of panic
You experience trauma flashbacks or dissociation
Panic interferes with sleep, work, or relationships

CBT, EMDR, somatic therapy, and mindfulness-based interventions can all complement breathwork.

🌱 Final Words: You Are Not Broken

Panic attacks during MS don’t mean you’re weak—they mean your body is trying to protect you, even if it misfires sometimes. Breathwork helps re-educate your system that: