“Why am I breathing so much?”
“Do I always breathe like this?”
“Can anyone else hear my breathing?”
“What if I’m not breathing enough?”
It’s normal to occasionally feel a heightened awareness of your breathing, especially if you’re experiencing anxiety or panic. It’s common to be cognizant of other bodily functions too, such as blinking or feeling your heartbeat. While being in tune with your body can be a positive thing, these sensations start to feel intrusive if they become long-lasting.
You may not be able to break away from thoughts about your breath, or feel stuck in cycles of manually inhaling and exhaling. Maybe you’re scared that if you stop focusing on breathing, your body will forget how to do it.
Read on to figure out if your excessive fixation on breathing is a sign of a mental health condition, like anxiety or somatic obsessive-compulsive disorder, a subtype of OCD which focuses on bodily functions.
Why does thinking about breathing cause anxiety?
In this day and age, it’s become very easy to feel disconnected from our own bodies. So, when we do randomly notice how hard, soft, fast or slow we’re breathing, it may feel a bit jarring.
Some people can randomly become conscious of their own automatic breathing, think about how it sustains their livelihood, and enjoy the experience of connecting with themselves. For others, the idea that this action sustains their livelihood feels extremely overwhelming. It may spiral into thoughts like “What if I forget to breathe? Will I die?” or “Wait, is my breathing normal? How can I tell if something’s wrong?”
It’s not inherently bad to have these worries pop up, nor do they necessarily signal that something’s happening to your body. But when they cause a great deal of distress or anxiety, or they make it difficult for you to focus on anything other than breathing, it’s time to address what’s going on.
If you find yourself urgently trying to ease any anxiety or distress you feel when you’re tuned into your breath, you may be experiencing a subtype of OCD called somatic OCD—also known as sensorimotor OCD.
Can OCD cause you to overthink breathing?
If you’re unfamiliar with OCD, it’s a chronic mental health condition that’s marked by a cycle of obsessions and compulsions. Obsessions are recurrent and unwanted thoughts, urges, feelings, sensations or images that cause distress.
Those with OCD respond to obsessions with compulsions, which are repetitive behaviors or mental acts done in an attempt to ease discomfort, neutralize distressing thoughts, or prevent something bad from happening.
What is somatic OCD?
Somatic OCD is a subtype of OCD with obsessions around the sensations happening in your body. You might find yourself unable to stop noticing or thinking about “normal” everyday functions like breathing or swallowing. Since these functions typically happen automatically, obsessions tied to thoughts like these can be extremely overwhelming and frustrating.
When you begin worrying about the normalcy of your breathing or fixating on some aspect of it, you might wonder if you’ll ever be able to stop noticing each inhale and exhale. “Even though you’ve been breathing your entire life—and apparently been doing just fine because you are still alive—your OCD says, ‘Yeah, but what if it’s not enough? What if it’s not right,’” explains Dr. Patrick McGrath, Chief Clinical Officer at NOCD.
Your OCD tells you that you could manage breathing better if you try to consciously take it over. This can lead to various compulsions. As Dr. McGrath explains, “You keep checking your breathing.”
You might breathe deeply or exhale very loudly. You might clear your throat a lot. You might drink a lot of water to make sure that your throat doesn’t dry up so that the breathing airway is as moist as it should be.”
Dr. Patrick McGrath
Dr. McGrath recalls treating an older patient who consistently forced out loud, deep coughs. “She would literally do that just to make sure that her throat was cleared, and that there was no mucus that would be impeding her breathing.”
Some common breathing-related obsessions include:
- Asking yourself, “What if I suddenly stop breathing?”
- “Is my breathing too deep, too shallow, etc.?”
- “Am I breathing the right amount of breaths?”
- “Is my breathing normal like other people?”
- “Will I always be focused on my breathing?”
- “What if I never stop paying attention to my breathing?”
- Urges to breathe in a particular manner
With OCD, you feel like you have to respond to those obsessions with compulsions. It may be in an effort to prevent something bad from happening (“If I focus on deep breathing, I won’t fail my science test”), neutralize the obsessive thoughts (“If I think hard enough about my breathing, I can make sure it’s done right”), or just generally ease any discomfort.
Common breathing-related compulsions:
- Excessively researching anything related to breathing
- Counting frequency of breaths within a time frame
- Breathing in set, specific manner
- Trying to breathe in different ways to “test out” which way is “best”
- Frequently consulting doctors for tests or reassurance
- Consistently scanning your body
- Avoidance of sleeping or activities that increase heart rate, breathing, etc.
- Avoidance of travel, social situations, or other environments where you could become more aware of your breathing and/or contract illnesses related to lungs
- Seeking reassurance from others (“Does my breathing sound normal to you?”)
- Rumination
- Mental review (“Was my last breath a “good one”? I need to think through how it made me feel.”)
Manual breathing isn’t always bad
Although excessively hyper fixating on your breath can negatively interfere with your life, intentional breathwork can be beneficial to your mental health. Most of the time, you’re partaking in automatic (or spontaneous) breathing, a process where the breath is subconsciously controlled by the autonomic nervous system. Manual breathing, also called mindful breathing, is when you actively control your breath. Mindful breathing may help you ground yourself in the present moment and reduce stress. You slow down from the fast pace of everyday life and approach any thoughts that arise—including intrusive ones—in a non-judgemental way.
While mindful breathwork can be a good tool for dealing with anxiety and panic, Dr. McGrath says to make sure that it doesn’t turn into an obsession or compulsion itself. If practicing manual breathing leads to increased stress, the best path forward is getting treatment for somatic OCD.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Treating somatic OCD
OCD (and all OCD subtypes) is very responsive to an evidence-based treatment called exposure and response prevention therapy (ERP).
In ERP, you work with a specially-trained therapist to find out what triggers your cycle of obsessions and compulsions. From there, you and your therapist will work to expose you to these triggers, starting small and working your way up to more challenging ones. This will allow you to experience obsessions about your breathing in a controlled environment. The goal is to help you experience triggers and eventually feel less urgency to complete your compulsions.
You’ll engage in exposure exercises in order to resist the urge to seek short-term relief through compulsions. Here are some examples:
- Walking or running on a treadmill to elevate your heart rate, then resisting the urge to check your pulse as you catch your breath.
- Drawing your attention to your breathing rate, then sitting with the worry that you might never stop counting your breaths, rather than intentionally distracting yourself.
- Saying “I might not be getting enough oxygen to my lungs,” and not going online to research symptoms of hypoxia.
Many people who go through ERP therapy find that the distress caused by their intrusive thoughts is significantly reduced, and the need to engage in compulsions goes away.
If you’re experiencing somatic OCD symptoms focused on breathing, it can be hard to see a way out of your struggle—after all, you’re always breathing! But ERP led by an experienced professional can truly make an impact on your life, even if it feels difficult to breathe right now.