How Breathing Affects How You Feel
A plain-language explainer on how over-breathing during anxiety creates uncomfortable but harmless sensations, why they feel alarming, and how slowing the breath helps.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
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How Breathing Affects How You Feel
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Breathing and the body
Your breathing changes with how you feel, all on its own. When you are calm it slows and softens. When you are excited, frightened or upset it speeds up, often without you noticing. This is completely automatic and normal, your body adjusting your breathing to match the moment. It means your breath and your feelings are closely linked, which is something you can gently use to your advantage.
Over-breathing
When we feel anxious, we tend to breathe faster and deeper than the body actually needs. This is sometimes called over-breathing. It lowers the amount of carbon dioxide in your blood, and that simple change can cause real physical feelings: dizziness, tingling in the hands or face, a sense of breathlessness, and a racing heart. These sensations are uncomfortable, but they are completely harmless, and they pass once your breathing settles.
Why it feels alarming
Here is the catch. Because these sensations feel strange and strong, it is easy to misread them as a sign that something is wrong, that you might faint, or that you cannot get enough air. That frightening thought makes you breathe even faster, which produces even more of the same sensations. So a loop forms, where the breathing and the fear feed each other. Understanding what is really happening can take a lot of the fear out of it.
Slow breathing helps
The good news is that the loop works in reverse too. Gently slowing your breathing, especially making the out-breath a little longer than the in-breath, lets the carbon dioxide level recover and the sensations settle. You do not need to force it or breathe in any special way, just ease off and slow down. Like any skill, it feels more natural with practice, so it is worth trying when you are calm, not only in difficult moments.
A note
This is not about breathing correctly all the time, or watching your breath and worrying you are doing it wrong. Your body knows how to breathe. Slow breathing is simply a tool you can reach for in anxious moments, one option among several, to help things settle a little. Used that way, it can be genuinely helpful without becoming one more thing to get right.
Which of these do you notice?
These are the sensations over-breathing can cause. They are uncomfortable but harmless. Tick any that you recognise when you feel anxious.
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When to use ‘How Breathing Affects How You Feel’
‘How Breathing Affects How You Feel’ is an interactive cognitive behavioural therapy (CBT) worksheet, most often used in CBT for panic.
It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device — or download it as a print-ready PDF.
How it works
Most people work through it in around 6 minutes. It moves through six short steps:
- Breathing and the body — Your breathing changes with how you feel, all on its own. When you are calm it slows and softens. When you are excited, frightened or upset…
- Over-breathing — When we feel anxious, we tend to breathe faster and deeper than the body actually needs. This is sometimes called over-breathing. It lowers…
- Why it feels alarming — Here is the catch. Because these sensations feel strange and strong, it is easy to misread them as a sign that something is wrong, that you…
- Slow breathing helps — The good news is that the loop works in reverse too. Gently slowing your breathing, especially making the out-breath a little longer than…
- A note — This is not about breathing correctly all the time, or watching your breath and worrying you are doing it wrong. Your body knows how to…
- Which of these do you notice? — These are the sensations over-breathing can cause. They are uncomfortable but harmless. Tick any that you recognise when you feel anxious.
Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.
The CBT approach behind it
In common with other CBT methods, ‘How Breathing Affects How You Feel’ works by building practical skills to manage difficult thoughts and feelings in the moment. The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going — and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This worksheet is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- Clark, D.M., Salkovskis, P.M., & Chalkley, A.J. (1985). Respiratory control as a treatment for panic attacks. Journal of Behavior Therapy and Experimental Psychiatry, 16(1), 23-30. doi:10.1016/0005-7916(85)90026-6
- Clark, D.M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24(4), 461-470. doi:10.1016/0005-7967(86)90011-2
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
- Samaritans: 116 123 — free, day or night, 365 days a year
- SANEline: 0800 689 5555 — 4:30pm–10:30pm, every day
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