Respiratory alkalosis in anxiety crisis

Anxiety crisis is a serious problem for people, I could say, as described by patients who suffer from it, that they feel they are going to die, that their heart is going to fail them, that their body is paralyzed, among many other symptoms that they come to feel.

Anxiety is a public health problem, as simple as that, which is not recognized as such, and that more and more people suffer from it, but it is not taken care of and in some moments it usually reaches a crisis. This is a maximum level of expression, and should be treated by psychiatrists and/or psychologists.

The maximum expression of this disease is the Anxiety crisis, whose picture is expressed and worsened by what is respiratory alkalosis, and it is this that I would like to explain below.

Previously I described in the following post: Anxiety: a silent enemy in our lives, the main symptoms that people with anxiety present, but when we talk about a crisis we are at another level, the person arrives at the medical emergency in a state that worries family and close friends, who become totally desperate thinking that he/she is going to die.

The picture looks very serious, but physically it is not really so serious, it is more a psychological consequence of a situation that they consider they cannot overcome, and their respiratory and heart rate accelerates. It is very common that it occurs when the person faces situations of great emotional stress.

The big problem is that the person increases the cardiac frequency in an unconscious way (that is to say, he/she breathes up to 30 times or more per minute) which produces an increase of bicarbonate in blood, and we call this medically Respiratory Alkalosis. It is a situation that can be corrected very easily, and I could say that it is not life threatening, at least not to the level reached in an anxiety crisis.

I am sure you have seen people who have had a paper bag placed over their face so that they breathe into it, and they basically breathe the same air that they eliminate.

I will recall a very basic but equally important point regarding our breathing, which basically consists of two processes:

• Inspiration: air enters our body rich in Oxygen.
• Expiration: air leaves our body rich in CO2.

We will remember this from our biology classes at primary school level. Reading what I have placed you can intuit that if what relieves the symptomatology of "respiratory alkalosis" is to inspire the same air that we eliminate, it means -by logic- that everything is triggered by an exaggerated elimination of CO2, which we compensate with the inhalation of air rich in this element.

Pixabay / Author: sweetlouise

The concentration of bicarbonate in the body decreases and a really complex event occurs at the metabolic level, in which the levels of bicarbonate in the blood decrease, and the blood pH increases.

This elevation of the pH affects the functioning of practically everything in the body, including the muscles. It is for this reason that the person feels that he/she cannot move, because the hands cramp up, as well as the legs, and they enter into despair, thinking that they could even die for this reason.

Obviously anxiety is not the only reason that produces a respiratory alkalosis, there are other causes, but I can say that the main one is this. And in general the response of relatives and patients is the same, and what triggers the problem is usually a strong emotional event.

Pixabay / Author: jarmoluk

Laboratory tests, specifically pH and arterial gas tests, will show that we are not in fact in the presence of a case of respiratory alkalosis.

But as you can see, the solution is quite simple, but I fully understand that for many people to live that, or even for family and friends who are usually present is something very unpleasant to see.

In general I can say that the treatment is very simple, at least the emergency one, just placing an isoosmolar hydration solution (0.9% solution works well), it seems unscientific, but the person breathing in a paper bag helps to quickly relieve the symptomatology, and it is something that can be done at home.

Subsequently, the person will require psychological consultation, who will help him/her to prevent this situation from happening again, by teaching psychological tools and also to determine what is the cause that triggers the crisis.

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Links consulted

• Respiratory Alkalosis
• The role of hyperventilation - hypocapnia in the
  pathomechanism of panic disorder
• Evaluation of respiratory alkalosis