The Do’s and Don’ts of Paper Bag Breathing

Paper bag for anxiety panic attack

Just like the way a crutch gets used on a broken leg or a bandage for a cut, a brown paper bag is an ’emblem’ used for hyperventilation, often seen on TV or in comic books. The act of grasping a paper bag and continually breathing into it is referred to as re-breathing and has, for a long time now, been commended for providing easiness in uncontrolled and hasty breathing. Some doctors keep paper bags in their offices, just in case. This technique regarding paper bags gets used when an individual over-breaths, or hyperventilates, like in the case of a panic attack.

So, why is this hyperventilation thing bad? Mainly, because it leads to reduced carbon dioxide levels and dishevels the oxygen and carbon dioxide balance in one’s blood. Once the body gets much more oxygen than required (yes, excess oxygen is bad for you), it can cause a high-level pH, a condition known as respiratory alcalosis. Result is the feeling of weakness and dizziness. Hyperventilation is among the most common causes of this situation.

You’ve probably heard of pH, but, unless you earn for living by wearing white coat and handling laboratory tubes, you’re less likely to know that this abbreviation means the ‘potential of hydrogen’ or the ‘power of hydrogen’. Irrelevant.

What is relevant is that pH expresses the alkalinity or acidity of a solution on a logarithmic scale that ranges from 0 to 14 and has 7 as a neutral. Values that are greater than 7 are categorized as more alkaline while those below 7 are more acidic. In human beings, the average pH ranges between 7.35 and 7.45 (slightly alkaline). If for any reason your pH is out of this range, you may not be feeling good.

When an anxious (but, otherwise, healthy!) individual breathes into a paper bag for six or more times, carbon dioxide level goes up and pH levels in the body are reduced. Result: the body feels better.

There’s no standard about the size of the paper bag but it is advisable to use large enough to comfortably breath and hold it. The proposed size of a bag should be from six inches by four. Off course, get the clean bag, free of any particles that could be inhaled. You certainly don’t need pop-corn leftovers in the bag when trying to calm down your breathing (imagine the situation of watching a horror movie in the cinema).

Some would ask, why not use a plastic bag instead of a paper bag? It’s not because paper bags are environmentally friendly (that’s nice, but not decisive in this case) but because it’s less likely that you can suffocate with them. Plastic bags are more flexible hence they can stick to your nose and mouth preventing you from breathing at all. Also, plastic bags often crumble and may contain residues from plastic monomers or printer ink which are bad to inhale. Paper bags are advantageous to plastic bags because they tear quickly and are more permeable than plastic ones consequently reducing suffocation risks for an individual (common sense tells that, when suffering from a panic attack, suffocating will only worsen the condition.)

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So, we come to the other side of the story.

Being cautious is important. Numerous medical experts and studies recommend that, despite this paper bag method getting acknowledged, it should be eradicated. Why? Because it is dangerous. It’s true that paper bags help with anxiety-triggered hyperventilation. Anxiety is responsible for roughly 25% of all hyperventilation cases, making it the most common reason.

But, what about the rest 75%?

The tricky thing is that a number of medical disorders can get confused for being hyperventilation that is anxiety-caused. These conditions include heart attacks and asthma. In such cases, an increment of carbon dioxide (and reduction of oxygen) can prove to be deadly. ‘The Annals of Emergency Medicine’ has research which describes three circumstances when persons having heart attack wrongly thought they were hyperventilating and used paper bags which then led to their deaths due to the loss of oxygen.

In the case of asthma, there is a belief that the paper bag practice can replace a steroid inhaler (plus warms the lungs as a bonus). Stop right there. Paper bag is not a remedy to be used in relieving attacks by asthma patients. Airway inflammation categorizes asthma outbreaks that in turn constrains the exchange of air. Breathing of paper bags does not help in clearing these airways, however, it defeats the purpose of first aid for asthma entirely.

During an asthma attack, it is vital not to breathe into paper bags. You will only turn blue!

Below are six steps one should carry out during an asthma attack, in the case of an inhaler’s absence:

  • Sit straight. Lying down or bending over can add more constricts to your breathing.
  • Take long and deep breaths. This step involves breathing in through the nose and breathing out via your mouth.
  • Stay composed. Keeping calm will make your breathing more relaxed and could further avoid your chest muscles to tighten.
  • Find some fresh air. Move far from the trigger – any place with clean air is advisable when having an asthma attack because the attack can get triggered by chemical smells, cigarette smoke or dust.
  • Take a hot beverage with caffeine. Caffeinated drinks that are hot such as coffee can aid in slightly opening up airways and offer relief for a few hours.
  • Emergency help. If the difficulty in breathing, coughing, and wheezing persists even after some resting, you are advised to seek medical and emergency assistance.

Don’t forget to regularly perform breathing exercises that help with asthma.

Generally, the advise is to practice breathing techniques whenever you can. Sit down, try to calm down, relax. The main thing is slow your breathing, since, the more tense you are, the faster you’ll breathe. That, in turn, sends the message to your brain that you’re in danger. And, guess what the brain does then? Forces you to breathe even faster so that you can fight with the danger. The danger that doesn’t exist. Practice natural breathing.

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