Between one-tenth and one-third of COVID-19 survivors have shown some degree of neurologic or psychiatric disability six months after infection. This was the conclusion of a recent study of more than 200,000 post-COVID-19 patients in Britain. The symptoms included memory loss, nerve disorders, anxiety, depression, substance abuse and insomnia. There have also been numerous reports of brain fog, PTSD, and heart and lung issues. People with continuing symptoms are often referred to as “long haulers,” and the National Institutes of Health is referring to it as “post-acute sequelae of COVID-19." There is a great deal of new research into why some people have lingering symptoms. There are a large number of ways that a novel virus could cause these types of symptoms and these include long-term changes to the immune system and chronic inflammatory responses that are resistant to treatment. In fact, several other viruses, including the 1918 flu pandemic, are known to have created lasting symptoms. I won’t go into all the ways that a virus could be perpetuating symptoms here. But I would like to speculate about one way that the virus could bring about persistent symptoms that is fully within our ability to counteract and even treat after the fact. Namely, the virus is likely - at least to some degree - causing people to breathe more shallowly and then get stuck in the habit of shallow breathing.
Infection with COVID-19 causes acute respiratory symptoms and sufferers often have trouble breathing. In my opinion, it is highly plausible that this experience can cause negative adaptations in breathing habits. A number of injuries and surgeries have been shown to cause patients to change their habitual breathing patterns from long, deep breathing to short, shallow breathing. For example, many people recovering from abdominal surgery learn to breathe shallowly because they fear that they will burst stitches at the incision site. Unfortunately, studies show that they often do not go back to their previous breathing pattern, and instead continue to breathe shallowly. In fact, many people placed on an artificial respirator develop shallow breathing habits after they are weaned off it. Fear and trauma can also cause us to breathe shallowly. Often, we don’t realize how much even minor trauma can affect our breathing. Even after the traumatic incident is resolved, we continue to breathe in a distressed manner. Some people will spontaneously revert back to healthy breathing. However, most people won’t revert without some form of therapy or breathing exercises.
I believe that fear of getting COVID-19 and the insecurities involved in living through a year-long pandemic has caused many people to breathe more shallowly. It is also possible that the additional respiratory work involved in breathing through a face mask has stifled many people's breathing patterns. Additionally, I believe that people that suffered through an actual infection and experienced shortness of breath (dyspnea) may have learned to breathe in a dysfunctional manner. COVID patients commonly complain that they find themselves gasping for air, or that their chest is too tight to take a full breath. When breathing becomes chronically shallow, the diaphragm is immobilized, and peaceful and relaxed breathing becomes suspended. When you are not breathing with your diaphragm you are forced to breathe with your thoracic muscles in a mode that is often called distressed breathing. This leads to being stuck in a constant state of fight or flight (sympathetic overactivation) and can cause hyperarousal which commonly leads to, or contributes to, disorders including anxiety, depression, PTSD, and memory problems. See the link?
Let me offer another related example. I have taken up treading water over the last year. I often tread water for up to 50 minutes at a time up to five days per week. It took me a couple of months to realize that the fear of swallowing water was influencing me to breathe very shallowly while I treaded. After coming to this realization, I was able to become more aware of my breathing during and after treading water to ensure that I am breathing on long intervals. I also had to address the breathing changes with some breathing exercises. Addressed properly my breathing returned to normal.
I spoke to a close friend over the phone while she was infected with COVID. When her breathing pattern was at its worst, it was difficult to tell whether she was talking or sobbing. She sounded almost like she was drowning. Her breathing was incredibly labored and shallow, and I believe that the experience had lasting repercussions on her breathing style. From observing her experience, I think that COVID respiratory infection could be turning nasal breathers into mouth breathers (which I discuss here), and causing people to unnecessarily brace their diaphragm during exhalation (which I discuss here).
It is very possible that COVID-19 took a world full of stressed people and made their breathing habits even worse, increasing their anxiety, cortisol levels, and predisposing them to other stress-related disorders. Unfortunately, many of us breathe up to 20 breaths per minute. Most experts believe that this constitutes hyperventilation and that we should be breathing closer to five breaths per minute. That equates to 5 second inhales and 7 exhales. Anyone can teach themselves to do this. Just as we can learn to breathe more shallowly, we can also relearn to breathe deeply. It requires practice, training, and deep breathing exercises, but regardless of whether you have symptoms or not, it is worth doing.
Again, I am not trying to claim that the majority of the symptoms experienced by COVID-19 long haulers are caused by a change in breathing habits. But I strongly believe that a proportion of them are. This is why I think it is important for people, especially those who have been infected, to undergo breathing retraining. There are many excellent programs that will guide you to lengthen and deepen your breaths. You may want to try my system that I call Program Peace. The following link will take you to a free webpage with numerous breathing exercises that are intended to help people breathe fully using the diaphragm.
Check out https://programpeace.com/breathing-retraining/ if you would like to get started now.
Or for a preview, check out the video below.
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