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The psychology and science of #fear of #suffocation and #panic : a thread
It is easy to mock people who believe that #masks will poison them with #CO2 or kill them.
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It is easy to mock people who believe that #masks will poison them with #CO2 or kill them.
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While mask wearing has become politicized, particularly in the US, what is most notable when you listen and watch people talking about masks is their FEAR.
2/ https://twitter.com/Hoeshateme5/status/1276249276734230535?s=20
2/ https://twitter.com/Hoeshateme5/status/1276249276734230535?s=20
Some people have an experience of suffocation when they wear masks.
This is not unique to wearing medical masks or face coveringsâ this is true of wearing sleep apnea masks or Halloweâen masks too!
3/ https://pubmed.ncbi.nlm.nih.gov/15781905/
This is not unique to wearing medical masks or face coveringsâ this is true of wearing sleep apnea masks or Halloweâen masks too!
3/ https://pubmed.ncbi.nlm.nih.gov/15781905/
Believing that you are suffocating when you are not happens in people with a highly sensitive âfalse suffocation alarmâ
False suffocation alarms can be triggered by trivial changes to CO2 or changes in breathing patterns in reaction to anxiety.
4/ https://www.sciencemag.org/news/2007/10/lungs-brain-dont-panic
False suffocation alarms can be triggered by trivial changes to CO2 or changes in breathing patterns in reaction to anxiety.
4/ https://www.sciencemag.org/news/2007/10/lungs-brain-dont-panic
The anxious or panic-prone person senses a change in respiration that they experience as being short of breath, and they feel anxious, think catastrophic thoughts (âIâm suffocatingâ) and they start breathing harder and faster.
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https://ppw.kuleuven.be/ogp/2012fearofsuffocation.pdf
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https://ppw.kuleuven.be/ogp/2012fearofsuffocation.pdf
This maladaptive reaction to feeling short of breath sets off the panic cycle. Before long adrenaline is pumping, anxiety is through the roof, and you are convinced you are dying. The mask is whipped offâŠ.
And reliefâŠ. So you naturally conclude the mask is killing you.
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And reliefâŠ. So you naturally conclude the mask is killing you.
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I suspect *some* people who are claiming medical exceptions for masks have had a similar experience. One or two experiences where you fear suffocation while wearing a mask quickly reinforces the idea that masks are not for you.
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When we mock people for having these beliefs, we make them defensive and more entrenched. How dare we suggest that their experience of suffocation isnât real?
Mask fearers genuinely believe that their lives are in danger.
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Mask fearers genuinely believe that their lives are in danger.
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There is an imperative now that we support people in wearing masks, for them and for public health.
To do this, we need to validate their experienceâyes, you really did experience a feeling of suffocationâand educate.
Here is my stab at it:
To do this, we need to validate their experienceâyes, you really did experience a feeling of suffocationâand educate.
Here is my stab at it:
Fear of suffocation and panic are common. They happen because you happen to have a brain that is highly sensitive to sensations of suffocation, and you are prone to having an anxious reaction to these sensations.
But you are not in danger from wearing a mask.
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But you are not in danger from wearing a mask.
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It is possible to extinguish this false suffocation reaction and to learn to feel comfortable wearing a mask.
To do this, we use an evidence-based therapy called exposure therapy.
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To do this, we use an evidence-based therapy called exposure therapy.
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In briefâyou extinguish your fear reaction that arises when you feel like your breathing is obstructed.
Start by practicing a type of breathing that counteracts the gasping air hungry breathing that happens when you feel you are suffocating.
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Start by practicing a type of breathing that counteracts the gasping air hungry breathing that happens when you feel you are suffocating.
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Then gradually, start by holding the mask in front of your face, but not on your face. Breath slowly and deeply.
Continue this until you donât feel any anxiety, at least 5 minutes.
Next time, bring the mask a bit closer and repeat.
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Continue this until you donât feel any anxiety, at least 5 minutes.
Next time, bring the mask a bit closer and repeat.
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If you feel your anxiety or sense of suffocation increasing, first remind yourself that you are not suffocating. You are not in danger.
Keep breathing slowly and deeply. Wait until your anxiety has completely resolved. Then repeat.
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Keep breathing slowly and deeply. Wait until your anxiety has completely resolved. Then repeat.
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Continue this process until you have the mask on your face, ear loops on.
Keep breathing slowly and deeply until your anxiety has resolved. Then keep wearing the mask, breathing normally. Any time you feel your anxiety ramping up, do your box breathing again.
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Keep breathing slowly and deeply until your anxiety has resolved. Then keep wearing the mask, breathing normally. Any time you feel your anxiety ramping up, do your box breathing again.
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Practice wearing the mask around the houseâespecially if you are afraid of panicking in public.
And try not to take off the mask when you anxiety is rising. This reinforces the fear. Breathe through the anxiety, and take off the mask when the anxiety has gone.
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And try not to take off the mask when you anxiety is rising. This reinforces the fear. Breathe through the anxiety, and take off the mask when the anxiety has gone.
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You may ask where my expertise in this area comes from.
One, as a psychiatrist with an interest in anxiety disorders.
Two, as a person with a very sensitive suffocation alarm!
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One, as a psychiatrist with an interest in anxiety disorders.
Two, as a person with a very sensitive suffocation alarm!
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I was the med student who avoided scrubbing into surgery at all costs. When I left surgery early, everyone thought I was squeamish.
I wasnât! I loved the gore. I just felt like I couldnât breathe.
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I wasnât! I loved the gore. I just felt like I couldnât breathe.
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This pandemic has really forced me to confront my fear of masks and overcome my feeling of suffocation.
Now I wear one everyday at work and you wonât catch me in indoor public spaces without one.
Fin.
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Now I wear one everyday at work and you wonât catch me in indoor public spaces without one.
Fin.
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