Just relax and concentrate on your breathing.

“Just relax and concentrate on your breathing” is a comment that is heard by almost all patients attending an emergency department with an exacerbation of acute asthma. It’s meant to reassure the patient but has exactly the opposite effect. I have severe asthma and often have to attend my local emergency department with acute attacks. These attacks leave me struggling to breathe; sitting up is difficult and speaking almost impossible. Doctors’ and nurses’ initial instinct is to offer support, and naturally because of how I look their advice is to sit back, relax, and don’t talk. I always try to talk, however; and having spoken to other people with asthma they do too. Concentrating on breathing induces a sense of panic because you can’t do it and fear for what will happen if this is not resolved. By talking you are concentrating on something else. Your speech may not be great, and speaking will look like a huge effort, but the effort of talking takes away the fear of not being able to breathe. This can help people having an asthma attack from falling into a vicious cycle where over-focusing on breathing ends upmaking them hyperventilate. Ask what works