Manual breathing: why you can’t stop noticing your breath

“You are now breathing manually.”

If you’ve ever read that line online and suddenly found yourself unable to stop noticing every breath, you’ve had a taste of manual breathing. For most people, the feeling fades within a minute. For some, especially people with anxiety, it can stick around for hours, days or longer, and it can be very distressing.

Here’s what manual breathing is, why it happens, and the most important thing to know: your body never forgets to breathe.

What is manual breathing?

Manual breathing is when you become aware of your breathing and feel as if you have to control it yourself: deciding when to breathe in, how deep to go and when to breathe out. It can feel as if your breathing has stopped being automatic, and that if you stop paying attention, you might stop breathing.

People describe:

• not being able to stop noticing each breath
• feeling as if breathing is effortful or unnatural
• feeling like you can’t get a satisfying breath
• worrying you’ll forget to breathe, especially when falling asleep
• yawning or sighing a lot to try to “reset” your breathing

Your body can’t forget to breathe

This is the most reassuring fact about manual breathing. Breathing is controlled automatically by your brainstem, the oldest part of your brain, which monitors the level of carbon dioxide in your blood and adjusts your breathing to match. It does this every second of your life, whether you’re awake, asleep or thinking about something else.

You can take over your breathing on purpose, like when you hold your breath or breathe slowly. But the moment your attention moves on, the automatic system takes straight back over. Even if you held your breath, rising carbon dioxide would soon force you to breathe again.

So manual breathing is a feeling, not a fact. Your breathing is still automatic. You’ve just noticed it.

Why manual breathing happens

Attention

Your brain filters out most body sensations so you can get on with life. When you notice your breathing, you bring it into the spotlight. The harder you try to push it back out, the more you check whether it’s gone, and the more it stays in the spotlight.

Anxiety

When you’re anxious, you scan your body for signs of danger, and breathing is one of the first things you notice. Anxiety also changes how you breathe, making it faster and higher in your chest, which feels unfamiliar.

Sensorimotor OCD

For some people, manual breathing is part of sensorimotor OCD (sometimes called somatic OCD): getting stuck on normal body processes like breathing, blinking, swallowing or your heartbeat. It isn’t dangerous, but it can be very distressing, and it responds well to treatment.

What helps

The key is changing how you respond, rather than trying to force the awareness away:

• Remind yourself: “My brainstem is breathing for me. I don’t need to do anything.”
• Let it be there. Notice your breathing, then let it be in the background, like the sound of a fan.
• Turn your attention outward, to a conversation, a task, music or what you can see.
• Don’t test it. Checking whether you’re still breathing manually keeps it going.

Our post on how to stop manually breathing goes through these steps in more detail.

How Breatheasy can help

Breatheasy can help in two ways. Its guided breathing exercises give you a rhythm to follow for a few minutes, with your phone pulsing as you breathe in, so you can practise breathing with your body instead of fighting it, and then let go. And if checking your breathing has become a compulsion, Breatheasy’s “Ride out an urge” tool waits with you while the urge to check rises, peaks and falls. Breatheasy is coming soon to iPhone and Android.

When to get help

Talk to a doctor if manual breathing is causing you a lot of distress, keeps coming back, or is getting in the way of sleep or daily life. Cognitive behavioural therapy (CBT), including exposure and response prevention (ERP) for sensorimotor OCD, helps most people.

If you’re actually short of breath, have chest pain, or your lips turn blue or grey, call 911.

Sources

• Russo, Santarelli and O’Rourke (2017). The physiological effects of slow breathing in the healthy human. Breathe.
• Obsessive compulsive disorder (OCD), NHS
• Generalised anxiety disorder (GAD), NHS