# AI instructs 'take deep breaths' during panic attack without specifying exhale length or hyperventilation risk

- **ID:** `mental-health/panic-attack-breathing-instructions`
- **Domain:** mental-health
- **Category:** data_error
- **Error Code:** `PANIC-BREATH-001`
- **Verification:** ai_generated
- **Fix Rate:** 85%

## Root Cause

During panic attacks, hyperventilation causes low CO2; 'deep breathing' without extended exhale can worsen hyperventilation and increase panic; proper technique requires exhale longer than inhale.

## Workarounds

1. **Use the 4-7-8 breathing pattern: inhale through nose for 4 seconds, hold for 7 seconds, exhale through mouth for 8 seconds. This ensures prolonged exhale and activates parasympathetic nervous system.** (90% success)
   ```
   Use the 4-7-8 breathing pattern: inhale through nose for 4 seconds, hold for 7 seconds, exhale through mouth for 8 seconds. This ensures prolonged exhale and activates parasympathetic nervous system.
   ```
2. **Provide a paced breathing audio cue or visual timer: 'Exhale to the count of 6, inhale to the count of 3. Repeat until you feel your shoulders drop.'** (85% success)
   ```
   Provide a paced breathing audio cue or visual timer: 'Exhale to the count of 6, inhale to the count of 3. Repeat until you feel your shoulders drop.'
   ```
3. **If user cannot do 4-7-8, offer an alternative: 'Breathe out through pursed lips like blowing through a straw for 6 seconds, then let air in naturally for 3 seconds.'** (80% success)
   ```
   If user cannot do 4-7-8, offer an alternative: 'Breathe out through pursed lips like blowing through a straw for 6 seconds, then let air in naturally for 3 seconds.'
   ```

## Dead Ends

- **** — Users often inhale too deeply and exhale too quickly, perpetuating hyperventilation (75% fail)
- **** — Equal inhale/exhale does not correct CO2 balance; exhale must be longer (e.g., 4-7-8 or 4-6 ratio) (60% fail)
- **** — Can increase anxiety about breathing itself; user may feel they are 'doing it wrong' (70% fail)