I have been diagnosed with an anxiety disorder and mild depression. I am concerned that my problem is physical, and that the doctors are missing something. The most upsetting symptom is a constant feeling of unreality, like I am in a dream state and nothing around me is real. The second symptom is the feeling that I cannot breathe very well. I do not have asthma and I have had my heart and lungs checked out. Is this feeling of shallow breathing common with anxiety? What is the longest that someone can have derealization and 24-hours-a-day anxiety? I am only 21 and I feel as if I am going to die soon. I am scared.

Katy

Yes, shallow breathing is common with anxiety. It's a consequence of anxiety-related muscle tension in the diaphragm and chest.

The derealization you describe could be a psychological phenomenon separate (but perhaps related to) the anxiety and depression, or it could be in some way related to the shallow breathing and anxiety. For instance, you may not be exhaling and inhaling deeply enough to properly expel the carbon dioxide in your lungs (the "waste product" of breathing). I wonder if that might be contributing to your derealization. If you're having trouble sleeping (which is common in depressed and/or anxious people), constant interruption or deprivation of the dream stage of sleep might also contribute to such problems.

I'm glad your physicians have determined you do not have a serious heart or lung condition. What I'd recommend now is for you to see a psychologist or other licensed therapist to further assess and address the anxiety and depression. I suspect that when you get help in that area, your breathing problem will abate. If your derealization continues past that point, your psychologist can assess and address any other psychological factors as well.

You might also benefit from doing yoga. Restorative yoga is especially designed to relax the person and replenish his or her energy. Yoga teacher Judith Lasater has a great book on restorative yoga called Relax and Renew: Restful Yoga for Stressful Times. Another resource is the Yoga Journal's videotape series, which includes a "Yoga for Relaxation" tape featuring restorative yoga poses. Your local video store may have it in its exercise video section. There's also a branch of yoga, pranayama, that focuses on breathing. Perhaps your community has a yoga teacher who can teach you pranayama. You might also be interested in Gay Hendricks' book Conscious Breathing: Breathwork for Health, Stress Release and Personal Mastery.

David Burns' book Feeling Good: The New Mood Therapy is also an excellent self-help book on depression and anxiety, and might be a helpful adjunct to sessions with a psychologist. Please do seek out such psychological therapy -- it can be really helpful for people with the problems you're experiencing. Good luck.