A professional woman came in with lifelong anxiety manifesting with palpitations, thoracic breathing, and anxious scanning for physical symptoms. Perimenopause had intensified her anxiety. She engaged in a treatment program including heart rate variability biofeedback (HRV) to lower her body’s arousal. Her lifelong dysfunctional breathing pattern was very difficult to change, however she was highly motivated and practiced consistently. After four sessions her anxiety greatly decreased along with the anxious scanning and palpitations. Because there is a strong hormonal component to her symptoms, she will have to frequently apply her anxiety management skills and be in close contact with her physician to help in stabilizing her hormones.

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