When your anxiety is high or you’re feeling panic start to wash over you, there’s a simple tool you can use to calm the physiological effects of anxiety: your breath.
The average person takes between 17,280 to 23,040 breaths a day without any effort. Breathing is controlled by the brainstem via the autonomic nervous system (ANS) which also regulates other involuntary body functions like blood pressure and heartbeat. Despite the involuntary mechanics of breathing, Eastern cultures have practiced controlling the breath or “pranayama” to improve health for thousands of years. But why would you add effort to something that already comes so easy to most people? Numerous studies have shown that controlled breathing is associated with beneficial health outcomes and in particular, the ability to instill calm. Here is what is happening physiologically when you feel distress and how breathing exercises for anxiety can help you calm down.
How your body responds to stress
Distress in our modern society primarily consists of work deadlines, relationship woes, or falling short of the desired number of likes on your last social media post, instead of immediate dangers like running away from the proverbial Saber Tooth Tiger. When faced with or simply perceiving a stressor, an area in the brain called the amygdala that contributes to emotional processing sends a distress signal to the hypothalamus. The hypothalamus, which is akin to a command center, communicates with the adrenal glands through the sympathetic nervous system (SNS), one of two branches of the ANS, to secrete the hormone epinephrine, a.k.a. adrenaline. This causes an increase in heart rate, blood pressure, and breathing. In addition, glucose is released into the bloodstream to provide energy. All of this happens almost immediately and is commonly referred to as the fight-or-flight response. Then cortisol, the stress hormone, kicks in around 15-20 minutes later.
When the threat has passed, the other branch of the ANS called the parasympathetic nervous system (PNS) calms the body down via the vagus nerve (VN), a bidirectional bundle of nerve fibers running from the brain to the neck, thorax, and abdomen. Under normal conditions, the activation of the PNS acts as the brake on the SNS, eliciting a “rest-and-digest” response and returns the body to a state of calm. However, in a state of chronic stress, the body continues to activate the SNS without the normal counteraction by the PNS. Activating the PNS can stop this perpetuating stress response and restore homeostasis.
Breathing exercises are one way to activate the PNS. Studies looking at controlled breathing have found that it decreases anxiety and has a positive impact on mood, reduces stress, and decreases blood pressure.
Now that you have a little background on the benefits of breathing (besides keeping you alive), start practicing!
4 Breathing exercises for anxiety you can do now
Described as a “natural tranquilizer for the nervous system” by Dr. Andrew Weil, this breathing exercise promotes deep relaxation. This practice hasn’t been studied yet, but anecdotally, we’ve seen this practice be helpful for Parsley Health members dealing with stress and anxiety.
How to do it:
Start by placing the tip of your tongue behind your upper front teeth along the ridge of the gums. This is where it will remain throughout the entire exercise.
- Exhale completely through your mouth around your tongue, making a whoosh sound.
- Close your mouth and quietly inhale through your nose to a count of 4. Visualize nourishing energy flowing into your body.
- Hold your breath for a count of seven. Imagine your breath spiraling and pulling any negative energy from your body.
- Exhale audibly through your mouth for a count of eight. Imagine that negative energy being expelled. You have now completed one breath.
- Inhale again and repeat the cycle three more times for a total of four breaths.
If you find it difficult to hold your breath, count faster, but keep the 4:7:8 ratio. As you build your practice, work on slowing down the count and breathing more deeply.
Named because of the four-sided pattern of the practice, box breathing instills a deeply calm body while amplifying focus and an alert state of mind. It combines a breathing exercise with a visualization exercise, where you imagine drawing a box while you take each breath. This exercise has also not been studied by scientists, but the doctors and health coaches at Parsley find it helps many members who are new to breathwork ease symptoms of anxiety.
How to do it:
Start by sitting in a comfortable chair with your back supported and feet flat on the floor.
Close your eyes and expel all of the air from your lungs.
- Then hold your breath to a slow count of four. Avoid clamping down as this can create back pressure.
- Quietly inhale through your nose to a slow count of four. First, expand the abdomen, then diaphragm, then the upper chest. This trains you to breathe deeply.
- Hold your breath again to a slow count of four.
- Slowly and smoothly exhale through your nose for a slow count of 4. Let the breath go from the upper chest, diaphragm, then lastly the abdomen. You have now completed one box breathing circuit.
- Repeat the cycle for 4 minutes or as long as you need to.
You can progress to a 5-5-5-5 ratio and so on as your breathing threshold improves. Build up to 20 minutes per day, ideally practicing a single, dedicated session with additional shorter “spot drills” as needed.
The diaphragm is a muscle that separates the chest cavity from the abdominal cavity. Diaphragmatic breathing consists of breathing deeply and expanding the abdomen instead of the chest and facilitates slower breathing. When you inhale, the diaphragm contracts, pushing down on the abdominal organs. During an exhale, the diaphragm relaxes and moves back towards your spine. Focus on completely exhaling to allow the diaphragm to fully relax and allow for maximum air exchange by creating space for the next inhale.
Diaphragmatic breathing promotes blood circulation, lowering the pulse rate and blood pressure by improving vagal tone. A systematic review found that diaphragmatic breathing may reduce physiological and psychological stress. In addition, diaphragmatic breathing has been used as behavioral interventions for pain, anxiety, and motion sickness, and a meta-analysis showed improvement in GERD symptoms by strengthening diaphragm tension.
How to do it:
Start by lying down with your knees bent and feet hip-width distance apart. You can also do this in a comfortable, seated position. To help visualize the internal flow of your deep breaths, place one hand on your abdomen which will rise and fall with your breaths and the other hand on your chest.
- Inhale deeply through the nose while expanding the abdomen, feeling the hand on your abdomen rise while the hand on the chest remains still.
- Pause and then contract the abdomen, exhaling slowly and completely through pursed lips. You will feel your abdominal hand fall.
Aim to practice 5-10 minutes daily, progressively increasing to multiple times per day.
Alternate nostril breathing
Alternate nostril breathing, also called Nadi Shodhana in Sanskrit or Anulom Vilom, is a breathing technique that involves inhaling and exhaling through one nostril at a time. This technique can also be done by dedicating one nostril for inhalations and the other for exhalations. Alternative nostril breathing has been shown to reduce anxiety in a simulated-public speaking model and in a clinical trial, decrease heart rate and breathing rate after 15 minutes and following 8 weeks of practice. In addition, a six-week practice of alternative nostril breathing improved vagal tone, increased HRV, and promoted cardiovascular health.
The mechanism behind alternative nostril breathing’s beneficial effects on the body involves asymmetric nasal airflow with the dominant airflow occurring in one nasal passage then alternating to the other over a period of hours, described as the “nasal cycle.” This asymmetry of airflow is controlled by the ANS. Breathing, which generates this airflow, then activates mechanical receptors in the nasal passages resulting in each nostril sending its own signal to the regions of the hypothalamus regulating the ANS and results in calm and relaxation.
How to do it
Start by sitting in a comfortable position with your spine straight and chest open. Rest your left hand on your lap as you will use your right hand during the practice.
- Hold your right hand in front of your face and gently anchor the index and middle fingers between your eyebrows. Close your eyes.
- With your right thumb, gently close your right nostril and inhale slowly through your left nostril which should be open.
- With your right ring finger, gently close your left nostril so that both nostrils are closed and pause at the top of your inhale.
- Open your right nostril and exhale slowly through that side, pausing at the bottom of the exhale.
- Inhale slowly through the right nostril.
- Gently close both nostrils again and pause at the top of your inhale.
- Open your left nostril and exhale slowly through that side, pausing at the bottom of the exhale. You have now completed one alternative nostril breathing circuit.
- Repeat steps 2-7 with the same counts.
You can slowly progress to longer counts as you refine your practice. Aim to complete 5-10 cycles during stressful times or when you just need a reset.
So the next time you feel anxiety start to take over, choose one of these breathing exercises to activate your parasympathetic nervous system and let calm set in.