Breathing is the single most important thing we as humans do all day.
24/7 we’re always breathing. You would think we’ve mastered this skill.
The math seems so easy.
Breathe in + breathe out = life.
Yet so many people are not properly breathing, and it may be at the heart of our modern-day mental health crises.
Breathing And The Brain
While it’s common knowledge that breathing is essential for living, it may not be as commonly understood that proper breathing is essential for thriving.
This is because the way you breathe has as much influence on your mental health as it does on your physical health.1Andrea Zaccaro, Andrea Piarulli Marco Laurino, Erika Garbella, Danilo Menicucci, Bruno Neri, and Angelo Gemignani. How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing Front Hum Neurosci. 2018
This is due to the inextricable link of the mind/body connection.
Breathing directly controls the action of your autonomic nervous system.2Brown RP, Gerbarg PL, Muench F.e. Breathing practices for treatment of psychiatric and stress-related medical conditions. Psychiatr Clin North Am. 2013
The depth and pace of your breath from moment to moment can dictate whether you are activating the sympathetic or parasympathetic nervous systems.
In other words, each breath dictates whether you are in a state of calm and peace, or a state of stress and panic.
And since the autonomic nervous system has a direct effect on mental health,3Gail A. Alvares, PhD, Daniel S. Quintana, PhD, Ian B. Hickie, MBBS, FRANZCP, and Adam J. Guastella, PhD. Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis J Psychiatry Neurosci. 2016
it’s safe to say that mastering its expression through breathing is essential for optimizing mental well-being.
What Is Diaphragmatic Breathing?
Diaphragmatic breathing or “deep breathing,” is an integrative exercise in mind/body optimization, that is useful for dealing with stress and psychosomatic conditions.
This breathing technique involves the contraction of the diaphragm, expansion of the belly, and deepening of inhalation and exhalation. 4Xiao Ma, Zi-Qi Yue, Zhu-Qing Gong, Hong Zhang, Nai-Yue Duan, Yu-Tong Shi, Gao-Xia Wei,* and You-Fa Li. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults Front Psychol. 2017
As a consequence, this decreases the respiration frequency and maximizes the amounts of blood gases.
Diaphragmatic breathing is at the core of most yoga, meditation and mindfulness practices.
Mastering this style of deep, controlled breathing shows promise in healing from many psychological disorders such as anxiety, depression.5Tekur P, Nagarathna R, Chametcha S, Hankey A, Nagendra HR. A comprehensive yoga programs improves pain, anxiety and depression in chronic low back pain patients more than exercise: an RCT Complement Ther Med. 2012 , PTSD6Descilo T, Vedamurtachar A, Gerbarg PL, Nagaraja D, Gangadhar BN, Damodaran B, Adelson B, Braslow LH, Marcus S, Brown RP. Effects of a yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 South-East Asia tsunami. Acta Psychiatr Scand. 2010 , motion disorders7Russell ME, Hoffman B, Stromberg S, Carlson CR. Use of controlled diaphragmatic breathing for the management of motion sickness in a virtual reality environment. Appl Psychophysiol Biofeedback. 2014 , and many other stress-related disorders8Friedman BH, Thayer JF. Autonomic balance revisited: panic anxiety and heart rate variability. J Psychosom Res. 1998
There is even evidence of diaphragmatic breathing improving instances of ADHD and focus disorders.9Xiao Ma, Zi-Qi Yue, Zhu-Qing Gong, Hong Zhang, Nai-Yue Duan, Yu-Tong Shi, Gao-Xia Wei,* and You-Fa Li,*. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults Front Psychol. 2017
Needless to say, implementing a practice of diaphragmatic breathing can make a profound difference in your life and save you a lot of money on drugs and therapy.
How Diaphragmatic Breathing Reduces Anxiety
Anxiety is defined as the disproportionate feeling of fear in relation to the nature of the given threat level.10Weinberger DR. Anxiety at the frontier of molecular medicine. N Engl J Med. 2001
This emotion is accompanied by higher levels of stress and is implicated in a number of psychiatric disorders including depression, panic attacks, phobias, generalized anxiety disorder, obsessive-compulsive disorder and post-traumatic stress disorder.11Gross C, Hen R.. The developmental origins of anxiety. Nat Rev Neurosci. 2004
From a physiological perspective, anxiety is directly related to levels of oxidative stress in the body.12Jaouad Bouayed, Hassan Rammal, and Rachid Soulimani. Oxidative stress and anxiety Oxid Med Cell Longev. 2009
Oxidative stress is the result of your body’s natural defense mechanisms being overwhelmed by harmful foreign invaders.13Valko M1, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J.. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol. 2007
While a low level of oxidative stress is a normal byproduct of cellular metabolism, chronic oxidative stress in the body can also be harmful to the brain.14Ng F, Berk M, Dean O, Bush AI. Oxidative stress in psychiatric disorders: evidence base and therapeutic implications. Int J Neuropsychopharmacol. 2008
Diaphragmatic breathing has been shown to have an ameliorating effect on oxidative stress through its ability to raise endogenous antioxidant levels and lower cortisol in the body.15Martarelli D, Cocchioni M, Scuri S, Pompei P.. Diaphragmatic breathing reduces exercise-induced oxidative stress. Evid Based Complement Alternat Med. 2011
By physically fighting oxidative stress, diaphragmatic breathing can lower the physiological precursors that lead to anxiety.
Pranayama and Anxiety
Pranayama, known as the fourth limb of Aṣṭāṅga yoga, has also demonstrated beneficial anxiolytic effects.
As most yogis know, this practice of controlled, focused breathing is a great tool for calming stress.
This is due to pranayama’s direct positive effects on the cardiovascular system including blood pressure, heart rate, and respiratory rate.16Apar Avinash Saoji,∗ B.R. Raghavendra, and N.K. Manjunath. Effects of yogic breath regulation: A narrative review of scientific evidence J Ayurveda Integr Med. 2019
Pranayama practitioners have even demonstrated improvements in heart rate variability,17Nivethitha L, Manjunath NK, Mooventhan Ae. Heart Rate Variability Changes During and after the Practice of Bhramari Pranayama. JInt J Yoga. 2017
which is promising since anxiety disorders have been linked to low HRV.18John A. Chalmers, Daniel S. Quintana, Maree J.-Anne Abbott, and Andrew H. Kemp. Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis Front Psychiatry. 2014
In many instances, those who practice pranayama breathing exercises have even been able to quit smoking.19Shahab L, Sarkar BK, West R.. The acute effects of yogic breathing exercises on craving and withdrawal symptoms in abstaining smokers. Psychopharmacology (Berl). 2013
Pranayama is so powerful that positive mental and physical effects can be seen in as little as 5 minutes of practicing.20Vialatte FB, Bakardjian H, Prasad R, Cichocki A. EEG paroxysmal gamma waves during Bhramari Pranayama: a yoga breathing technique. Conscious Cogn. 2009
Nāḍi śodhana, Kapālabhāti, Bhastrikā, Śītalī and Bhrāmarī are the important and most practiced types of prāṇāyāma among practitioners.
Bhrāmarī Prāṇāyāma
The Bhrāmarī Prāṇāyāma is one easiest forms of yogic breathing to practice.
It requires the practitioner to sit in a comfortable posture and inhale and exhale through nostrils slowly and deeply.
While exhaling, you produce a humming sound through the nasal airways, keeping your mouth closed, and using your fingers to seal off the ears.
This powerful form of pranayama breathing has been shown in longer-term randomized controlled trials to shift participants into the parasympathetic domain.21Kuppusamy M, Kamaldeen D, Pitani R, Amaldas J, Ramasamy P, Shanmugam P, Vijayakumar V. Effects of yoga breathing practice on heart rate variability in healthy adolescents: a randomized controlled trial. Integr Med Res. 2020
This is due to Bhrāmarī Prāṇāyāma’s ability to significantly improve overall pulmonary function and positively affect lung function.22Kuppusamy M, Dilara K, Ravishankar P, Julius A. Effect of Bhrāmarī Prāṇāyāma Practice on Pulmonary Function in Healthy Adolescents: A Randomized Control Study.adolescents: a randomized controlled trial. Anc Sci Life. 2017
The physical and mental health benefits of this cannot be understated.
Alternate Nostril Breathing – Nadi Shodhana and Anulom Vilom
Alternate nostril breathing is the practice of alternating inhalation and exhalation through the different nostrils.
Nadi Shodhana and Anulom Vilom are 2 styles of alternate nostril breathing popular in Hatha yoga practice that claims to purify the body’s energy channels through balancing the flow of prana.
Like traditional pranayama, alternate nostril breathing has proven to be a very effective method for improving cardiovascular metrics and promoting parasympathetic dominance.23Srivastava RD, Jain N, Singhal A. Influence of alternate nostril breathing on cardiorespiratory and autonomic functions in healthy young adults. Indian J Physiol Pharmacol. 2005
These cardiovascular benefits translate directly into mental health relief.24Kirkwood G, Rampes H, Tuffrey V, Richardson J, Pilkington K. Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med. 2005
In the brain, this style of yogic breathing balances the 2 cerebral hemispheres which helps to promote visuospatial memory and overall 25 Naveen KV, Nagarathna R, Nagendra HR, Telles S.Kirkwood G, Rampes H, Tuffrey V, Richardson J, Pilkington K. Yoga breathing through a particular nostril increases spatial memory scores without lateralized effects Psychol Rep. 1997
Kundalini Breathing Techniques And Anxiety
Kundalini is a style of yoga focused on dynamic breathing techniques, meditation and chanting.
The intention of the practice is to create vitality in the body, balance in the mind, and awareness of your highest spirit.
Kundalini yoga’s emphasis on strenuous breathing patterns, intense focus and tuning of chakras are known to strengthen the nervous and endocrine systems and test the will of the practitioner beyond the limitations of their ego.
In practice, kundalini has shown effective in lowering instances of perceived stress and salivary cortisol levels.26Jocelyn N García-Sesnich, Mauricio Garrido Flores, Marcela Hernández Ríos, and Jorge Gamonal Aravena. Longitudinal and Immediate Effect of Kundalini Yoga on Salivary Levels of Cortisol and Activity of Alpha-Amylase and Its Effect on Perceived Stress, Int J Yoga. 2017
Kundalini yoga and breathing techniques have also shown effective at lowering feelings of anxiety, fear, anger and OCD.27Shannahoff-Khalsa DS. Patient perspectives: Kundalini yoga meditation techniques for psycho-oncology and as potential therapies for cancer., Integr Cancer Ther. 2005
Breathing and Mindfulness
Focusing on your breath takes your mind away from the worries and struggles that occupy your attention.
It’s these worries that activate your HPA axis and force a stress response in the body.28Chrousos GP1, Kino T, Charmandari E.. Evaluation of the hypothalamic-pituitary-adrenal axis function in childhood and adolescence., Neuroimmunomodulation. 2009
The act of focusing your undivided attention takes these worries out of your consciousness and helps promote mental health and wellbeing29Grossman P, Niemann L, Schmidt S, Walach H.. Mindfulness-based stress reduction and health benefits. A meta-analysis., J Psychosom Res. 2004 .
Benefits of mindfulness-based stress reduction exercises include reductions in stress, anxiety, depression and even instances of physical pain30Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results., Gen Hosp Psychiatry. 1982
4 7 8 breathing technique
The 4-7-8 breathing technique was made famous by Dr. Andrew Weil who is the founder and director of the Integrative Medicine Center at the University of Arizona.
Like pranayama, the 4-7-8 technique shows promise in lower anxiety and stress and improving mental acuity through its promotion of mindful breathing.
To do this breathing technique you simply sit comfortably, breathe in through your nose for 4 seconds, hold the breath for 7 seconds and breathe out for 8 seconds. You can repeat this up to 4 times.
Dr. Weil uses this technique to help patients with falling asleep.
Although there are no clinical studies there is a lot of anecdotal evidence on the 4-7-8 breathing technique’s success.
I’ve been a practitioner of both the 4-7-8 technique and the 5-2-7 technique and have had positive results with both.
How do you breathe deeply when you have anxiety?
No matter which breathing technique you choose, by simply setting the intention to implement a mindful breathing routine you will already be making progress in naturally treating anxiety.
To breathe deeply you must set the intention that you want to breathe deeply and then do it.
Mindfulness is a practice and takes time to master. You must approach this with patience and not be too hard on yourself.
Don’t expect the anxiety to melt away with one session. You must commit to it every day, and eventually, you’ll find that moment of bliss where you don’t feel worried and anxious.
Until then, feel free to experiment with the different styles of yogic and controlled breathing styles to find which one works best for you.
Of course, nootropic supplements can help lower HPA activity and make the process a little easier too.
- 1Andrea Zaccaro, Andrea Piarulli Marco Laurino, Erika Garbella, Danilo Menicucci, Bruno Neri, and Angelo Gemignani. How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing Front Hum Neurosci. 2018
- 2Brown RP, Gerbarg PL, Muench F.e. Breathing practices for treatment of psychiatric and stress-related medical conditions. Psychiatr Clin North Am. 2013
- 3Gail A. Alvares, PhD, Daniel S. Quintana, PhD, Ian B. Hickie, MBBS, FRANZCP, and Adam J. Guastella, PhD. Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis J Psychiatry Neurosci. 2016
- 4Xiao Ma, Zi-Qi Yue, Zhu-Qing Gong, Hong Zhang, Nai-Yue Duan, Yu-Tong Shi, Gao-Xia Wei,* and You-Fa Li. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults Front Psychol. 2017
- 5Tekur P, Nagarathna R, Chametcha S, Hankey A, Nagendra HR. A comprehensive yoga programs improves pain, anxiety and depression in chronic low back pain patients more than exercise: an RCT Complement Ther Med. 2012
- 6Descilo T, Vedamurtachar A, Gerbarg PL, Nagaraja D, Gangadhar BN, Damodaran B, Adelson B, Braslow LH, Marcus S, Brown RP. Effects of a yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 South-East Asia tsunami. Acta Psychiatr Scand. 2010
- 7Russell ME, Hoffman B, Stromberg S, Carlson CR. Use of controlled diaphragmatic breathing for the management of motion sickness in a virtual reality environment. Appl Psychophysiol Biofeedback. 2014
- 8Friedman BH, Thayer JF. Autonomic balance revisited: panic anxiety and heart rate variability. J Psychosom Res. 1998
- 9Xiao Ma, Zi-Qi Yue, Zhu-Qing Gong, Hong Zhang, Nai-Yue Duan, Yu-Tong Shi, Gao-Xia Wei,* and You-Fa Li,*. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults Front Psychol. 2017
- 10Weinberger DR. Anxiety at the frontier of molecular medicine. N Engl J Med. 2001
- 11Gross C, Hen R.. The developmental origins of anxiety. Nat Rev Neurosci. 2004
- 12Jaouad Bouayed, Hassan Rammal, and Rachid Soulimani. Oxidative stress and anxiety Oxid Med Cell Longev. 2009
- 13Valko M1, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J.. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol. 2007
- 14Ng F, Berk M, Dean O, Bush AI. Oxidative stress in psychiatric disorders: evidence base and therapeutic implications. Int J Neuropsychopharmacol. 2008
- 15Martarelli D, Cocchioni M, Scuri S, Pompei P.. Diaphragmatic breathing reduces exercise-induced oxidative stress. Evid Based Complement Alternat Med. 2011
- 16Apar Avinash Saoji,∗ B.R. Raghavendra, and N.K. Manjunath. Effects of yogic breath regulation: A narrative review of scientific evidence J Ayurveda Integr Med. 2019
- 17Nivethitha L, Manjunath NK, Mooventhan Ae. Heart Rate Variability Changes During and after the Practice of Bhramari Pranayama. JInt J Yoga. 2017
- 18John A. Chalmers, Daniel S. Quintana, Maree J.-Anne Abbott, and Andrew H. Kemp. Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis Front Psychiatry. 2014
- 19Shahab L, Sarkar BK, West R.. The acute effects of yogic breathing exercises on craving and withdrawal symptoms in abstaining smokers. Psychopharmacology (Berl). 2013
- 20Vialatte FB, Bakardjian H, Prasad R, Cichocki A. EEG paroxysmal gamma waves during Bhramari Pranayama: a yoga breathing technique. Conscious Cogn. 2009
- 21Kuppusamy M, Kamaldeen D, Pitani R, Amaldas J, Ramasamy P, Shanmugam P, Vijayakumar V. Effects of yoga breathing practice on heart rate variability in healthy adolescents: a randomized controlled trial. Integr Med Res. 2020
- 22Kuppusamy M, Dilara K, Ravishankar P, Julius A. Effect of Bhrāmarī Prāṇāyāma Practice on Pulmonary Function in Healthy Adolescents: A Randomized Control Study.adolescents: a randomized controlled trial. Anc Sci Life. 2017
- 23Srivastava RD, Jain N, Singhal A. Influence of alternate nostril breathing on cardiorespiratory and autonomic functions in healthy young adults. Indian J Physiol Pharmacol. 2005
- 24Kirkwood G, Rampes H, Tuffrey V, Richardson J, Pilkington K. Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med. 2005
- 25Naveen KV, Nagarathna R, Nagendra HR, Telles S.Kirkwood G, Rampes H, Tuffrey V, Richardson J, Pilkington K. Yoga breathing through a particular nostril increases spatial memory scores without lateralized effects Psychol Rep. 1997
- 26Jocelyn N García-Sesnich, Mauricio Garrido Flores, Marcela Hernández Ríos, and Jorge Gamonal Aravena. Longitudinal and Immediate Effect of Kundalini Yoga on Salivary Levels of Cortisol and Activity of Alpha-Amylase and Its Effect on Perceived Stress, Int J Yoga. 2017
- 27Shannahoff-Khalsa DS. Patient perspectives: Kundalini yoga meditation techniques for psycho-oncology and as potential therapies for cancer., Integr Cancer Ther. 2005
- 28Chrousos GP1, Kino T, Charmandari E.. Evaluation of the hypothalamic-pituitary-adrenal axis function in childhood and adolescence., Neuroimmunomodulation. 2009
- 29Grossman P, Niemann L, Schmidt S, Walach H.. Mindfulness-based stress reduction and health benefits. A meta-analysis., J Psychosom Res. 2004
- 30