Breathing 101: Reducing Anxiety and Improving Your Quality of Life

Breathing is something we do in every minute of every day, but for the most part, we are rarely even aware of our breathing.  Scientific studies are showing that in addition to relieving stress, anxiety, and depression, practicing focused breathing techniques can even increase cognitive performance ⁽¹⁾.  There are different ways to practice focused breathing and, I’ll talk about a few here, as well as how they have impacted my life.

The Science Behind It All

Every traumatic brain injury has different outcomes, however, there are distinct behavioral patterns that can be identified in most TBI survivors.  Persistent post-concussive symptoms can include alteration of our stress response, leading to heightened stress that reduces our cognitive abilities and creates memory deficits ⁽²⁾.  Similarly, increased anxiety is a common outcome, even to a point where the patient’s risk for developing PTSD remains elevated for years post-injury ⁽³⁾.  Additionally, post-TBI depressive disorders are also a common outcome ⁽⁴⁾.

While there are currently very few medical treatments that can be prescribed for TBI recovery, there are many effective therapeutic strategies that can be employed ⁽⁵⁾.  There are several therapeutic approaches to controlled breathing that have been shown to have a positive impact on stress, anxiety, and overall sense of well-being. 

Diaphragmatic Breathing

Also known as “deep breathing,” diaphragmatic breathing is defined as, “an efficient integrative mind-body training for dealing with stress and psychosomatic conditions” ⁽¹⁾.  Diaphragmatic breathing refers to a breathing technique where we exhale completely, then pull air deeply into our lungs by expanding our belly until our lungs are full.  The deeper inhalation and exhalation work to maximize the balance of oxygen and carbon dioxide in our blood, and often results in a slower respiration rate.

Many scientific studies have demonstrated the value of focused breathing practice as an effective, nonpharmacological intervention to enhance emotional stability and reduce anxiety, depression, and stress ⁽⁶⁾.  Yogic style breathing techniques (including diaphragmatic breathing) practiced by healthcare professionals in the context of the unprecedented COVID-19 pandemic working requirements offered great benefits, as well, in these areas.  Additionally, the participants expressed a significant improvement in life satisfaction, resilience, and their quality of sleep ⁽⁷⁾.

Slower Breathing

The average breaths per minute run from 10 to 20, for most people.  Breathing techniques that slow your respiration rate to 10 breaths per minute or less have also been shown to significantly reduce stress levels and anxiety, as well as improve overall sense of well-being ⁽⁸⁾.  The optimum rate of breathing for relaxation and improved heart rate variability has been determined to be 5.5 breaths per minute ⁽⁹⁾.  The rate of 5.5 breaths per minute not only improves our mental state, but also improves our physical state measurably – including lowering our blood pressure ⁽¹⁰⁾.

What Our Ancestors Knew

Some of the earliest texts on the importance of breathing well comes from many ancient cultures around the world and are thousands of years old.  This is nothing new, but breathing’s just not something we think about very often unless our sinuses are congested or we’re under water.  If we look to yoga, a practice that is at least five thousand years old, we see a very strong focus on proper breathing for both mental and physical health.  The most ancient spiritual text from India, the writings of the Buddha, ancient Chinese teachings, and more; there are many sources that have taught the importance of our breath in the quality of our lives.

What I’ve Learned

By starting to pay attention, I’ve learned that when I am stressed or anxious my breathing often becomes very shallow.  Shallow breathing increases both our blood pressure and our heart rate, which then increases the stress hormone cortisol in our systems.  I’ve learned that if I take a conscious moment to redirect my breathing to be deeper and slower my stress and anxiety seem to dissipate much faster than normal.

I’ve learned that if I focus on my breath when I meditate I can fall into a rhythm of healthy breathing very quickly.  I always seem to feel more relaxed and more energized when I finish my meditation if I pay attention to my breath.  On my meditation app I’ve found several guided meditations that gently draw me back to breath awareness throughout the meditation.  

Something else I’ve learned is the value of little reminders to breathe.  I was listening to an audio book recently that discussed the benefits of a mindfulness bell.  This is a bell that rings periodically through the day, and when it does, the idea is to stop what you’re doing (when possible) and take a moment to focus completely on your breath.  Breathe deep and slow, feeling the air entering and leaving your body and quieting your mind for a moment.  And, of course, there’s an app for that.  I found one that I like. I set mine to chime every 40 minutes with a quiet bell.  Each time it chimes, I take a mindful breath.  So far, I really like it.  The other advantage is that this repeated practice each day is helping me become more in tune with my breath throughout the day.  It provides regular reminders that, when I add diaphragmatic and slow breathing to my activities of daily life, I am improving both my mental and physical health.

In Closing

Focused breathing techniques can be used both as treatment and as prevention.  When you’re feeling stress, anxiety, or any emotional difficulty, taking a few moments to focus on your breath can help you find balance in that moment.  If you make time to practice these breathing techniques each day, you will improve your mental and physical health, increase resilience, and even add to your longevity.

There are many good texts to read on better breathing, but one that I can strongly recommend is Breath: The New Science of a Lost Art, by James Nestor.  It was a NY Times best seller, and even named best book of 2020 by NPR.  James covers so many important aspects of how our breath impacts everything about us, and he’s very engaging in his writing style.

My path forward is to continue to bring my attention to my breathing, to breathe correctly and as close to 5.5 breaths per minutes as I can without watching a clock.  I intend to write more about breathing in upcoming posts, with a little more detail.  For now, I leave you with one word:  Breathe.

References

1. Xiao Ma, Zi-Qi Yue, Zhu-Qing Gong, Hong Zhang, Nai-Yue Duan, Yu-Tong Shi, Gao-Xia Wei, and You-Fa Li, (2017), The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults
2. B Hanna-Pladdy, Z M Berry, T Bennett, H L Phillips, W D Gouvier, (2001), Stress as a Diagnostic Challenge for Postconcussive Symptoms: Sequelae of Mild Traumatic Brain Injury or Physiological Stress Response
3. Krista M. Rodgers, Yuetiva K. Deming, Florencia M. Bercum, Serhiy Y. Chumachenko, Julie L. Wieseler, Kirk W. Johnson, Linda R. Watkins, and Daniel S. Barth, (2014), Reversal of Established Traumatic Brain Injury-Induced, Anxiety-Like Behavior in Rats after Delayed, Post-Injury Neuroimmune Suppression
4. Mohammad Farris Iman Leong Bin Abdullah, Yin Ping Ng, Hatta Bin Sidi, (2018), Depression and Anxiety Among Traumatic Brain Injury Patients in Malaysia
5. Michael Galgano, Gentian Toshkezi, Xuecheng Qiu, Thomas Russell, Lawrence Chin, and Li-Ru Zhao, (2017), Traumatic Brain Injury: Current Treatment Strategies and Future Endeavors
6. Richard P Brown, Patricia L Gerbarg, (2005), Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression. Part II–Clinical Applications and Guidelines
7. Kanchibhotla Divya, Saisudha Bharathi, Ramrakhyani Somya, Mehta H Darshan, (2021), Impact of a Yogic Breathing Technique on the Well-Being of Healthcare Professionals During the COVID-19 Pandemic
8. Andrea Zaccaro, Andrea Piarulli, Marco Laurino, Erika Garbella, Danilo Menicucci, Bruno Neri, and Angelo Gemignani, (2018), How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing
9. I M Lin, L Y Tai, S Y Fan, (2014), Breathing at a Rate of 5.5 Breaths per Minute with Equal Inhalation-To-Exhalation Ratio Increases Heart Rate Variability
10. Patrick R. Steffen, Tara Austin, Andrea DeBarros, and Tracy Brown, (2017), The Impact of Resonance Frequency Breathing on Measures of Heart Rate Variability, Blood Pressure, and Mood