3 Tips on How Breath Can Calm Anxiety and Stress

In therapy, I often encounter patients tormented by chronic anxiety and depression or struck by grief and the dissolution of intimate relationships; feeling hopeless and exhausted, they search relentlessly for something to relieve the emotional pain. As the pandemic imposes restrictions on the outside world, I have become increasingly curious about holistic approaches harvesting the power within our body and mind and science-based interventions that could help activate our body’s natural ability to heal and rebuild. Two books have piqued my interest, “Why We Sleep” by Dr. Matthew Walker and “Breath” by James Nestor. Both books delve deeper into essential bodily functions, sleep, and breath, unassumingly simple yet under-appreciated by many.

I am intrigued by the power of breath for many reasons: Breath is not only the channel that connects us to the world outside but also a bridge that links the mind and body; we take on average 20,000 breaths a day! Breath is also a foundational building block to mindfulness practice, an increasingly popular intervention backed by decades of research to have myriad benefits to our mental health and wellbeing.

Additionally, each culture has unique expressions tied to breathing, “you take my breath away” when we are in awe of beauty, “a breath of fresh air,” when we feel excited by something refreshing and different. In California, many of us remembered the “orange” day in San Francisco, when the sky was covered by an apocalyptic orange blanket from the rampaging wildfire. Braving the smoke-filled air with my covid-19 mask on, I recall an intense hunger for fresh air triggered by the dooming suffocation.

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Nose Breathing vs. Mouth Breathing

With increased air pollution and allergies, many of us have converted into mouth breathers over the years. While you might say any way that gets air into your lungs is a good way. Nasal breathing has several benefits compared to mouth breathing.

Your nose serves multiple purposes in breathing. The nasal passages warm up and humidify the air going into your lungs; tiny hair-like structures in your nose are responsible for filtering out toxins. The sense of smell adds another layer of protection against any foul substances coming into our bodies. Occasionally breathing through your mouth is not terrible, yet chronic mouth breathing can lead to a host of issues, such as dry mouth, gum disease, and sleep apnea (Kim et al., 2011).

One study showed a surprising finding that 80 percent of patients with chronic breathing disorders also met the criteria for depression and/or anxiety (Kunik et al., 2005). To know if you are mouth breathing throughout the night, some giveaway signs are snoring, dry mouth, feeling tired despite having enough sleep. A study found that taping participants’ mouths shut effectively increased rapid-eye-movement (REM) sleep through the night (Teschler et al., 1999), an important stage of sleep related to dreaming and learning.

Paced Breathing Calms Anxiety, Lowers Blood Pressure, and Improves Cardiovascular Health

Researchers have long noted the healing power behind the simple act of breathing, from calming anxiety and decreasing stress levels among children with ADHD (Sonne & Jensen, 2016), to lowering blood pressure (Bachler et al ., 2020) and improving sleep quality. A one-day breathing retreat effectively reduced job burnout (Salyers et al., 2001). Slow and paced breath can activate the parasympathetic nervous system, the part of our body responsible for inducing relaxation and calming responses.

On the contrary, rapid and labored breathing can send us into a state of panic. During a panic attack, our brain perceives a seemingly neutral situation (e.g., driving) as if it is a wild tiger chasing us down, activating our body’s preservation mode, the “fight-or-flight” response, resulting in an intense cascade of physical responses. You may feel light-headed, fear losing control, or experience palpitations and shallow breath. During the regular act of breathing, we inhale oxygen and exhale carbon dioxide. Shallow and rapid breathing can lead to “over-breathing” or an increase of oxygen and a decrease of carbon dioxide in our system, leaving us gasping for air.

Many of us have the habit of holding our breath when feeling stressed or nervous; by shifting our attention to slow and paced breathing, we are anchoring ourselves to the present moment and reshaping our autonomic system to react more effectively. Some studies have suggested the ideal respiratory rate to be 5.5-6 breaths per minute, with longer exhales than inhales (Adhana et al., 2013).

Diaphragmatic Breathing (Belly Breathing)

Diaphragmatic breathing is another breathing technique involving the contraction of the diaphragm with each inhalation and exhalation. Diaphragmatic breathing has many benefits, including improving attention, mood (Ma et al., 2017), and sleep (Liu et al., 2021). The diaphragm is a large dome-shaped muscle located below the lungs; engagement of the diaphragm when breathing can help strengthen the core and stabilize movement.

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To help strengthen your diaphragm and breath more efficiently, practice the following steps suggested by the Harvard Health online library:

Lie on your back on a flat surface (or in bed) with your knees bent. You can use a pillow under your head and knees for support if that's more comfortable.

Place one hand on your upper chest and the other on your belly, just below your rib cage.

Breathe in slowly through your nose, letting the air in deeply, towards your lower belly. The hand on your chest should remain still, while the one on your belly should rise.

Tighten your abdominal muscles and let them fall inward as you exhale through pursed lips. The hand on your belly should move down to its original position.

In Chinese, breath writes as “呼吸(hu-xi),” which translates into “exhale-inhale.” I never quite understood why exhale comes before inhale until now. Exhale represents the letting go of stagnant energy that will make room for each inhale that brings renewal. Our breath is like water, splashing waves with rapid and dysregulated breath, calming streams with paced and gentle breath.

Take it slow, one breath at a time.