In this article we will explore the 4 breathing habits that go hand-in-hand with anxiety and uncover the most fundamental changes you need to make in order to feel calm, relaxed and optimistic more often.
We’ll also dive into a recent study conducted around anxiety and breathwork and how these 4 habits tie into the findings.
Scientists have shown that through breathwork training, you can select to experience the emotions of joy and optimism over fear, depression and anxiety. Breathwork training is receiving a lot of attention right now from the scientific community, and for good reason. In another study, scientists researching breathing retraining in anxiety and panic disorder have shown that conscious breathing and mindfulness techniques can be used to reduce the frequency and intensity of panic attacks and increase resilience to stress. Learn how to use breaethwork to reduce anxiety. Breathwork and anxiety can go hand in hand.
Let’s explore how you can be more in control of your emotions and the way you move through life. Breaking each one of these 4 habits can be a game-changer, and significantly impact the way you function, the way you feel, and the way you show up in the world.
Research into breathing patterns and emotions shows that when you adopt a slumped posture and corresponding breathing pattern, you will experience sadness and other ‘negative’ emotions. The research also shows that by changing your breathing pattern with breathwork training, in addition to changing your posture, you can change the emotion you are feeling. That’s empowering to know!
So when you improve your posture, not only will you improve your ability to breathe better, but you will also feel better.
Good posture – standing or sitting tall without straining and with your spine long, chest open, shoulders back and relaxed down away from your ears, chin slightly lifted – creates more space to breathe well and results in positive emotions such as joy and optimism, and reduces the incidence of stress, anxiety and panic attacks.
Awareness Exercise: Without changing anything, notice how you are sitting or standing right now. Notice whether you are slouched or slumped forward, or whether your body is comfortably upright and open. Notice the qualities of your breathing and notice any corresponding emotions or feelings. The first step to breaking negative habits is becoming aware of them.
Slump forward, with your shoulders rolled forward, your upper back curved, and look down with your eyes rather than up, and try and take a deep belly breath in. Almost impossible, right?
Another good reason to improve your posture is that poor posture can cause shortness of breath and leads to over-breathing, which in turn feeds into the stress-anxiety loop. Let’s break the loop by learning about breathwork and anxiety. By adopting a slumped posture, you greatly limit your ability to access your diaphragm and breathe deeply and diaphragmatically. When you breathe diaphragmatically, you increase your oxygen exchange; breathing into the lower third of the lungs gives you 70% more oxygen than chest breathing. (Check stat with Johannes)
When you are slumped, your body still wants to breathe and because your brain can’t get the oxygen it requires, you’ll experience a sensation of ‘air hunger’. However, as you can’t access your diaphragm, your brain will recruit the back-up breathing muscles around your neck and chest to help you inhale.
These neck muscles are not very efficient and are not designed to be used for the 17,000 breaths you take on average per day. They get tired, fatigued, and can create muscle trigger points that can generate headaches, jaw and neck pain. The neck muscles also need to work more frequently to get the required oxygen intake which in turn makes you breathe faster and shallower, creating a habit in which you are over-breathing.
Over time, over-breathing expels too much carbon dioxide from your blood and alters your blood chemistry. The receptors in your arteries then set a new threshold of carbon dioxide; when you reach this threshold it stimulates you to breathe faster than may be required. The shortness of breath sensation can come from your body requiring oxygen or from your suffocation response getting triggered by an increase in carbon dioxide levels.
This over-breathing pattern activates the fight-flight-freeze response and puts you in a state of stress and arousal, which feeds into the anxiety loop. Your posture is absolutely vital when it comes to reducing anxiety, and when it comes to breathing better and feeling better.
Awareness Exercise: Sit comfortably and bring your awareness to your breath. Without changing anything, notice if you are breathing into your chest or your belly. If you are breathing into your chest, and your breathing pattern is rapid, short and shallow at rest, it’s an indication you are over-breathing.
Recognising a habit of mouth breathing, and then consciously retraining yourself to breathe through your nose is the one of the most important and impactful things you can do for yourself, because this simple change will improve all aspects of your health and wellbeing.
When you breathe through your mouth, it means your breathing rhythm is quicker and shallower, which as we have seen, activates the stress response. Shallow breathing disrupts the balance of oxygen and carbon dioxide necessary to be in a relaxed state, so this type of breathing will perpetuate symptoms of anxiety.
Nose breathing means slower breathing, which has many benefits. Nose breathing actively targets the diaphragm muscle, which is not just a muscle of breathing but is also linked to our emotions. When we breathe low and slow, by using our nose and diaphragm, it makes us feel relaxed and calm through activation of the rest-digest response. As we use the diaphragm, and therefore strengthen it, we also increase our resilience to stress and our vagal tone, by stimulating the vagus nerve.
So, try breathing in and out through your nose whenever possible. If you have problems with nose breathing, then begin slowly and aim to increase the amount of time you spend consciously breathing through your nose each week by 10%.
If you are new to breathwork and have problems with nose breathing, it could be beneficial to work one-on-one with a breathwork instructor who can guide you, or join a breathwork training course to learn how to do breathwork properly.
Awareness Exercise: Without changing anything, bring your awareness to your breath. Notice if you are breathing through your nose or through your mouth. Set a timer throughout the day at intervals to check in again.
Diaphragmatic breathing has many benefits, as this study shows. Try breathing ‘low and slow’ by gently expanding your lower belly, ribs and side body 360 degrees as you inhale, rather than your chest, in order to further activate your parasympathetic nervous system, which will dampen your response to stress and allow your body’s systems to reset. It can be helpful to have your hands over your belly or sides/ribs – fingers on front of lower ribs, hands spanning the side body and thumbs around the back – to have something to gently press into on your inhale breath.
Awareness Exercise: Without changing anything, notice if you are chest breathing or belly breathing. Count how many seconds you are breathing in for. The ideal length of inhalation is more than 4 seconds (ideally 5.5 seconds when you are at rest). Count your exhalation as well. The ideal length of exhalation to activate rest-and-digest is more than 5 seconds. The longer the exhalation, the more you will be using your breath to relax.
When you inhale, your sympathetic nervous system (fight-flight-freeze or stress response) up-regulates, and your heart rate speeds up. As you exhale your parasympathetic nervous system (rest and digest or relaxation response) kicks in to slow your heart rate down again. When you extend your exhalation you engage the rest-and-digest part of your nervous system, which promotes relaxation. Breathwork techniques focused on dealing with anxiety will help extend your time in a parasympathetic state by helping you to lengthen your exhalation.
Awareness exercise: See if you can notice the subtle change in your heart rate whilst you centre your attention on your breath for a few moments. Then, begin focusing on your exhalation. Consciously breathe all the way out…all the way to empty…slowly and comfortably, and feel your abdomen hugging in towards your spine at the end of the exhalation. When you focus on the exhalation and breathe out fully, the next breath takes care of itself. Take 5 more breaths, just focusing on exhaling fully. Simply let your belly relax for each inhalation. Notice how you feel.
Our very own Johannes Egberts became a published author in a medical journal on Breathwork and Anxiety; how they can be linked and breathwork, used as treatment for this disorder. For all of you that way inclined I’ll include the link at the bottom.
For reference the journal is called Brain Sciences and it is an international, peer-reviewed (all the good ones are), open access journal on neuroscience that is published monthly online by MDPI. The article is titled “Breathwork Interventions for Adults with Clinically Diagnosed Anxiety Disorders: A Scoping Review.” The review is collaboration with a bunch of intelligent people, experts from the fields of medicine, pharmacotherapy, psychiatry, psychology, neuroscience, wellness, literacy and breathwork.
It’s 23 pages worth of collaborative assessment from these big brains, in their words, examining the “efficacy of breathwork interventions… for clinically diagnosed anxiety disorders”. What does that mean? Between them they used the most reputable and reliable medical journal search engines to find clinical trials (adhering to relevant professional guidelines) in which people over the age of 18, with clinically diagnosed (in accordance with DSM- 5 classification system) participated in any style of breathwork over the period of 1984-2022. The search yielded them sixteen articles for them to thoroughly review.
Before I get into the actual review I want to touch on the relevance and scope of this study and examine the context of anxiety in our modern world. In writing this I wanted to break down the information into simple terms, but I am using their words below because… well they’re the smart ones:
“Anxiety disorders are the most common group of mental disorders”.
“World Health Organization ranked anxiety disorders as the ninth most common cause of health- related disabilities”.
“Heightened anxiety over protracted periods can lead to a wide variety of physical symptoms and behavioural changes, such as shortness of breath, palpitations, insomnia, and restlessness. These can have severe implications for overall health and well-being.”
“Dysfunctional breathing is a hallmark of anxiety; however, mainstays of treatment do not tackle breathing in patients suffering anxiety”.
Anxiety is “under- diagnosed and under- treated”.
“quality of care is often poor, with substantial patient dissatisfaction”
“Integrated approaches combining pharmacotherapy and psychotherapy are the mainstays for anxiety disorders. Yet, the financial burden of these interventions is staggering”…
“pharmacological treatments… [can be] poorly tolerated, leading to adherence and compliance issues”
“many patients do not seek treatment and often face practical limitations, such as service costs, undesirable side effects or lack of access to providers, and prefer to self- manage their condition instead”
In summary, the point being: anxiety is an exceedingly large and multi-faceted beast and our current protocols are falling short in adequately addressing the issues at hand. Whilst I am trying my best to offer you an easy to digest version of what they discuss these experts really know their stuff, so I am borrowing a quote from them again when they say that there is a dire “need for cost-effective, non-pharmacologic, and self-administered therapies that can be utilised by large populations to release stress and anxiety”.
Further detail on the link between breathwork and anxiety is explored. These links include, but are not exclusive to,
You can read more on how to understand anxiety here.
Given all this background I’m guessing you’re starting to understand why there is such interest in assessing the impact of breathwork on anxiety- probably even before you started reading this. The link between breathwork and anxiety seems quite irrefutable.
Before I get to the results however, I should point out that within these sixteen studies different styles of breathwork were employed. The frequency and duration of the breathwork sessions was not consistent. The outcomes assessed were variable with some being objective, some subjective and others tailored specifically to the aims of the study.
Despite these incongruences the results speak for themselves:
“Significant improvement in all measures compared with control”.
“Significant improvement in all measures”.
“Improved HRV and panic symptoms compared with control”.
“Significant improvement in anxiety measures compared with controls”.
“Significant improvement in all measures at post-treatment and follow-up”.
“Significant improvement in panic severity by using both breathing training methods, maintained and at 6-month follow-up”.
“Significant improvement in panic symptoms, panic-related cognitions, and perceived control”
All of the studies- bar one- saw significant improvements in the participants.
There is discussion regarding the “limitations” of the trials studied. Namely that there are insufficiencies in the consistency and volume to adequately draw conclusions on how, moving forward, breathwork can be optimally utilised for anxiety.
We, however, see this as a strength to build further upon- we know that breathwork works and we aim to include and educate as many people as possible in all modalities. Be it pranayama, alternate nostril, box breathing, breakthrough, holotropic, rebirthing… the list goes on. We are bringing this all to the masses.
The study highlights “despite the strong relationship between breathing practices and symptom improvement in anxiety disorders, breathing is not targeted in gold standard treatments”. In truth we are all wondering why.
Their conclusion reads:
“This scoping review supports the clinical utility of breathwork interventions and discusses effective treatment options and protocols that are feasible and accessible to patients suffering anxiety. Future research directions include optimization and standardization of breathwork practices and protocols for the treatment of anxiety disorders”.
The evidence of the link between breathwork and anxiety is irrefutable. Breathwork is an effective and accessible treatment approach for people suffering anxiety. Here, at Breathless, we are working tirelessly to offer you all the ability to tap into this resource, provide the evidence and the experience and make these practices gold standards and mainstays. The question is why wouldn’t we? It’s a cost effective, the most readily available approach anyone has the ability to engage with and we are excited to share it with you.
Here you can find 6 breathwork techniques to combat anxiety.
by Jacqueline Kasch
Pharmacist, Writer and Breathwork Instructor
Experiences, expeditions and education to unlock your potential, open your heart and let your breath set you free.
Copyright © 2022 | Breathless
Copyright © 2022 | Breathless
