Behavioral Health Consultant, Trainer and EAP Manager

Seattle, Washington

Anxiety, Mind and Body: Breathe Easy

Question: Why is deep breathing always advised for anxiety?

Answer: The single most potent tool against anxiety always seems at first to be rather lame. It is slow, controlled breathing using the belly. It is not the only measure, but it may be the simplest, most effective one. Because we’re so inclined to dispense with it or misuse it, it’s important to understand how it works.

When we’re anxious or in a panic we tend to breath in a rapid shallow way, using the chest. When relaxed, breathing slows down and we use more of the belly. Likewise, when we can force the breathing to be more slow and “diaphragmatic” (that’s belly-breathing), anxiety will reduce.

First, a biology reminder. The lungs function as a bellows: we expand the chest wall and the lungs within expand, drawing air in. But you can also breathe without moving the chest wall at all. If you push out your belly, you can draw down the horizontal membrane that separates all the lower organs from the heart and lungs above. The lungs expand downwards. Try it. You might find this method of breathing difficult, even impossible at first. It is counter-instinctive, and you may be many years out of the habit.

If chest-breathing adds to anxiety, why do we do it? Why would we tend to breathe in a way that adds to our misery? In short, we evolved this way. Chest-breathing is part of the fight-or-flight survival system. Think of our ancient ancestors, surviving all the threats they encountered over countless generations. We can suppose that in your lineage there were many thousands who heard a sound which could indicate a tiger coming over the hill. Or who saw someone from another tribe, with an ambiguous facial expression which might have warned of developing hostility. We can suppose that some remained relaxed in these situations…and we can suppose that they did not live to pass along their genes. We inherited our traits from the most jumpy, reactive survivalists.

So, when your brain senses something ambiguous, it may be inclined to interpret it as a danger signal. Having done so, it will send a signal to the rest of your body. A message, “Hey! Get ready for survival action!” Your body will immediately adopt its finely-honed set of survival-mode responses, everything you want happening when it’s time to flee that tiger or fight the attacker from the marauding tribe. Adrenaline and cortisol will surge, your heart rate will increase, your blood pressure will rise, blood flow will change, the upper digestive system will shut down (so the blood can go elsewhere), while the lower tract will activate (so you can quickly shed excess weight), you’ll have rapid, shallow breathing, and so forth. These and other physical changes are beyond our control. We cannot willfully manage any of them…except one: The breathing. I’ll come back to this in a moment.

When the body is in its activated state, you are ready to fight or flee. Battle or bolt. It is exactly what you want to have happen if you really are in a sudden struggle for survival. But in the absence of a real, immediate and identifiable threat, the whole arousal process has another effect: it is terribly uncomfortable. This too has a positive function. When your home smoke alarm goes off, it does not emit a pleasant little melody but rather an ear-splitting shriek. This gets people out of burning homes and it saves lives. Likewise, your fight-or-flight arousal system is unsettling. Just as the brain sent a signal to the body, the body sends a return message, “We’re doing our part here! You better do yours!”

Now, the brain has its own survival response as part of this whole system. All our higher-order abilities such as imagination, planning, analysis, creativity, empathy – things which can be awfully darn helpful in managing conflicts and solving problems – are out the window. We strip the thinking down to two essential questions: “Where is the danger?” And, “What am I going to do about it?” We want to zero in on the problem and take immediate, drastic action. We scan the horizon and hone in on whatever seems to be the culprit. The perceived threat might be the sense that you’re about to have a heart attack, it may be the spider on the other side of the room, it could be worries about your others judging you, or just a general sense that things are falling apart…there is a limitless variety. But when it comes to need to take fight-or-flight action, we’re stuck.

So now, not only do we sense there is an impending danger, not only are your internal alarms blaring, not only is your body amped up and your thoughts racing, now on top of it all you feel helpless to do anything about it. We’re all the more stuck with the problem that caused the anxiety, and beset by acute discomfort on top of it all.

So what is to be done?? Right now!!

Again, all those physical components of anxiety are “autonomic”, beyond our direct control. You cannot, for instance, willfully lower your heart rate. But ONE of them can be controlled – your breathing. This is the chink in the dragon’s armor.

Again anxious breathing is rapid, shallow and up in the chest. When you can force the opposite, slow, deep and using the belly or diaphragm, it is like an “all-clear” signal to the whole rest of the system. You can settle uncontrolled crying, improve your focus, find better comfort, expand creative thinking, lower your blood pressure…it’s a virtual panacea.

A word of caution. Controlled breathing does not feel like it is doing much at the moment. Remember, we instinctively search for the “big guns” solutions. Something sweeping and fast-acting. The relatively soft effects of slow breathing certainly do not fit that bill.

Try this method. Use it twice every day for several minutes, paring it with something you already do regularly such as brushing your teeth. It will then be more accessible for putting it to use as needed, whenever you are tense or panicky:

• Sit comfortably.
• Inhale fully through the nose, counting slowly to two.
• Be sure to use the diaphragm pushing outwards with your belly, pulling downwards on your lungs.
• Pause for the count of one.
• Exhale slowly, counting to four, through pursed lips.
• Focus on your breaths, and on relaxing your stomach, shoulders and face.

If you feel at all lightheaded, it is merely a sign you are going too fast, eliminating carbon dioxide too quickly. Slow down, and it will clear up immediately.

Questions? Email me.

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