Breathing Practices for Anxiety, Stress and Burnout

AdobeStock_307313422_inhale%20and%20exhale_300x727

 

By Dr Rosalba Courtney ND, DO, PHD, an Osteopath with over 40 years' experience as a practitioner, teacher, researcher and writer. ​

 

Breathing disturbances are both a result and cause of stress, anxiety and overwhelm. Ensuring that breathing is mostly nasal and that the diaphragm is working well are important first steps. Here are some other tips and practices for making sure you get the most out of breathing for stress resilience. 
 

Deeper breathing is not always better breathing (if it makes you hyperventilate)

People who suffer from anxiety, panic disorder and burnout are much more likely to chronically over breathe or hyperventilate. Some are likely to hyperventilate when trying to use deep breathing to relax and destress because (due to a range of factors) they tend to breathe with too much effort and force. 

Chronic hyperventilation has many adverse effects on health and on the function of the brain and nervous system. Low CO2 from hyperventilation is a major contributor to panic and anxiety attacks. Breathing retraining for hyperventilation tends to focus on using softer, lighter and more gentle breathing that gradually trains the body to allow normal levels of CO2 to accumulate.  

The problem is that most hyperventilators don’t know that they are over-breathing, particularly as they often subjectively feel chronically short of air. 

The best way to test for hyperventilation involves using a capnometer, or device for measuring the level of CO2 in exhaled air. However,  short breath holding time can also indicate whether a person is likely to be a chronic hyperventilator.  
 

Practice 1: Breath holding test for hyperventilation

  • Breathe in, Breathe out without forcing the exhalation. 
  • Then pinch your nose and hold your breath. Hold your breath for as long as you have no sense of wanting to breathe. Let go when you feel a definite desire to breathe. 
  • Count the seconds until you feel this urge.  
  • If your breath hold time is less than 10 seconds there is a strong indication you have hyperventilation.
  • If it is between 11-20 seconds there is a moderate chance you have hyperventilation. 
  • If it is between 21-30 seconds there is a slight chance you have hyperventilation. 

 

What to do when focusing on your breathing feels unpleasant

The feeling that one’s breathing is unsatisfying, restricted or in any way unpleasant to focus on is a major obstacle to using breathing as an anchor for mindfulness or as a tool for stress reduction. Experiencing breathing as unpleasant is not uncommon in people with anxiety or dysfunctional breathing. In this situation indirect breathing techniques that involve shifting focus between other body sensations and the breath can be helpful. 

 

Practice 2: Body/breath focus shift

  • Choose a position that is comfortable.  
  • Bring your attention to your body.  Feel the sensations where the body contacts the floor, chair or other surface. Notice any holding, softness, hardness, movement.  
  • Then shift your attention to your breath, focusing on the feeling of air in the nostrils or movement in your body, the expansion and widening during inhalation and the narrowing during exhalation.  
  • Alternate your focus, shifting from the breath to the body and back to the breath.

 

The perils of over controlled breathing

Everyday breathing is regularly irregular just like a healthy heart. While excessive irregular and chaotic breathing is a problem in anxiety and stress so is overly rigid, excessively controlled breathing.  

Excessive breathing irregularity can manifest as frequent breath holding, sighing, yawning and mid-sentence gasping. However normal breathing does contain some sighs and even some breath holding. These act as a neurological resetter,  and help to equalize pressures throughout the lungs and help maintain normal levels of oxygen and carbon dioxide. 

Excessively rigid and controlled breathing sometime occur in anxiety, depression and trauma.  The person with excessively controlled breathing can be overly conscious of their breath yet somewhat disconnected from their body and its sensations.  

Chaotic irregular breathing and overly controlled breathing are both types of dysfunctional breathing, which can result in symptoms and affect the body’s ability to heal. 

This breathing technique introduces structured irregularity and helps to reconnect mind and body.
 

Practice 3: Breath holds with breath following

  • Breathe in, Breathe out without forcing the exhalation. 
  • Then pinch your nose and hold your breath. Hold your breath for as long as you have no sense of wanting to breathe, then keep holding until you the urge to breathe gets moderately strong.  
  • When you start breathing again. Just watch the breath, notice how it starts off larger and deeper and then gradually softens and slow. 
  • Sit and watch your breath for 1-2 minutes then repeat the breath hold.
  • Do this 3-5 times

 

If your anxiety persists or gets worse, make an appointment with your doctor to discuss your symptoms and possible treatments. 

To learn more from Dr Rosalba about working with breathing for managing anxiety and increasing stress resilience, register for our new short course Helping Your Patients Reduce Stress. This course explores the impact of stress and the scientific evidence base of some of the therapies that may be able to alleviate stress, including mindfulness, breathwork, CBT, hypnotherapy, yoga, water and sound therapy.