Don't wait to exhale: Do it every day to feel happier & decrease anxiety
For nearly forty years I slogged through daily bouts of anxiety and monthly panic attacks. During the same time, I was active in recreational sports like skiing, dancing, tennis, aerobics, martial arts, and water sports but struggled with endurance and consistency. It never occurred to me that the common thread between anxiety and athletic endurance was breath until my martial arts instructors pointed out that they noticed my form became weak and inconsistent when my breath became shallow and partial. The instructors kept telling me to breathe; I kept saying I was breathing. What I missed is that they were really telling me to exhale - the hardest thing they could have asked me to do at that time due to constant stress and symptoms of PTSD.
After several injuries (not related to martial arts) I had to stop and transitioned to vinyasa yoga while I intentionally slowed down my life to de-stress. It was during sun salutations and great instruction from yoga teachers that I learned how to use my breath, both inhales and exhales, to get me through difficult movement. At the end of every vinyasa class I felt a calm I had never experienced before doing any other activity.
When more injuries lead me to kundalini yoga, where breath work and meditation are foundational, I finally learned how to really breathe. The kundalini belly breathing, breath-of-fire, and alternate nostril breaths were breaths I continued to do outside of the yoga studio and a remarkable thing happened: anxiety levels and panic attacks decreased significantly! I was curious about the connection between breath and anxiety and brought that curiosity to graduate school. All of my research projects were examining the efficacy of breath, meditation, and medication in reducing anxiety. I found the most effective intervention to decrease anxiety and PTSD was deep belly breathing, with long exhales; meditation for at least 45 minutes was a close second. Medication had many negative side effects and contraindications whereas breathing and meditation have zero negative side effects and few contraindications.
Recent research shows long exhales are very effective at increasing positive feelings and reducing anxiety
Now, a new research study published in Cell Reports Medicine January 2023 found that slow and deep inhales through the nose followed by slow and full exhales through the mouth (‘cyclic sighing’) was most effective at improving mood and reducing anxiety - even more effective than mindfulness meditation - when practiced at least five minutes per day for 28 days.
At Flourish we have many blog and Instagram posts, as well as audio meditations, around deep belly breathing with elongated exhales because we know that long, intentional exhales send internal signals of safety to the autonomic nervous system. When ‘neuroception of safety’ signals are consistent, like elongated exhales, the exhales can hack into fight-or-flight (sympathetic nervous system) by signaling there is safety / no perceived threat, which it turn can engage the parasympathetic nervous system where we can relax, laugh, rest, and thrive. Many of my clients have heard me say ‘remember to exhale’ more times than they probably wanted to. But I talk about exhaling so much because it is very powerful in shifting our physiological state and creating a sense of calm.
Knowing the importance of exhaling and seeing this recent study on the effectiveness of cyclic sighing was validating. However, I was slightly surprised, in a good way, at the study’s results showing more effectiveness of cyclic sighing than mindfulness meditation (being with the breath and not changing it). These results are promising as most people can find 5 minutes for breath exercises every day. Meditation is harder to commit to especially if you don’t live alone or have a packed schedule. For instance, cyclic sighing can be done in the car, during a Zoom meeting (when you aren’t talking), or when you are walking the dog. This is way easier to integrate into your day than five minutes of mindfulness meditation.
See how to do cyclic sighing
3 tips to breathe better and feel happier from the Washington Post’s article on the breath study published in Cell Reports Medicine:
Figure out what breathing practices work best for you - While elongated exhales showed the best results on mood and anxiety, try other breathing techniques to see what works best for you.
Start with 5 minutes every day to build a routine - The more consistently you make an effort to pause and focus on your breathing for at least five minutes, the easier it will be to breathe more deeply, unconsciously, and consistently.
Anywhere, everywhere, all the time - Breath is accessible almost everywhere and anywhere with zero side effects; taking five minutes to inhale and exhale slowly and fully can have you feeling a sense of ease while in a tense situation.
References
Balban, M. Y., Neri, E., Kogon, M. M., Weed, L., Nouriani, B., Jo, B., Holl, G., Zeitzer, J. M., Spiegel, D., & Huberman, A. D. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895. https://doi.org/10.1016/j.xcrm.2022.100895
Zaccaro, A., Piarulli, A., Laurino, M., Garbella, E., Menicucci, D., Neri, B., & Gemignani, A. (2018). How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12. https://doi.org/10.3389/fnhum.2018.00353