Breathing is the essence and significant luxury of life. When a person is stressed or upset, breathing becomes shallow and quick. The brain releases a stress hormone known as cortisol, which alerts the body to activate a counter mechanism for this situation. Breathing exercises play a crucial role in lowering cortisol levels in the body. 

Whenever a stressful condition is encountered the  body enters into a fight or flight response as a basic survival mechanism. These stressful situations can range from any emotional liability or constant worry about tedious tasks to immediate physical threat or disease. These trigger a cascade of stress hormone production and release that bring about well-orchestrated physiological changes. Researchers propose that repeated activation of such responses takes a toll on the human body in a longer run, promoting conditions such as obesity, insomnia, chronic hypertension, atherosclerosis formation, and apparent brain changes leading to depression, anxiety, and addiction, etc. 

What happens during the response to stress? 

The stress response initiates in the brain, where a part called the amygdala receives information from the eyes or ears about any advancing danger. This portion of the brain is associated with the processing of the received information, identifying the threat, and then forwarding it to the hypothalamus for further action. At the hypothalamus or the commanding center of the brain in this scenario, instructions are dispatched to tackle the impending threat to the rest of the body via the autonomic nervous system that activates its subdivision; the sympathetic nervous system. Adrenaline aka epinephrine and cortisol are the two main hormones that are released into the bloodstreams by adrenal glands that bring about the changes directed by this activated system.(1)

This resultant reaction or changes includes dilation of the blood vessels supplying the vital organs and constriction of the rest supplying to the other parts of the body. The heart pumps faster under the influence of adrenaline to further increase the blood supply to these vital organs. The breathing rate also accelerates to cope up with increased oxygen demands, and the brain becomes more alert with the extra oxygenation. Senses such as sight, hearing, touch, etc. sharpen to increase the awareness about the surroundings. The liver and fat storages dump extra amounts of glucose and fats from storage into the bloodstream to be consumed by hyperfunctioning organs.   

To summarize the result is high blood pressure, increased pulse rate, hyperventilation, constricted pupils, and excessive sweating. This reaction persists unless the triggering threat or stimuli is removed, which then causes the eventual fall of the adrenaline and cortisol and resolution of these symptoms.  

Breathing Exercises to Control Stress

Daily stress and anxiety can, and does, affect a person’s physical and mental health. When a person is under stress, breathing becomes shallow, quick, and the air is moved in and out through the lungs using shoulders, rather than the diaphragm. Breathing exercises help a person release stress. By becoming aware of your breathing, the likelihood of spiraling into anxiety or panic attack is lowered. 

Here are several breathing exercises that are useful in relieving stress: 

Diaphragmatic breathing

Diaphragmatic breathing, also known as deep breathing, is a simple yet powerful relaxation technique. It allows you to take deeper breaths that engage the lower part of the lungs and engages far more of the lung capacity. That means more oxygen gets into the bloodstream. It balances the autonomic nervous system, which regulates body temperature, bladder functions and also helps ease stress and other mental health issues. Deep breathing increases the supply of oxygen to the brain and stimulates the parasympathetic nervous system, which ultimately promotes a stress-free state of calmness. How to do diaphragmatic breathing? Here’s how. (2)

Sit comfortably, with your knees bent and your shoulders, head and neck relaxed.

Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.

Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should remain as still as possible.

Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips. The hand on your upper chest must remain as still as possible.

1. Get into a comfortable position with your back straight. Close your eyes, and be attentive towards your breath and body. 
2. Breathe in through the nose. Inhale slowly and deeply by counting to four as you hold the breath. 
3. Exhale all of the air through the nose or mouth. 
4. Place one hand on your stomach and the other on your chest. As you breathe in and out, feel the rise and fall of breathing, more in the belly than in the chest. You have to make the hand that rests over the stomach move more than the one on the chest. 
5. Take three more, slow and deep breaths, allowing the body to become relaxed and stress-free. 

To benefit most from this exercise one has to be consistent and mindful. Mindfulness is basically about recognizing and understanding your emotions, and it lets you focus on your breath. Believe it as if you are breathing in calmness and peace and breathing out stress and anxiety. 

 SIGNIFICANCE:

1. Reduce anxiety and stress
2. Strengthen the diaphragm
3. Improves immunity
4. Cleanses and rejuvenates vital channels of energy

4-7-8 Breathing

The 4-7-8 breathing exercise is derived from the yogic practice of pranayama, meaning “regulation of breath”. It is very simple, easy, and it takes no time. It helps when a person is feeling anxious, stressed, or having trouble falling asleep. This exercise requires no specific position and can be done while sitting or lying down. Here’s the simplest way of doing 4-7-8 breathing: (3)

1. Breathe in through your nose for 4 seconds. Take a deep and slow breath.
2. Hold your breath and count from 1 to 7. 
3. Breathe out and count from 1 to 8. Exhale all the air out through your mouth by the time you count to 8. This counts as one good breath.
4. Repeat until you feel less stressed and calm but never exceed more than four breaths at a time.  

SIGNIFICANCE:

1. Reduces anxiety and stress
2. Calms the brain
3. Improves sleep quality

This exercise is a natural tranquilizer for the nervous system. The more you practice, the more beneficial it becomes. This breathing technique helps get rid of useless stress, anxiety, and helps a person fall asleep. 

Pursed-lip Breathing

Pursed-lip breathing (PLB) is the simplest technique that allows people to control their ventilation, oxygenation, and shortness of breath. This technique requires a person to inhale through the nose and exhale from the mouth slowly. Pursed-lip breathing creates a back pressure inside airways, creating a positive end-expiratory pressure (PEEP). As a result, this technique helps support breathing easily by opening the airway and reduces general stress. It reduces stress and anxiety by resetting the vagus nerve, which has a direct effect on the parasympathetic nervous system and helps mitigate anxiety by lowering the heart rate. This exercise can only be effective if performed correctly. Here’s how it is done. (4)

1. Sit comfortably and relax shoulder and neck muscles. 
2. Keep the lips pressed together tightly, except at the center. 
3. Breathe in slowly through your nose for two counts, keeping the mouth closed. 
4. Keep the lips pursed as if you are about to flicker the flame of a candle or whistle. 
5. Breathe out slowly through pursed lips while counting till 4. 

SIGNIFICANCE:

1. Improves ventilation
2. Helps control breathing rate and shortness of breath.
3. Prolongs exhalation to slow the breathing rate. 
4. Relieves dyspnea
5. It keeps the airways open longer and decreases the work of breathing. 
6. Very helpful for patients suffering from COPD.

Breathing is one of the simplest things in the world we often take for granted, but what is life without a breath? Paying attention to your breathing pattern and following any breathing exercise for a particular time can make life easier and less stressful. 

REFERENCES: 

1. Makino S, Hashimoto K, Gold PW. Multiple feedback mechanisms activating corticotropin-releasing hormone system in the brain during stress. Pharmacology Biochemistry and Behavior. 2002 Aug 1;73(1):147-58.

2. Martarelli D, Cocchioni M, Scuri S, Pompei P. Diaphragmatic breathing reduces exercise-induced oxidative stress. Evidence-Based Complementary and Alternative Medicine. 2011 Jan 1;2011.

3. Menk MI. Self-Help Techniques to Reduce Anxiety. Anxiety. 2018 Jan 19.

4. Babu B, EALIAS J. PURSED LIP BREATHING EXERCISE–A SELF-MANAGEMENT APPROACH TOWARDS SHORTNESS OF BREATH. Indian Journal of Applied Research. 2016 Sep;6(9):654-6.

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