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Anxiety and Stress

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Controlled Breathing

Diaphragmatic Breathing

  • What is it? Diaphragmatic breathing involves taking slow, even breaths into the diaphragm (stomach area) instead of the chest.
  • When should I use it? Diaphragmatic breathing can be helpful when trying to decrease intense physical symptoms of stress and anxiety, such as increased heart rate, shortness of breath, and "butterflies" in the stomach.
  • Why does it work? Taking slow, even breaths into the diaphragm create a stronger relaxation response in the body than taking deep breaths into the chest. This type of breathing stimulates the body's parasympathetic nervous system, or the part of the nervous system that "shuts down" intense physical symptoms of stress and anxiety.
  • Why should I do it? The goals of diaphragmatic breathing are to (1) slow down breathing, (2) make breathing more even, and (3) direct the breath into the diaphragm instead of the chest.

To practice, start by placing one hand on your chest and the other hand on your stomach. As you inhale, try to direct the air toward your stomach so that your stomach expands, pushing the hand that is on your stomach away from your body. As you exhale, pull the muscles of your stomach in toward your body to push the air out of your lungs. Most people find this difficult to do at first but that it gets easier with practice. The goal is to eventually be able to make the hand on your stomach move when you inhale and exhale and for the hand on your chest to move as little as possible.

After you have mastered the basics of how to get the air into your diaphragm, then start to focus on slowing down your breathing. Many people find it helpful to count as they inhale and exhale. For example, you could try slowly counting to three as you inhale, and then slowly counting to three as you exhale. This will help you take slow, even breaths in and out. Remember that the goal is not to take deep breaths, but to take normal size breaths that are slow and even and are directed into your diaphragm.

For this to be most helpful, try first practicing several times for 5-10 minutes when you do not feel that stressed or anxious. Then, as you get better at doing this type of breathing, start practice during times of higher stress. The more your practice, the easier it will be to calm your body when you are under stress.

Pursed Lip Breathing

Pursed lip breathing is one of the simplest ways to control shortness of breath. It provides a quick and easy way to slow your pace of breathing, making each breath more effective.

Benefits of pursed lip breathing:

  • Improves ventilation
  • Releases trapped air in the lungs
  • Keeps the airways open longer and decreases the work of breathing
  • Prolongs exhalation to slow the breathing rate
  • Improves breathing patterns by moving old air out of the lungs and allowing for new air to enter the lungs
  • Relieves shortness of breath
  • Causes general relaxation

Practice this technique 4-5 times a day at first so you can get the correct breathing pattern.

Pursed lip breathing technique

  1. Relax your neck and shoulder muscles.
  2. Breathe in (inhale) slowly through your nose for two counts, keeping your mouth closed. Don't take a deep breath; a normal breath will do. It may help to count to yourself: inhale, one, two.
  3. Pucker or "purse" your lips as if you were going to whistle or gently flicker the flame of a candle.
  4. Breathe out (exhale) slowly and gently through your pursed lips while counting to four. It may help to count to yourself: exhale, one, two, three, four.

With regular practice, this technique will seem natural to you.

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