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Breathing Exercises to Help with Anxiety and Stress

Breathing Exercises to Help with Anxiety and Stress

By: Sally Sherwin • Posted on January 16, 2023


There is a story in one of the ancient texts of yoga where Tongue, Eye, Ear, Mind, and Breath are arguing about which among them was the best. The wise sage tells them “He by whose departure the body seems worse than worse, is the best of you.”

One by one, Tongue, Eye, Ear, and Mind all leave the body only to come back and ask “Have you been able to live without me?” The answer was always yes, until Breath got ready to leave! The others realized quickly that Breath was the best among them as the body certainly could not survive without her (and yes, this ancient text refers to Breath as “her”).

Breathing with Control and Awareness

We tend to take our breathing for granted – it’s a simple process that just happens on its own, right? Yes, but if we add mindfulness to the process of breathing we can positively affect our stress, pain, cognition, blood pressure, sleep and mood - just to name a few. Breathing with control and awareness helps us calm the stress state (sympathetic nervous system) and activate the relaxation state (parasympathetic nervous system).

Babies breathe deeply and naturally using their entire lung capacity. It’s only as we mature that we adopt breath practices that don’t support our well-being. Holding the breath, shallow breathing from the upper chest, and breathing too quickly are all adaptations we have made in response to anxiety and stress in our lives.

A simple way to build a breath practice is to add deep breaths to habits you already have, such as taking three deep breaths before eating, before brushing your teeth, before fastening your seatbelt, etc. Another tip is to place a colorful sticker on your computer, your bathroom mirror, even your refrigerator or steering wheel to remind you to breathe.

The Connection Between Posture and Breathing

Good posture is vital for good breathing, a healthy body and a calm mind. Poor ergonomics at your desk and computer or slouching over devices like cell phones and tablets contribute to neck and jaw problems, headaches and back pain, high blood pressure and elevated heart rate, stress and anxiety and digestive system issues.

Tips for good posture

  1. Sit comfortably in a supportive, armless chair (such as a dining room chair)
  2. Place feet flat on floor, hip width apart, knees over ankles, and toes pointing forward
  3. Roll shoulders up, back, and down (opens chest)
  4. Lift your heart to sit tall with a long spine
  5. Top of head lengthens toward the sky

Three Major Types of Breathing Exercises

  1. Breaths that bring balance to the body and mind (not too calming, not too energizing)
  2. Breaths that boost energy
  3. Breaths that calm and relax

NOTE: Start with 3-5 rounds of each breath and if a particular breath is uncomfortable or doesn’t seem to work for you, try another.

Balancing Breaths

Balancing breaths encourage a balance of energy and relaxation in the body, mind, and emotions.

Easy breath evens and calms breath

  1. Inhale and exhale through nose
  2. Allow breath to become relaxed and even
  3. Aim for this to be your normal way of breathing
  4. To further quiet the mind and support breath control, silently count to 4 on the inhale, then 4 on the exhale

Alternate nostril breath balances the nervous system, promotes calm body with clear mind, lowers stress and anxiety

  1. Take three deep breaths through both nostrils
  2. Use your right thumb to close your right nostril
  3. Inhale through your left nostril
  4. Pause breathing after the inhale
  5. Close your left nostril using your right index finger
  6. Release thumb and exhale through the right nostril
  7. Inhale through right nostril
  8. This completes one round. Try for three rounds to start
  9. Have tissues handy!

Relaxing Breaths

Relaxing breaths promote the relaxation response for stress and anxiety relief.

Relaxation breath - Lengthening the exhale calms the body, mind, and emotions

  1. Inhale through the nose
  2. Exhale through the mouth with a long and audible sigh
  3. Make sure the exhale is much longer than the inhale
  4. If you feel lightheaded, return to Easy Breath in and out of the nose, same length

Easy diaphragmatic breath promotes deeper, more efficient breathing

  1. When first practicing this breath, lie down on your back
  2. Place your hands on your belly
  3. Begin to inhale and exhale through your nose
  4. Allow the breath to even out, calm, and relax
  5. Notice where you feel the body move when you breathe
  6. Allow the belly to expand on your inhale and contract on your exhale

Three-part exhale breath – pausing on the exhale is relaxing and reduces tension

  1. Inhale through the nose deeply
  2. Exhale 1/3rd of the breath and pause
  3. Exhale 1/3rd and pause
  4. Exhale the rest of your breath and pause
  5. Repeat

IMPORTANT NOTE: Retention breaths such as Square Breath (inhale to a count of four, hold for a count of four, exhale to 4, hold for 4) and 4-7-8 Breath (inhale to a count of four seconds, hold for 7 seconds, exhale for 8 seconds) are often recommended for relieving stress and anxiety. However, these are advanced techniques and are contraindicated for those just starting a breath practice.

Long holds after an inhale can be very energizing because doing so increases the heart rate and CO2 in the lungs and blood as well as increasing heat and energy in the body.

For more information about Cleveland Clinic Centers for Integrative and Lifestyle Medicine, please call 216-448-4325 to schedule an appointment.

Be Strong, Be Healthy, Be in Charge!

Sally Sherwin, C-IAYT, E-RYT 500

References: Breath and Pranayama
  1. Nestor, James (2020) Breath: The New Science of a Lost Art. New York: Riverhead Books
  2. Rosen, Richard. (2002) The Yoga of Breath. Halifax NS: Shambhala Publications
  3. Farhi, Donna. (1996) The Breathing Book. New York: Holt and Company
  4. Swami Rama; Rudolph Ballentine, MD; Alan Hymes, MD. (1979) The Science of Breath. Pittsburgh: Himalayan Institute Press
About Sally Sherwin, C-IAYT, E-RYT 500

Sally Sherwin is on the Cleveland Clinic’s senior Yoga Therapy staff and is one of the founders of the Cleveland Clinic School of Yoga.

At Cleveland Clinic, Sally works individually with patients to address specific health challenges, and in small group settings for stress and anxiety, chronic pain, digestive disease, eating habits and nutrition, cancer survivors, neurological disease, and brain wellness. She created the breathing and meditation protocols for Clinic research now in trial with epilepsy patients, and in a trial about to begin for those at risk of neurological disorders. Both studies are investigating whether mind/body practices can reduce stress and promote better quality of life in patients with neurological issues.

Sally is a Reiki Master/Teacher and provides individual Reiki sessions at the Wellness Institute. She is also an accredited teacher of T’ai Chi Chih, which is a simple and accessible mindful moving practice based on the development and flow of essential energy.



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