Guide
Breathing more slowly, with a slightly longer out-breath, helps the body shift into “calm” mode. It isn’t magic, but it is a simple, free tool that is available anywhere.
What we know
- Slow breathing (about 6 breaths a minute) is associated with lower physiological arousal and a feeling of calm.
- Short, regular practice (5 minutes a day) seems to improve mood; a recent trial observed this effect with the “cyclic sigh” (two in-breaths, one long out-breath).
- Relaxation techniques, including muscle relaxation, have a moderate effect on anxiety.
A little theory · Why the out-breath? When you breathe out, the vagus nerve (which slows the heart) is more active; a long, slow out-breath encourages a state of calm. This is one of the explanations put forward for the effect of breathing practices (Gerritsen and Band, 2018).
A little theory · A meta-analysis of 12 controlled trials found that breathing exercises slightly reduce stress, anxiety and low mood compared with doing nothing. The effect is moderate: breathing is a help, not a treatment on its own (Fincham et al., 2023).
Things to bear in mind
- It isn’t about breathing harder, but more slowly: breathing too deeply can make you dizzy.
- Breathing alone doesn’t “cure” an anxiety disorder: it complements the work on thoughts, avoidance and values.
- If you have panic attacks, it shouldn’t become an essential safety behaviour (“if I don’t breathe like this, something will happen to me”): you practise it, you don’t cling to it.
Which exercise to choose?
There is no “best” way of breathing. Choose according to the moment: slow breathing for daily training, the cyclic sigh for a peak of tension, releasing your muscles in the evening, dropping anchor when your thoughts carry you away.
How to start
Practise when you are calm, a few minutes a day: that is what makes the tool available when tension rises.
Worksheets to practise
- 15 · Slow breathing · Slow breathing to accompany anxiety
- 43 · The calming sigh · A short breathing pattern with a long out-breath (cyclic sighing)
- 44 · Releasing the muscles · A brief progressive muscle relaxation
- 04 · Dropping anchor · Coming back to the present moment when anxiety rises
Sources
Zaccaro, A., Piarulli, A., Laurino, M. et al. (2018). How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, 353.
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.
Manzoni, G. M., Pagnini, F., Castelnuovo, G. & Molinari, E. (2008). Relaxation training for anxiety: A ten-years systematic review with meta-analysis. BMC Psychiatry, 8, 41.
Fincham, G. W., Strauss, C., Montero-Marin, J. & Cavanagh, K. (2023). Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Scientific Reports, 13, 432.
Gerritsen, R. J. S. & Band, G. P. H. (2018). Breath of life: The respiratory vagal stimulation model of contemplative activity. Frontiers in Human Neuroscience, 12, 397.
These worksheets do not replace therapy. If you are in distress or having suicidal thoughts, call your local emergency number (112 in Europe; 3114 in France, free, 24/7).
