Diaphragmatic breathing has long been associated with relaxation and anxiety reduction, though for centuries the evidence supporting this has come anecdotally from practitioners of meditation and yoga. In recent decades, however, findings from numerous research studies have validated the positive effects of diaphragmatic breathing on anxiety reduction (Brown and Gerbarg, 2005a,b; Brown et al., 2013). While the exact mechanisms are not fully understood, there is evidence to support a few different hypotheses.
One hypothesis is that diaphragmatic breathing lowers anxiety by reducing cortisol levels in the body (Ma et al., 2017). Another posits that this type of breathing lowers anxiety by stimulating the vagus nerve. According to this theory, stimulation of the vagus nerve activates GABA pathways in the prefrontal cortex (Jerath et al., 2015), which seems to prevent the amygdala—a brain area responsible for processing fear and anxiety—from becoming over-activated (Brown et al., 2013). For a more detailed discussion of how diaphragmatic breathing may lower anxiety through vagus nerve stimulation, I recommend the following article by my Psychology Today colleague, Christopher Bergland.
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Regardless of the mechanism, there are many methods that use diaphragmatic breathing to lower anxiety. Over the years, in response to my own anxiety, I have experimented with a number of different techniques, borrowed from my experiences in yoga. After a series of trial-and-error sessions, I cobbled together features from a few different techniques to create a breathing exercise that I call the deflated balloon technique. The reason for naming this breathing exercise as such is because the goal is to reduce anxiety by deflating your diaphragm and lungs quickly, like a balloon gushing air. If you can imagine what a deflated balloon looks like—how flexible and supple it is—that’s what you want to accomplish with your whole body when performing this exercise.
As shown in the video below, the deflated balloon technique should only take about three minutes to complete (give or take a minute). It’s been so helpful for me in reducing my own anxiety that I started using it with my patients, and subsequently, it’s worked so well for them (particularly during panic attacks) that I wanted to share it with you. Though I cannot be certain whether the reduction in anxiety that I experience when I perform this exercise is a cause or an effect of the reduced blood pressure and heart rate that I experience, I can attest that each time I’ve monitored my blood pressure and heart rate after doing the exercise I’ve gotten a reduction of about 10% in both measures.
So here’s the technique.
Disclaimer: If you have any medical issues that would make yoga or intensive breathing exercises a risky endeavor, consult your doctor before trying this technique. In addition, if you feel light-headed or experience imbalance during this exercise, stop immediately and consult your doctor before trying it again.
Step 1: Take a deep breath in, not just filling up your lungs but your diaphragm as well, and raise your hands over your head.
Step 2: Hold your breath until you can’t hold it anymore.
Step 3: When you finally exhale, explode the air out your mouth, and as you do so, bend over at the waist, keeping your knees as straight as you can. Make sure you release your neck muscles to allow your head to dangle loosely.
Step 4: Remain bent over until you have to take in another breath. When you breathe in again, repeat the technique by coming back up and raising your hands over your head.
Step 5: Repeat the technique a second time, and then a third time. After exploding the air out your mouth for the third time, bend over again, but this time keep breathing normally as you remain bent over.
Don’t force yourself to stretch, but rather, allow gravity to naturally stretch the muscles in your back and legs until your fingers can touch your toes naturally, without pushing yourself at all. This might take a minute or two for some, but if you don’t reach your toes it’s okay: the primary goal is to stretch with relaxation, not to touch your toes. If it’s easier for you, you can bend your knees slightly so you don’t feel a strain. When your fingers can touch your toes, or you feel sufficiently relaxed, you’re done.