Calm Mind

From birth, we enter the world with an inhale. In departure, we exhale. (In fact, many languages associate the word “exhale” with “dying.”) Breathing is so central to life that it's no surprise humans have long recognized its significance—not just for survival, but for the functioning of the body and mind, and have sought to control it to improve well-being.

As early as the first millennium B.C., both Taoism in China and Hinduism emphasized a “vital principle” flowing through the body, akin to energy or internal breath, and viewed respiration as one of its manifestations. In China, this energy is called qi, while in Hinduism, it’s prana (a key concept in yoga).

Later, in the West, the Greek term pneuma and the Hebrew word rûah referred both to breath and the divine presence. In Latin languages, spiritus forms the basis for both “spirit” and “respiration.”

Ancient recommendations for modulating breath to influence health and mind also emerged. Pranayama (breath retention) yoga was the first system to build a theory around respiratory control, suggesting that controlled breathing could increase longevity.

In more recent times, German psychiatrist Johannes Heinrich Schultz developed “autogenic training” in the 1920s as a relaxation method. This approach, partly based on slow, deep breathing, remains one of the most popular techniques for relaxation in the West today. Modern mindfulness meditation also emphasizes breathing exercises.

In fact, every relaxation, calming, or meditation technique relies on breathing, which may be the common denominator in all methods for calming the body and mind. Research into basic physiology and the effects of breath-control methods supports the value of monitoring and regulating inhalations and exhalations.

Mind Under the Influence

Even a basic understanding of physiology helps explain why controlled breathing can induce relaxation. Emotions influence the body. When happy, the corners of your mouth rise, and the edges of your eyes crinkle in characteristic ways. Likewise, when calm, at rest, or engaged in pleasant social exchanges, your breathing slows and deepens. This is the influence of the parasympathetic nervous system, producing a relaxing effect. Conversely, when frightened, in pain, or tense, your breathing speeds up and becomes shallower. In these moments, the sympathetic nervous system, which governs stress reactions, is activated. Less well-known is that these effects also work in reverse: the state of the body affects emotions. Studies show that a smile can prompt the brain to respond with more positive feelings.

Breathing, in particular, exerts special power over the mind. This is evident in patients with breathing difficulties. When occasional, acute breathing issues arise, they can trigger panic attacks; when chronic, they can cause persistent anxiety. It is estimated that over 60% of people with chronic obstructive pulmonary disease (COPD) suffer from anxiety or depression. These disorders may stem from concerns about the consequences of the disease, but mechanical factors—like difficulty breathing—can contribute as well. This struggle often leads to faster breathing, which doesn’t necessarily improve oxygen intake but exacerbates discomfort and anxiety.

Rapid breathing can fuel panic attacks through a vicious cycle: fear causes faster breathing, which in turn increases fear. A 2005 study by Georg Alpers and colleagues at the University of Mannheim observed significant unconscious hyperventilation in people with driving phobia when they drove on highways, where pulling over wasn’t an option.

Whether anxiety stems from breathing problems or other sources, it can be alleviated by various breathing techniques from traditional Eastern practices (see Six Techniques for Relieving Stress). For instance, the exercise “follow your breath,” which focuses on breathing awareness, is often a first step in mindfulness meditation, while alternate nostril breathing comes from yoga. Combining reassuring thoughts with breathing is an approach seen in sophrology, a technique that harmonizes the body and mind, drawing on yoga and mindfulness.

Research shows that these techniques can reduce anxiety, although it may not entirely vanish. Breathing better is a tool, not a cure-all. Some methods have been validated by clinical studies; others have not. However, all techniques I describe here are based on principles that have proven effective. They aim to slow, deepen, or facilitate breathing and use it as a focal point or rhythm to distract from negative thoughts.

Spotlight on Cardiac Coherence

A closer look at one popular technique—cardiac coherence—illustrates how breathing exercises promote relaxation. This method attempts to synchronize breathing with heart rate, slowing and steadying the breath to stabilize the heartbeat.

The technique is rooted in the idea that slow, deep breathing activates the vagus nerve, a part of the parasympathetic nervous system that controls and monitors internal organs. Stimulating the vagus nerve induces calmness: heart rate slows, blood pressure drops, and muscles relax. When the vagus nerve signals the brain about these changes, it too relaxes, enhancing feelings of peace. Thus, this method works through both neurobiological and psychological mechanisms.

The stabilization of the heartbeat in cardiac coherence can profoundly diminish anxiety. Conversely, patients with an overactive heartbeat may be misdiagnosed with panic attacks, as their racing pulse affects their mental state.

A typical cardiac coherence exercise involves inhaling for five seconds and exhaling for the same duration (forming a 10-second cycle). Biofeedback devices can help visualize how deep, regular breathing slows and stabilizes heartbeats. Studies confirm the anxiety-reducing effects of this technique, though the biofeedback likely motivates the exercises more than it influences physiological mechanisms. Simply practicing slow breathing with the same discipline could yield similar results.

Some cardiac coherence methods advocate spending more time exhaling than inhaling (for instance, six seconds for exhalation and four seconds for inhalation). This works because the heart rate increases during inhalation and decreases during exhalation. Lengthening the exhalation phase may exert a calming effect on both the heart and the brain, though further studies are required to confirm this hypothesis.

Other research suggests that breathing affects not only the parasympathetic nervous system but also the central nervous system. In 2017, Stanford’s Mark Krasnow and his team showed in mice that neurons regulating respiratory rhythms also control the activity of the locus coeruleus, a brain region involved in attention, wakefulness, and anxiety. Breathing techniques may influence emotions by modulating this part of the brain.

Additionally, focusing on breathing can slow and deepen it, promoting relaxation. Cognitive resources are limited, so when you concentrate on your breath, you’re not dwelling on worries. Mindfulness practice helps people recognize when their attention drifts from breathing and returns to concerns, training them to refocus on the breath. This refocusing promotes relaxation and helps combat ruminative thinking in those with anxiety or depression.

When to Use Breathing Techniques

When is the best time to apply slow-breathing techniques? One good opportunity is during stressful situations, such as before an exam, a sports competition, or even a work meeting. In 2017, Ashwin Kamath and his colleagues at Manipal University in India studied stage fright among medical students. Those who practiced alternate nostril breathing for 15 minutes before speaking publicly experienced lower levels of stress than those in a control group.

These techniques also help with insomnia. In 2012, Suzanne M. Bertisch of Harvard Medical School found that more than 20% of American insomniacs used breathing exercises to sleep better. In 2015, Cheryl Yang’s team at National Yang-Ming University in Taiwan found that 20 minutes of slow breathing exercises (six cycles per minute) before bed significantly improved sleep. Participants fell asleep almost three times faster, woke less frequently during the night, and got back to sleep more quickly.

Breathing techniques can alleviate chronic anxiety as well. They’re particularly effective for individuals with psychiatric disorders such as phobias, depression, and PTSD. In 2015, Stefania Doria and colleagues at Fatebenefratelli Hospital in Milan trained 69 patients with anxiety or depressive disorders using a variety of breathing techniques. They observed significant symptom reduction, and improvement was sustained months later.

Breathing exercises also help relieve minor physical tension caused by stress. Therapists recommend regular practice throughout the day, particularly during breaks or transitions between activities. One common method is the “365 method”: breathe at six cycles per minute (five seconds inhaling, five seconds exhaling) for five minutes, three times a day, every day of the year. Some studies suggest that regular practice may even make people less vulnerable to stress by permanently altering brain circuits.

Inhale for Panic!

While slow breathing soothes, rapid breathing can induce anxiety. This paradox is used in behavioral therapy, where patients deliberately hyperventilate to artificially trigger anxiety, teaching them to manage it. They learn that poor breathing habits can amplify fear.

Open Questions

Traditional wisdom and increasing scientific evidence support the use of breathing techniques. However, further research is needed, especially in studies with control groups. One caveat: focusing on breathing may worsen panic for people with interoceptive anxiety (anxiety over physical sensations). For these individuals, breathing techniques should be practiced under supervision.

Considering how often emotional discomfort impacts health, everyone would benefit from regularly paying attention to their breath. Start with brief moments of mindful breathing several times a day. Breathing is like solar energy for relaxation: a free, accessible, inexhaustible tool for emotional regulation.

Interestingly, controlled breathing isn’t more widely practiced—perhaps because it's perceived as too simple or obvious to be effective. Alternatively, its profound connection to life and death may make people hesitant to engage with it. As Victor Hugo wrote in The Man Who Laughs (1869): “Generations are puffs of breath that pass away. Man respires, aspires, and expires.” Ultimately, we shy away from considering ourselves as mere “puffs of breath.”

Six Techniques for Relieving Stress

Here are some commonly used breathing techniques. Five to 10 minutes of practice can relieve stress and even prevent panic attacks. Regular practice can reduce daily anxiety.

• Stand Up Straight
  Good posture facilitates free breathing, allowing the diaphragm and rib muscles to move freely. This enables your body to breathe properly.

• Follow Your Breath
  Simply observe your breathing: focus on each inhalation and exhalation. Notice sensations as air moves through your nose and throat or as your chest and belly rise and fall. When your thoughts wander, gently return your focus to your breath.

• Abdominal Breathing
  Breathe deeply into your belly, expanding it as you inhale, and then your chest. Exhale by first “emptying” your stomach and then your chest. This is easiest to practice lying down with one hand on your belly.

• Rhythmic Breathing
  At the end of each inhalation, pause briefly, counting “1, 2, 3” before exhaling. This pause can also occur after exhaling or between breaths, helping to slow your breathing and calm anxiety.

• Alternate Nostrils
  Breathe through one nostril at a time, holding the other closed with your finger, then switch. This technique is soothing, especially when done slowly, and is thought to help balance the breath.

• Think Reassuring Thoughts While Breathing
  Associate each breath with calming thoughts. As you inhale, think, “I am inhaling calm,” and as you exhale, think, “I am releasing stress.”