How To Breathe: The End of Anxiety

We are mechanised by our breath, breathing on average over 22,000 times a day. Yet the powers of this simple function commonly get overlooked. Your breath is a tool that can help you overcome life’s biggest obstacles when you gain autonomy over it. Yes, breathing in and out unconsciously will keep you alive, but in this article, you will learn a breathing technique that will help you thrive. This technique is called box breathing. 

Notice your breath at this moment. How deep is your breath and how much are your lungs expanding? Perhaps your breath goes into your chest and out in short breaths, this is called shallow breathing. Referring to figure 1, the goal with box breathing is to allow more air to fill up the lungs. This is called deep breathing, in which you take a long and slow breath down into your diaphragm, allowing your lungs to expand full of air. Box breathing is a very easy technique to learn and anyone can do it. 

Box Breathing

Box breathing is a scientifically designed system of breathing that is impressively effective, even Navy Seals learn this technique as a part of their training to help them gain control over their mind and body. As shown in figure 2, there are 4 steps to box breathing and each step is equally important with its own set of benefits. 

Step 1: Breathe In

Slowly inhale through your nose for a count of 4 seconds, breathing in deeply and allowing your lungs to fill up fully. 

• Slows heart rate [1,2].
• Oxygen has time to enter the lungs deeper [6].

Step 2: Hold Inhale

Now that your lungs are full, do not exhale right away. Pause, and hold your breath in for 4 seconds. 

• O2 enters the bloodstream [6].
• CO2 enters the lungs [6].

Step 3: Breathe out

Avoid releasing all your air at once. Instead, slowly and evenly breathe through your mouth out for a count of 4 seconds. 

• Activates the parasympathetic nervous system [3].
• Activates the vagus nerve [4].
• Relaxes body and mind [1,5].

Step 4: Hold Exhale

Again, hold your breath and pause for 4 seconds. After 4 seconds, repeat step one. The goal is to go through this cycle at least 4 times minimum, and the longer you can practice, the better. 

• Deeper body and mind relaxation [1,2,5].
• Further activates the vagus nerve [4,5].
• Lowers blood pressure [2].
• Improves oxygenation [6,7].

The Benefits Of Box Breathing

In addition to the benefits listed above, diaphragmatic breathing exercises encompass a wide variety of overall health benefits. 

1. Improved Mood

Box breathing activates the vagus nerve which is our key to health [4]. Vagus nerve activation is correlated with decreased depression and anxiety, it is often referred to as the key to health [8]. Furthermore, controlled breathing has been studied time and again proving its effectiveness in decreasing depression [12]. Emploring this technique regularly will help you become present and overcome depression. 

2. Instant Anxiety Relief & Stress Resilience 

During anxiety attacks, the sympathetic nervous system is activated and cortisol is dumped into our bloodstream [9]. With consistent practice of this technique, the body decreases the rate of sympathetic nervous system (fight or flight) activation. In doing so, the body learns to stay calm in moments of adversity. Researchers have found that just one session of slow diaphragmatic breathing reduces anxiety levels and activates the parasympathetic nervous system (rest and digest) which allows the mind and body to relax [3,10]. 

3. Increased Cognitive Performance

By remaining physiologically relaxed in adverse scenarios, you will be able to make better decisions. Studies show that taking deep diaphragmatic breaths allows for mental clarity and increases attentiveness, resulting in overall increased cognitive performance [11]. 

If you are ever feeling stressed during an exam, notice your heart rate going up when meeting certain people, or are in a situation that is bringing about anxiety, try this box breathing technique and experience the mental clarity and relaxation that will come along with it. Practice this method daily to watch the benefits play out into all moments of your life, giving you back control over your life. You can practice box breathing anywhere, anytime, so give it a try! 

1. Chen, Y. F., Huang, X. Y., Chien, C. H., & Cheng, J. F. (2017). The Effectiveness of Diaphragmatic Breathing Relaxation Training for Reducing Anxiety. Perspectives in psychiatric care, 53(4), 329–336. https://doi.org/10.1111/ppc.12184
2. Hopper, S. I., Murray, S. L., Ferrara, L. R., & Singleton, J. K. (2019). Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: A quantitative systematic review. JBI Database of Systematic Reviews and Implementation Reports, 17(9), 1855-1876. http://dx.doi.org/10.11124/JBISRIR-2017-003848
3. Zaccaro, A., Piarulli, A., Laurino, M., Garbella, E., Menicucci, D., Neri, B., & Gemignani, A. (2018). How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing. Frontiers in human neuroscience, 12, 353. https://doi.org/10.3389/fnhum.2018.00353
4. Yuan, H., & Silberstein, S. D. (2016). Vagus Nerve and Vagus Nerve Stimulation, a Comprehensive Review: Part I. Headache, 56(1), 71–78. https://doi.org/10.1111/head.12647
5. You, M., Laborde, S., Zammit, N., Iskra, M., Borges, U., & Dosseville, F. (2021). Single Slow-Paced Breathing Session at Six Cycles per Minute: Investigation of Dose-Response Relationship on Cardiac Vagal Activity. International journal of environmental research and public health, 18(23), 12478. https://doi.org/10.3390/ijerph182312478
6. Patel, S., Miao, J. H., Yetiskul, E., Anokhin, A., & Majmundar, S. H. (2022). Physiology, Carbon Dioxide Retention. In StatPearls. StatPearls Publishing.
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8. O’Reardon, J. P., Cristancho, P., & Peshek, A. D. (2006). Vagus Nerve Stimulation (VNS) and Treatment of Depression: To the Brainstem and Beyond. Psychiatry (Edgmont (Pa. : Township)), 3(5), 54–63.
9. Bandelow, B., Wedekind, D., Pauls, J., Broocks, A., Hajak, G., & Rüther, E. (2000). Salivary cortisol in panic attacks. The American journal of psychiatry, 157(3), 454–456. https://doi.org/10.1176/appi.ajp.157.3.454
10. Magnon, V., Dutheil, F., & Vallet, G. T. (2021). Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults. Scientific reports, 11(1), 19267. https://doi.org/10.1038/s41598-021-98736-9
11. Ma, X., Yue, Z. Q., Gong, Z. Q., Zhang, H., Duan, N. Y., Shi, Y. T., Wei, G. X., & Li, Y. F. (2017). The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Frontiers in psychology, 8, 874. https://doi.org/10.3389/fpsyg.2017.00874
12. Kharya, C., Gupta, V., Deepak, K. K., Sagar, R., Upadhyav, A., Kochupillai, V., & Anand, S. (2014). Effect of controlled breathing exercises on the psychological status and the cardiac autonomic tone: Sudarshan Kriya and Prana-Yoga. Indian journal of physiology and pharmacology, 58(3), 211–221.