Easy breathing. Breathing is something we take for granted. We presume that because we have done it all our lives then we must be doing it OK, but this is not at all the case. Are you someone who suffers from asthma, COPD? If so you certainly will have problems with breathing. What is less well known is that people suffering from anxiety, depression, IBS (irritable bowel syndrome), angina, CHD, headaches, migraine, neck and shoulder pain, muscle aches and pains and many more vague and medically unexplained symptoms also have problems with not breathing properly. Attention to breathing has been recognised as being important by many eastern traditions like Buddhism and yoga. It is also part of much meditation and relaxation practice. Paying attention to proper breathing, even after a life-time of poor breathing, works. Patients have commented: “I can control my worried thoughts with 5 breaths now – they just go pop and disappear. I’m so proud of myself “. (64year old with a previously severe anxiety disorder) “I can control my angina when I’m stressed. I’ve never breathed properly all my life. This is amazing.” (55 year old man with CHD) “I’m so much calmer. I practice breathing several times a day now.” (22yr old man with anxiety problems). “My post-herpetic neuralgia feels less of a problem, when I’m breathing properly.” (60 year old man) “I’m astounded that my oxygen saturation level goes up to normal when I’m breathing more slowly.” (55 year old woman with asthma just having had a course of steroids and thinking she wasn’t better). What might you be doing that is not helpful? • Breathing from the top part of your chest and not using your diaphragm • Not breathing into the sides of your chest and the back of your chest • Breathing too fast (hyperventilation) • Not allowing a gap between the in breath and the out breath • Panicking about your breathing • Forcing your breath out Why does this matter? • If you breathe from the top of your chest, you hold your shoulder and neck tightly and increase the feeling of bodily tension. • If you don’t expand your lungs fully oxygen doesn’t get into you blood stream as effectively • If you breathe too fast you blow off too much carbon dioxide. This hyperventilation can cause: feelings of unreality, faintness/dizziness, numbness and tingling especially around the mouth an in the hands, muscle tightening especially of the breathing muscles (and so a feeling of not being able to breathe), muscles spasms called tetany, amongst many other symptoms. • If you over-breathe chronically you can lose magnesium through your kidneys as they try to compensate for the chemical imbalance. This then contributes to a feeling of tiredness and unwellness. How should you breathe? When at rest the most restful breathing rate is between 6-8 breaths per minute. This takes a little practice to achieve. Lie down and practice trying to breathe with just your abdominal muscles. Let your shoulders relax down and relax your neck muscles. Make sure your out breath is a letting go breath and isn’t forced. Now sit up and try breathing abdominally not moving your upper chest at all. Start by practicing 7/11 breathing. Count to seven on the breath in and 11 on the breath out. Do this for 5 breaths. Notice how you feel, have a little rest and then try again until it feels more comfortable. Repeat this several times a day. Some people are more comfortable with breathing round a square. Imagine a square where each sided represents one of the following parts of the breathing cycle. Breathe in to the count of 5. Hold your breath to the count of 5. Breathe out to the count of five. Hold your breath for the count of five. As you are breathing imagine the square getting bigger, as you slow the rate of counting down. Imagine when you are breathing that you are breathing oxygen into different parts of your body, particularly if there are parts that are painful and tense. Some people can imagine the breath in a healing colour and find this very effective. Once you are good at breathing with just your abdominal muscles, let your chest muscles relax so that you can breathe into your back and breathe out sideways. Imagine that you are breathing with your whole body. Imagine that you are breathing in and out through your heart. Keep a regular check on your breathing throughout the day, eve3ry day. Abnormalities of breathing may be the first signs of some stress. Catch it early! How does this work? There is a part of the body called the autonomic nervous system which is divided into two parts – the sympathetic and parasymnpathetic. This nervous system regulates how we feel and how our body functions. It causes muscles to tighten and relax, acid to be produced or suppressed in the stomach, alters the motility of the gut wall, causes airways to open or constrict and so on. Anxious breathing with the upper chest stimulates the sympathetic nervous system, which causes amongst other things the release of adrenaline. This will cause anxiety to worsen, with palpitations, sweaty hands, tense muscles, raised blood pressure and closing down of small arteries including those in the frontal lobes of the brain where complex decisions are made. It will also make blood sugar rise. Abdominal breathing stimulates the parasympathetic system through the vagus nerve. This slows the pulse, decreases acid secretion, enables the voice to be louder. It also interestingly affects the muscles of facial expression allowing a greater range of expression. This makes socialisation easier. It explains why anxious people sometimes have a frozen sort of face. Easy breathing helps sleep. Recommended supporting Reading and CDs The Mindful way of Overcoming Depression (by Williams et al 2007) is a book explaining how to overcome depression with a large section on breathing. It also has an accompanying CD with breathing practices Positive mental training CDs www.positiverewards.com have been produced by an Edinburgh GP Dr Alistair Dobbin and have been successful with a wide variety of patients with the problems listed above. Several of the tracks show the difference effects caused by breathing in different ways.