The Mind Body Connection: Finding Health In An Age Of Stress

The Mind Body Connection: Finding Health In An Age Of Stress

woman exploring the mind body connection through yoga

What Is The Mind Body Connection?

Since the intention of this blog is to explore the many facets, practices and benefits of natural health and healing, it seems apt to begin our journey with a discussion of a central pillar of natural healing: the mind body connection

In this article we’ll look at some of the major ways the mind and body are connected, reviewing the scientific evidence supporting this vital link. We’ll explore the mind body connection from a bio-psycho-social viewpoint, appreciating how your physical and social environment, psychological state and body physiology interact to support or disturb health

We’ll learn how the body reacts to stress, the influence of coping and positive emotions on health, and discuss the contribution of mind-body and other holistic approaches from yoga, mindfulness and creative visualization to acupuncture and cognitive behavioural therapy, to maintaining optimum health through the mind body link

From fighting infection to cardiovascular health and the quality of your digestion, understanding the mind body connection is a vital first step to help you take control of your wellbeing for a happier and healthier life

How The Mind And Body Are Connected

While it’s not difficult to appreciate how physical illness and pain can impact you emotionally, understanding how a mental state can aggravate your gut or increase your blood pressure needs rather more clarification

The key to understanding how the mind and body are linked lies in the body’s three great regulating systems:

  • 1 – The Nervous System
  • processes data and regulates all bodily functions on a moment to moment basis through electrical impulses travelling along nerves
  • 2 – The Endocrine System
  • regulates physiology over days, weeks or months by means of circulating messengers known as hormones. Finally
  • 3 – The immune system
  • distinguishes between self and other to keep us safe from external and internal invaders, including bacteria, viruses and malignant cells

Though the functions of nervous and endocrine systems have long been considered to be integrated, the immune system was thought to work autonomously until, the 1970’s, psychologist Robert Ader and Nicholas Cohen, currently professor Emeritus of microbiology and immunology and of psychiatry at Rochester University (USA), demonstrated that immune responses can be conditioned and are thus under the influence of the brain. Thus, Ader and Cohen established the modern discipline of psycho-neuro-immunology, finally integrating all three systems into a single supersystem orchestrating the body’s need to maintain stability and health in an ever changing environment

Another factor of importance for regulating whole-body physiology is the microbiome, the colonies of micro-organisms living in on and in our bodies. The gut microbiome in particular has been shown to play a central role not only in digestive health but also in psychological wellbeing

A great starting point for understanding how mental states affect physical health is by studying how the body responds to stress 

Stress And Health
The General Adaptation Syndrome

First described by the endocrinologist Hans Selye in 1936, the body responds to stress with a series of hormonal and neural signals he called the General Adaptation Syndrome, or GAS 

Dr Selye noted that when we appraise any situation as challenging, the body mounts a stereotypical response by way of a cascade of hormones originating in a brain region known as the hypothalamus, and culminating in the release of the steroid hormone cortisol from the adrenal glands

diagram of physiological stress response

In its acute (short term) phase this adaptation to stress is essential for survival. Cortisol raises blood sugar and provides the body with the resources it needs to respond effectively to a stressor. In the long term, however, persistently elevated cortisol levels are associated with a broad range of health issues, including cardiovascular disease and stroke, peptic ulcers, inflammatory bowel disease and more

Stress And The Nervous System

At the same time as releasing cortisol, stress also triggers a fight-flight-freeze response through the sympathetic nervous system via chemical mediators which include the hormone adrenaline and neurotransmitter noradrenaline

Like the Cortisol response, sympathetic activity mobilizes the body into action to deal with stressors, raising blood pressure, quickening the heart and stimulating breathing in readiness for action. Also like Cortisol, fight-and-flight activity is pro inflammatory

Unlike the cortisol effect, however, the adrenaline-noradrelaine effect is short term, more strongly associated with positive stress-avoiding action, and has fewer long-term consequences on health

Stress And Inflammation

A significant consequence of stress on health is inflammation. Inflammation is one of the most basic responses of innate immunity for protecting us against injury and disease. During inflammation the immune system releases chemical mediators which attract immune cells to deal with invaders, damaged tissues or rogue cells. While protective in the short term, inflammation can, when excessive, prolonged (chronic) or inappropriate (eg. auto-immunity) damage the body’s own tissues, leading to problems ranging from intestinal and joint inflammation to blood-vessel damage and depression

While in the short-term stress tends to dampen inflammation and boost immunity (cortisol analogues are used clinically for their anti-inflammatory effects), persistently raised cortisol levels suppresses immune activity while raising inflammation. Chronic inflammation has been linked to a wide range of issues, including

  • Bronchospasm in asthma
  • Intestinal inflammation (Chrohn’s, Ulcerative Colitis, Coeliac’s) with pain, diarrhoea and impaired absorption
  • Arthritis with joint swelling with pain
  • Blood vessel damage with deposition of fibro-fatty plaques (atheroma) predisposing to heart disease and stroke
  • a range of mental health issues, including depression 

Neuroinflammation is an inflammatory response mediated specifically by cells within the brain and spinal cord. By triggering neuroinflammation stress has been shown to be a factor in a number of mental health issues, including depression and schizophrenia. Studies show that stressful life experiences are associated with raised pro-inflammatory chemical mediators (cytokines) in childhood, as well as a higher risk of mental illness in adulthood (Calcia 2016)

A literature review by Viktoriya Maydych (2019) finds that current research supports a direct link between stress, inflammation and reduced emotional attention, the triad itself being a predictor for depression

Coping With Stress

Not all of Hans Selye’s findings have been borne out by research. Later research has found that, depending on the individual’s appraisal of a stressor, the stress response may be short term, triggering sympathetic nervous system responses, longer term, triggering cortisol release, or both

Crucial to stress coping is the extent to which you feel you have the resources to deal with the stressor, and the kind of outcome you expect. Thus, feeling you can deal with a stressful situation and expecting a positive outcome is linked to short-term arousal, while feeling hopeless, helpless and generally having little control, along with expectation of a negative outcome is linked to longer-term cortisol mediated arousal

Inevitably, individual personality traits and past experiences of stress, especially during childhood, all play a significant role in stress coping

Rest-And-Digest: The Parasympathetic Nervous System and Natural Relaxation

Not surprisingly, the body has an inbuilt natural relaxation response mediated by the parasympathetic nervous system, the complement of the sympathetic system, having largely opposite effects, though it would be more accurate to consider the two systems as complementary

The parasympathetic system works to repair tissue damage and replenish the body’s resources depleted by stress, calming the heart and breath, lowering blood pressure and stimulating digestion, assimilation and excretion of wastes. Parasympathetic activity is also actively anti-inflammatory

Rest-and-digest responses are mediated primarily via the Vagus nerve, so called because of its long, wandering course from the brain stem to virtually every organ in the body

Parasympathetic Vagal activity is triggered by an appraisal of a situation as inherently safe. Stimulation of the Vagus has lately been hailed as the holy grail of instant rest-and-digest. External electrical stimulation of the Vagus in the neck, while effective, is a specialist surgical procedure reserved for the management of treatment resistant epilepsy and clinical depression. While reflex and mechanical stimulation of the vagus using stimuli including pressure and cold applications are advocated by some, their usefulness remains spurious

The connection of parasympathetic activity to safety, on the other hand, opens the door to a plethora of possible interventions, including yoga, mindfulness, creative visualization and psychological methods such as Cognitive Behavioural Therapy (CBT), all of which attempt to enhance stress coping, foment positive mental states and generally stimulate the rest-and-digest system using the mind body connection to exert their positive effects 

Scientific Evidence
For Mind-Body Therapies

Modern health research increasingly takes a bio-psycho-social stance on health and disease. The model replaces the old biomedical approach which sought to understand disease solely by looking at biological factors, with a broader understanding where personal history, lifestyle choices and the social and physical environment interact with biological processes to support or perturb health

This more holistic perspective is strongly supported by research. Where studies show that chronic stress is linked to many common health issues of our day, including cardiovascular disease, obesity, and autoimmunity, they also strongly support the effectiveness of interventions which promote relaxation and positive mental states to enhance immune activity, reduce inflammation and provide a whole range of positive physical and mental health outcomes

Having already looked at the effects of stress and coping with stress on health, we can now consider the evidence for positive emotions on wellbeing

Positive Emotion, Coping And Health

More recently, research has focused on the mind body link in the context of positive emotions. Studies supports the theory (Fredrickson, 1998) that emotions like optimism, curiosity, joy and love help to broaden an individual’s thought–action repertoire, prompting them to let go of automatic behaviours in favour of novel, creative thoughts and actions. This leads to a building of personal resources for dealing with current and future stressful events, as well as helping to undo some of the harmful effects of negative emotions

A number of subsequent studies have supported the role of positive emotions (Fredrickson, Cohen et al, 2000-2008) in coping. People who score highly for resilience – the ability to bounce back from and adapt to the demands of distressing events – experience more positive emotions, deriving positive meaning from day to day stressors. At the physical level they also also demonstrate faster rates of cardiovascular recovery (slowing of the heart, lowering of blood pressure) following laboratory induced stressful events (Tugade & Fredrickson, 2004).

Nor are positive emotions linked solely to the expectation of a positive outcome. Folkman (1997) found that positive emotions can also arise from events with unfavourable outcomes, provided the individual can find meaning or benefit arising from their experiences

The ability to find benefits from difficult experiences has been linked to reduced distress following bereavement, heart attack and exposure to disasters, including damage to property and loss of life (Tennen & Affleck, 1999).

Benefit-finding has been linked to better physical health outcomes, ranging from a lower propensity to re-infarction following a first heart attack, to reduced pain and improved mobility in inflammatory arthritis

Cognitive Behavioural Therapy

CBT works on the reciprocal relationship between cognition (thinking) and behaviour, helping individuals identify and change habitual thought patterns using a range of activities, such as being in the present moment (mindfulness), relaxation and reframing of negative thought patterns

CBT works on positive emotions by helping individuals to identify the negative assumptions underlying their thinking, consciously nurturing positive thoughts and behaviors until these become the new norm

By improving self awareness, reducing negative thoughts and developing better coping skills CBT helps to reduce anxiety and improve emotional resilience. Studies show that CBT can help with anxiety, depression, panic attacks, phobias and post-traumatic stress. CBT has also been used successfully in obsessive compulsive disorders and a range of eating disorders. Physical health benefits include relief from chronic pain, fibromyalgia and chronic fatigue, as well as a range of physical disorders with a strong psychological component, such as irritable bowel

Yoga And Mindfulness Based Approaches
For Health And Happiness

Yoga And Meditation

Yoga and meditation are mindfulness-based practices promoting self-awareness, relaxation, and resilience, and have been shown to enhance the whole spectrum of bodily and emotional health

Research consistently shows that people who practice yoga report lower levels of anxiety, depression, and stress, and experience significant improvements in physical fitness parameters such as flexibility, strength, and cardiovascular endurance

Yoga has been shown to improve all the major risk factors for cardiovascular and cerebrovascular (stroke) disease, reducing blood pressure, and improving blood cholesterol profile. Improvements have been found in respiratory function, chronic pain management and stress coping, leading to a reduction in circulating stress hormones while stimulating rest-and-digest 

Want to see for yourself how yoga works? Join one of our weekly yoga classes to help you maintain a healthy spine and allow your mind and body to rest and digest

 

Breath Work

Breath work is an integral part of yoga practice. Life force, or vital energy (prana) manifests in the body as breath, and in the mind as thinking and feeling. Breathwork in yoga is known as pranayama: control of the vital force. Thus, when the mind is excited (through joy or distress) the breath is quick, sometimes erratic. When the breath is quiet the emotions are calm and the mind is clear and relaxed

Quiet breathing (Zaccaro, 2018) has been linked to objective measures of parasympathetic activity, such as increased heart-rate-variability (HRV is the difference in heart rate during inhalation and exhalation and is a measure of Vagal tone), as well as the subjective experience of relaxed wellbeing. Though the precise mechanisms remain under review, breath affects mental wellbeing by at least two pathways: an interoceptive (ability to perceive the state of the inner body) mechanism related to sensors in the breathing apparatus, likely mediated by the Vagus nerve, and receptors within the nose signalling directly to emotional centres in the brain

Creative Visualization And Guided Imagery

An intrinsic practice in yoga and other mindfulness approaches, visualization has been shown to provide tangible health benefits associated with the systemic relaxation response mediated by the parasympathetic system and Vagus

Brain imaging techniques show that visualization stimulates the brain areas involved with inner perceptions as if they were actually happening. In the same way that the stress response can be triggered by the mere anticipation or memory of a stressor, the relaxation response can be elicited through techniques such as yoga nidra, a guided practice using body and breath mindfulness, and progressing through various stages of creative visualization to reach the deepest possible level of relaxation while remaining awake

Mindfulness

Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are modern takes on traditional Buddhist meditation with a very strong evidence base. Initially developed to manage stress and depression respectively, mindfulness helps develop positive emotions, resilience and cognitive function, while also exerting positive effects on physical health through the mind body connection, including a reduction in blood pressure and circulating stress hormones

The Gut Brain Axis:
Health, Nutrition And The Microbiome

The role of nutrition in health, though crucial, is beyond the scope of this article. One aspect of nutrition, however, is so pertinent to our discussion of the mind-body link that I would be negligent to ignore it. It concerns the microbiome, those trillions of bacteria and other micro-organisms living on every square inch of the surface of your body, from the lining of your gut and lungs to your skin, nails and even eyelashes, and one of the hottest topics in current health science

In an age of antibiotics and antibiotic resistance, where anti-microbial products find their way into everything from cleaning materials to items of clothing such as socks (it’s supposed to stop them from smelling), the role of “good” bacteria in health has become an imperative

As mentioned, the gut houses colonies of micro-organisms essential for health. Though the subject is too large to cover in a couple of paragraphs, there are some major topics worth discussing in relation to the mind body connection

The first is the gut-brain axis, a two way connection between gut and brain. We’ve described the vagus nerve as the main carrier of rest-and-digest activity from the brain to the organs. Yet 80% of Vagal nerve fibres are sensory, carrying information from the organs to the brain. And since, in terms of surface area, the gut is the largest organ in the body, a good part of the vagus is dedicated to listening to the gut

Gut bacteria produce more than 90% of the body’s serotonin, a chemical transmitter involved in mood and wellbeing (low serotonin levels have been linked to clinical depression), as well as digestive function, and previously thought to be largely confined to the brain.

In addition to serotonin bacteria manufacture health-promoting substances such as butyrate and propionate, short chain fatty acids with an important role in supporting immunity and down-regulating inflammation

Though the health of the gut microbiome is influenced by numerous factors, the effects of diet are unquestionable. A picture is emerging of optimal gut health depending not just on a large number of organisms, but also a wide variety of different species

Pro-biotic foods containing live or dormant bacteria can help replace beneficial bacterial colonies. Probiotics include fermented products including yoghurt, kefir and kombucha as well as bean and vegetable ferments such as miso, sauerkrout and kimchi

While directly supplying beneficial bacteria, studies show that commercial pro-biotics deliver a rather narrow range of species with limited benefits. Pre-biotics, on the other hand, provide the nutrition necessary for good bacteria to thrive, and have been shown to support a microbiome with much greater diversity. And the most abundant and effective pre-biotic? Fibre

The bulk of the fibre we ingest is cellulose, an insoluble carbohydrate which our digestive system is unable to break down. Fibre is, however, food for microbiotic organisms. In a beautiful display of symbiosis (a relationship of mutual benefit) our friendly microbes break down and feed on fibre while releasing by-products essential for our physical and mental wellbeing

Thus, a high fibre diet, one rich in whole grains, pulses and vegetables is one of the very best ways to support your friendly gut bugs, allowing them to thrive and provide in return a bounty of health and happiness

Holistic Body Therapies
For A Healthy Mind And Body

The contribution of body-work to your psycho-somatic wellbeing is well documented. Holistic body therapies, including holistic massage, Rolfing, shiatsu, tuina, chiropractic and osteopathy, all embrace the philosophy of body-mind unity

As an osteopath, I’d like to round off this article with a mention of the place of osteopathy within mind-body medicine. There is a general idea in the popular mind that osteopathy is a form of manual therapy primarily aimed at relieving back and sundry other aches and pains. While we hopefully do a decent job of helping your body to heal, osteopathy is a holistic system of healthcare which works with your structure for the sake of total physical and mental wellbeing. Osteopaths aim to create an optimal physical environment for all your vital functions to thrive

Osteopaths work with the functional and structural relationships between the musculo-skeletal system (soma), internal organs (viscera), and psyche (mind), with the spine as principle mediator between the brain and body

It’s no coincidence that of the list of conditions the profession can help with, according to available evidence, share the same characteristics as other therapies working within the mind-body spectrum

You can read more about osteopathy and some of the conditions osteopathy can help you with by clicking the link

Conclusions Towards a Bio-Psycho-Social Model Of Health

Where historically acute, especially infectious, diseases have been the dominant cause of ill health and death, the modern age has seen a shift towards chronic diseases such as cardiovascular disease, diabetes, obesity and cancer

Modern scientific medicine has indeed produced virtual miracles in curing and eradicating infectious disease and increasing human life-spans beyond anything we ever dreamed possible. Yet an exclusively bio-medical approach has fallen short of addressing the epidemic of chronic physical and mental health issues resulting from factors such as social isolation and stress

As the limitations of an exclusively bio-medical view of health and disease become increasingly apparent, the need to bring the psyche into the picture is ever more pressing. Neither do the mind and body operate in a vacuum, but rather within a complex set of interacting factors which includes personal history, job satisfaction, family and social relationships, coping strategies, diet and access to clean air and water, to name just a few

More than ever, there is a pressing need to address the health challenges of our day from a more holistic, ecological perspective, with the body, mind and environment as essential components and the individual at the centre of her wellbeing

References

  1. Yun-Zi Liu et al, (2019). Inflammation: The Common Pathway of Stress-Related Diseases.
  2. M A Calcia et al, (2016). Stress and neuroinflammation: a systematic review of the effects of stress on microglia and the implications for mental illness
  3. Fredrickson, B.L. (1998). What good are positive emotions? Review of General Psychology, 2, 300–319.
  4. Cohen, M.A., & Fredrickson, B.L. (2006). Beyond the moment, beyond the self: shared ground between selective investment theory and the broaden-and-build theory of positive emotions. Psychological Inquiry, 17, 39–44
  5. Fredrickson, B.L.et al, (2008). Open hearts build lives: positive emotions, induced through loving kindness meditation build consequential personal resources
  6. Fredrickson, B.L., & Joiner, T. (2002). Positive emotions trigger upward spirals toward emotional well-being. Psychological Science, 13, 172–175.
  7. Fredrickson, B.L., & Levenson, R.W. (1998). Positive emotions speed recovery from the cardiovascular sequelae of negative emotions. Cognition and Emotion, 12, 191–220.
  8. Fredrickson, B.L., Mancuso, R.A., Branigan, C., & Tugade, M.M. (2000). The undoing effect of positive emotions. Motivation and Emotion, 24, 237–258.
  9. Fredrickson, B.L., Tugade, M.M., Waugh, C.E., & Larkin, G.R. (2003). What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. Journal of Personality and Social Psychology, 84, 365–376.
  10. Michele M Tugade, B L Fredrickson (2004). Resilient individuals use positive emotions to bounce back from negative emotional experiences. J Pers Soc Psychol 86(2):320-33
  11. A Zaccaro et al (2018) How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing
Yoga And Mindfulness For Dysfunctional Breathing: 5 Exercises For Better Health

Yoga And Mindfulness For Dysfunctional Breathing: 5 Exercises For Better Health

young man practising mindfulness for dysfunctional breathing

Few will dispute the importance of breathing for sustaining life. Without oxygen, animal and human life processes stop within minutes. But did you know that excessive breathing also comes with a health warning?

How you breathe goes beyond providing oxygen and ridding the body of carbon dioxide, to profoundly affect your digestive, cardiovascular, nervous and other systems, as well as impacting on your emotional wellbeing. And the key to breathing well, or otherwise, is less with oxygen intake, and more with how much carbon dioxide you’re exhaling

This article will deal with the commonest form of dysfunctional breathing in healthy people: breathing pattern disorder or over-breathing:

Where, under normal conditions, exertion quickens the breath to match the body’s energy demands, dysfunctional over-breathing exceeds the body’s energy needs, changing your blood chemistry to produce symptoms such as muscle tension and pain, irregular heart rhythm, digestive complaints, dizziness and anxiety

In this article you’ll learn to recognize healthy and dysfunctional breathing patterns and some their major effects on your health. You’ll explore how you breathe, and address any imbalances by means of

How Does Dysfunctional Breathing Impact Your Health?

Dysfunctional breathing comes in two forms: breathing too little (hypoventilation), and breathing too much (hyperventilation). Underbreathing is a feature of diseases such as chronic obstructive pulmonay disease (COPD). Though sometimes co-existing with underbreathing in COPD, asthma and others, overbreathing is also seen in otherwise healthy individuals, with a  prevalence estimated at around 10%

A normal breathing pattern in human adults consists of

  • an average resting breathing rate of 12-18 breaths per minute
  • a 1:2 ratio of inhalation to exhalation, with a brief 1-2 seconds pause at the end of exhalation
  • breathing is through the nose
  • the diaphragm is the principle muscle used in breathing

Over-breathing has strong associations with stress and anxiety, each exacerbating the other to create a self-sustaining cycle

Features of a dysfunctional breathing pattern include

  • shallow, rapid, or irregular breathing
  • exhalation which is equal to or shorter than inhalation,
  • pausing between breaths may be absent
  • mouth breathing is common
  • high chest breathing is often favoured over diaphragmatic breathing

What follows is a short account of how dysfunctional breathing alters you blood chemistry to produce an array of multi-system disturbances. If you prefer, hit the button to skip this section and come back to it in your own time

The effects of dysfunctional over-breathing come about not so much from an excess of oxygen, but from the excessive loss of carbon dioxide (CO2 ). An acid when dissolved in water (blood), low CO2 levels make the blood relatively alkaline, the resultant respiratory alkalosis being the trigger for a host of multi-system dysregulations

Paradoxically, despite overbreathing raising blood oxygen levels, alkalosis keeps the O2 locked within the red-blood cells, rendering it effectively unavailable

Alkalosis subjects Calcium (Ca2+ ) to a similar fate, keeping it tightly bound to the blood protein albumin. Essential for nerve and muscle function, the reduced availability of Ca2+ is associated with symptoms such as muscle cramps, tingling / pins-and-needles, dizziness and other neuro-muscular disturbances

Two other common features of dysfunctional breathing are chest and mouth breathing. Strongly associated with tension, stress and anxiety, chest and mouth breathing further exacerbate overbreathing, potentially setting up a vicious cycle

In addition, mouth breathing bypasses an important protective mechanism:

Nitric oxide (NO), released from the mucous membranes of the nose in response to the passage of air, is a powerful chemical mediator of dilatation of the airways (bronchodilation), and blood vessels (vasodilation), facilitating air flow and gas exchange within the lungs

NO also contributes an important anti microbial function. Unsurprisingly, mouth breathing bypasses the protective effects of NO and is associated with a higher propensity for respiratory tract infections

Chest breathing often accompanies forward head and other postural imbalances, leading to muscular pain and fatigue in the neck and upper back regions, and further creating tension to exacerbate overbreathing

Symptoms Of Breathing Dysfunction May Include

  • frequent sighing and yawning
  • tingling in the extremities. mouth and face
  • Muscle pain, especially in the upper back, neck and shoulders
  • abdominal pain and digestive disturbance
  • racing or irregular heart beat
  • anxiety, inability to relax, and sleep disturbance
  • physical and mental fatigue
  • and others

For a fuller account of the mechanisms behind the symptomatolgy of dysfunctional breathing check the related article on breathing pattern disorder

Identifying Breathing Pattern Disturbances

Dysfunctional breathing can mimic other medical conditions, making diagnosis challenging. Symptoms such as shortness of breath, rapid breathing, and alteration in heart rhythm, may be due to respiratory or cardiac disease. Sensory disturbance and muscular pain may have a rheumatological or neurological origin; while causes of anxiety may be due to hormonal imbalances, such as with overactivity of the thyroid gland, needing the attention of an endocrinologist, as well as professional psychological support

If you are experiencing these or any other symptoms suggestive of breathing pattern disorder, first consult your doctor to rule out organic disease requiring specific attention

PRACTICAL – How Do You Breathe?

Breathing is automatic. And it can also be consciously directed. Looking at your breathing, how do you breathe?  Do you breathe through your nose? Do you mainly use your diaphragm, upper chest, or a combination of the two? How does your posture and position affect your breathing? Here are a handful of really simple ways to help you get better acquainted with your breathing habits:

1 – SNIFF TEST

This is a great way to see whether you habitually breathe using the diaphragm or the upper chest

Sit or stand with one hand on your belly and the other on your breast bone. Breathing through your nose take in a sharp, fast lungful of air. Can you tell which of your hands moves first? Try it a few times. This tells you a lot about where you breathe when you’re under stress: belly = diaphragm, breast bone = chest breathing

2 – PRACTICAL

Lie comfortably on your back, your knees bent, and feet on the floor at hips’ width. Place one hand on the middle of your belly, and another over the breast bone

young man practising breathing exercise for dysfunctional breathing

How comfortably are you able to breathe through your nose? Is one nostril clearer than the other?

Breathe quietly and comfortably. Which hand do you feel moving the most? Which hand moves first?

Now, place the hands on the sides of the lower ribs. Do your ribs expand sideways as you inhale?

3 – PRACTICAL

Now rest the back of your head on a soft (paperback) book a couple of hundred pages thick

Does this change the way you breathe? Is it more or less comfortable?

4 – EXERCISE

Sit on a chair. Maybe at your home or office work station? Adopt a comfortable sitting posture. Check how you’re breathing. Use your hands to help you

Now try to imagine yourself sitting at work. What sort of posture might you adopt? In that posture, how does breathing behave?

Breathing well at rest, however, does not guarantee you won’t overbreathe when stressed, tired, or just plain busy

Blood CO2 levels may be measured by capnography, a device that measures CO2 in expired air. other common clinical tests of breathing function include manual assessment,  cardio-pulmonary exercise testing and hyperventilation provocation testing, all of which require professional expertise and specialist equipment

Fortunately, there are simpler ways of testing for breathing dysfunction which require no equipment and correlate well with capnography and other findings

A fimr favourite for its ease of use and reliability, the Nijmegen Questionnare consists of 16 questions yielding scores based on frequency of symptoms. Each answer scores a number 0-4. Simply answer the questions and add up the scores

Though a score of 23+ is diagnostic of full-blown hyperventilation syndrome, scoring 15 or higher puts you on the dysfunctional breathing spectrum 

Nijmegen questionnaire for dysfunctional breathing

Nijmegen Questionnaire:
click the pic to open and download the pdf version

Yoga And Mindfulness Exercises
For Healthier Breathing

1 – Diaphragmatic Breathing

The diaphragm is a dome shaped muscle sitting at the base of the chest cavity. It spans from to the lower margin of the rib-cage and tip of the breast bone to a central tendon at the apex of the dome. It also has connections to the upper half of the lumbar spine (lower back vertebrae), but that needn’t concern us here

As the diaphragm contracts it tends to flatten. This changes the dimension of the chest cavity, lowering its pressure, which is equalized by air rushing in. You can see how inhalation is an active process involving muscle contraction

During exhalation the diaphragm simply relaxes and, being elastic, it recoils to its resting dome shape

The diagram below shows the relationship of the diaphragm, ribs and lungs

image of the diaphragm in normal and dysfunctional breathing

The diagram above also shows the lower ribs remaining fixed while the central part (tendon) of the diaphragm moving down on inhalation. This downward motion of the diaphragm presses down into the abdominal organs. With the belly wall relaxed, the organs are pushed forward – this is belly breathing

Now take a look at the diagram below. The first diagram shows belly breathing, with the lower ribs staying fixed while the central tendon moves down

If, on the other hand, the central tendon is fixed the diaphragm again flattens as it contracts, but this time the lower ribs are moved up. Because the lower ribs move like bucket handles, upward motion is accompanied by side-ways expansion. This is lateral rib breathing

In belly breathing the muscles of the waist anchor the ribs down while the belly remains soft. In lateral rib breathing the belly muscles pull in, pushing the viscera up against the central tendon to stabilize it, allowing the margin of the rib cage to expand 

If you find it hard visualize, don’t worry: just try it:

Diaphragmatic Breathing 2 Ways

schematic image of different forms of diaphragmatic breathing

PRACTICAL 1: Belly Breathing

First, let’s practice pure belly breathing:

Lie on your back, the soles of your feet flat on the floor at hips’ width apart, your knees bent upwards. Or, if you prefer, lie with your legs straight, placing a cushion or rolled up blanket behind your knees. Put one or both hands on your belly, a little to the side of the navel

As you inhale, imagine you’re sending the air through the chest and beyond into your belly. Notice how the belly rises. As you let the breath out, slowly and quietly, notice how the belly falls. During exhalation the diaphragm and rib muscles all relax. Let the exhalation fully finish, to ensure maximal relaxation

Don’t be in a hurry to breathe in. Let the breath come to you. When it does, simply guide the air into the belly and let your body take care of the rest

practice this for at least a minute

PRACTICAL 2: Lateral Rib Breathing

Lying on your back as before, place your hands a comfortable distance apart onto the front-side of your lower ribs

Now, place an imaginary object weighing just couple of pounds on the underside of the navel

With your hands on your lower ribs, gently hold your belly back to keep the inhalation in the lower chest. Avoid tensing the belly, just softly hold it back to prevent it from rising. Relax the lower lateral ribs, softening them to receive the breath

Exhale, long and quiet, waiting at the end of the outbreath for the inhalation to begin spontaneously

Practice breathing this way for further minute

PRACTICAL 3: Full Diaphragmatic Breathing

Lying on your back as before, place your hands a comfortable distance apart onto the front-side of your lower ribs

Now, place an imaginary object weighing just couple of pounds on the underside of the navel

With your hands still on your lower ribs, inhale, sending the air down into the belly. Notice how, as the belly rises there is a soft holding back. Look for a feeling of your belly falling back while remaining very soft. Does this soft holding back send the air into the lateral ribs? Relax the ribs, soften them so they can receive the breath

Exhale, long and quiet, waiting at the end of the outbreath for a new breath to begin

Stay with this for one more minute

2 – Developing A Healthy Breathing Pattern

Though not the whole story, breath retraining plays a key role in managing dysfunctional breathing, with studies showing a positive association between slow breathing, stress and mental wellbeing13 14

An average healthy adult at rest will breathe through the nose and use the diaphragm to take around 12-18 breaths per minute, with an inhalation – exhalation ratio of 1:2, spontaneously pausing for 1-2 seconds at the end of exhalation

From the exercises you’ve practiced so far, how closely does your breathing pattern reflect this “norm”?

The exercise below will encourage you to slow your breathing while giving you plenty of elbow room to breathe in a way that’s natural to you. Try it:

PRACTICAL 4 – Breathing Pattern Retraining

  • Sit or lie comfortably, bearing in mind that lying is usually more comfortable, but sitting helps keep you alert to your breathing. Try both, then decide which works best for you
  • Unless your nasal passages are seriously blocked, breathe through your nose
  • Aim to breathe as quietly as possible, staying within your comfort range
  • Gently guide the breath into your belly if you can. If that’s difficult, don’t worry for now. Belly breathing is not the only, or even the best way to use your diaphragm! What we’re really concerned with here is the breathing rhythm
  • Let your body take an in-breath, short or long, shallow or deep, into the belly or the chest
  • Now, let the breath go, slowly and quietly. Take your time. Let the exhalation fully finish
  • Now wait. Does the in-breath come right away? or is there a pause, short of long at the end of the out-breath? Either way, it’s fine. There is no right or wrong. Let your body decide

As you breathe, quietly, mindful of your breath, following it’s rhythm, your mind and body will feel calmer, and your breath retraining firmly underway

Mindfulness Of Breath
For Stress Relief & Relaxation

Essential for managing breathing pattern disorders is to develop better breath awareness. By being more mindful of how you breathe you can begin to recognize patterns and triggers that contribute to dysfunctional breathing

Mindfulness is often referred to as an acceptance-based approach. By practicing calm observation, without judgement, accepting things things as they are, and not as you imagine they should be, the regular practice of mindfulness can help you break the cycle of stress, anxiety and maladaptive breathing

Mindfulness Of Breathing

Mindfulness of breathing is a traditional body meditation from the Buddhist tradition. While the simple act of paying attention to the breath comes naturally to some, for others it’s not always a breeze. If imposing an overly strict breathing pattern on your body can meet with resistance, forcing your mind concentrate is by far the most effective for getting you tense and stressed! Fortunately there are tools out there to help you stay mindful while remaining happy and calm

PIPER

A mnemonic spelling Posture, Introspection, Purpose, Energy, and Resolve, PIPER is a really useful tool to help you navigate your mindfulness journey. Particularly helpful are the first two: posture and introspection

Posture is straightforward enough. Sit comfortably, on the floor, on a chair, or an arm-chair or settee with plentiful cushions to indulge your body’s every whim. It needn’t be complicated of profound, but it can make the difference between staying mindful or being constantly distracted by discomfort

Introspection is key to working with that endless flow of thoughts that take you from being in the here-and-now.

Take a few moments to think about how you’re feeling. Where are your thoughts? What is your mind most preoccupied with as you sit, be-cushioned, and very, very comfortable?

The 5 Hindrances To Staying Mindful

This is an attempt to classify all those thoughts, feelings, memories and desires that disturb your peace and happiness into 5 categories. They’re not meant to be strict – they are guidelines to help identify, contain and let go of whatever is distracting you from contemplating the breath. The 5 hindrances or distractions are

  1. Sense Desire: your mind is drawn to pleasant things: an interesting idea that we want to follow, people you like, pleasant memories, exciting plans for the future…
  2. Ill-will, annoyance and anger: you’re annoyed by something – a particular person, an irritating sound, a real or imagined situation …
  3. Restlessness and anxiety: Your mind is occupied by things you feel you ought to, or would rather be doing. You have an itch, or feel physically restless and want to fidget or move around …
  4. Doubt: you have doubts about the meditation, or your ability to do it satisfactorily, or whether it will really work for you …
  5. Sloth. Mental dullness, fatigue and torpor. Feeling sleepy is an absolute obstacle to being mindful …

Connecting with your current mental state, can you decide which of the hindrances best describe how you feel? Pick one or two which seem uppermost. If you can’t decide, don’t worry, just move move on with you mindfulness practice. As you practice the mindfulness exercise below if your mind stays focused that’s great. Or, if you meet with a distraction see what which of the above 5 categories you think it belongs to. Then simply name it, and let it go, returning to the breath. Remember, the moment you notice you’re not being mindful is the moment you begin to be mindful

The mindfulness exercise itself is staged into four phases. The first two use breath counting, while the later stages simply follow the breath’s continuous ebb and flow.

If you find a particular phase difficult, return to the previous one. There is only one objective to this practice, and that is to be mindful of the breath

Decide beforehand how long you want to practice, and set a timer to prompt you to cycle through the phases. Traditionally each phase is of equal length, but initially you can shorten the later, more challenging phases. Try downloading a meditation timer onto your PC, tablet or phone

PRACTICAL 5: Mindfulness Of Breathing

Stage 1: Sitting comfortably watch your body inhale, then slowly and quietly exhale – count 1. When you reach 10, return to 1. If you stop counting or count past 10, stop: where are your thougts? Can you name the distraction? Irrespective, let the though go and start counting from 1

Stage 2: Now count the breath just before the start of the inhalation. Follow the same procedure. Counting has no importance other than to serve as an aid to staying present and mindful. When you become mindful that you’ve been distracted, return to counting from 1

Stage 3: Let go of the counting. Follow the breath, sensing where in the body you can detect the movement of the breath. If you find it difficult to stay focussed, consider going back to stage 2

Stage 4: focus on the tip of the nose. Feel the sensation of the air touching the nostrils. If you find it difficult to stay focussed, consider going back to stage 3, or even 2

Mentally return to your physical environment. Open your eyes and continue with your day

Yoga And Other Mindfulness-Based Movement Therapies

Together with Tai Chi, Qiqong, Pilates and others, yoga is a mindfulness-based movement therapy. In contrast with most sports, the focus is not on achieving an external functional “goal”, but in the process of movement itself

While Western cultures, polarized on outward appearances, often present yoga as a form of exercise, yoga is an ancient Indian system of meditation for the purpose of spiritual development

The effects of exercise, breath-work and mindfulness have all been rigorously studied and shown to benefit dysfunctional breathing. Yoga combines all three into a single holistic practice

Numerous studies, including systematic reviews, the research gold standard, have found positive outcomes from practicing yoga and breath retraining for asthma8, fibromyalgia1, cardiovascular health11 including blood pressure and heart rate2, stress markers7, anxiety, and depression3 4 5 6, to name just a few

PRACTICAL: Free Live Yoga Class Online

The final proof is in the pudding: for our last practical you are cordially invited to join us for a free interactive yoga class, live online. Opt for yoga for musculoskeletal fitness or yoga to rest and replenish. All classes have a wellbeing orientation and incorporate the classical triad of movement & postures, breath-work and mindfulness

Classes are limited to 5 participants max. Get class info, schedule, and book your place on the online yoga classes page. Or contact me, quoting #free-yoga-practical

Life-Style Tweaks For Preventing And Managing
Stress Related Breathing

Integrating the insights gained in your formal mindfulness practice into your daily routine will help you enjoy a calmer life and maintain a healthier breathing pattern

Practicing breath awareness with exercise and movement is also greatly beneficial. Practices such as yoga, tai chi and Pilates all combine movement with breath-work and mindfulness to help you move, breathe and think with less tension and enhance your whole well-being

Simple changes, such as practicing good posture, going for a walk and taking regular breaks between periods of sitting can also prevent the buildup of tension and fatigue and help break the cycle of stress, while adequate sleep, a healthy nutritious diet, and proper hydration are essential components for staying healthy

Conclusion: Embracing A Healthy Breathing Pattern

The journey toward better breathing is not just about addressing a disorder; it is about cultivating a deeper connection with yourself. How you breathe profoundly affects you feel, and how you feel profoundly impacts your breath

By recognizing the symptoms, features and triggers of dysfunctional breathing, and making time for self-care with the help of some simple yoga and mindfulness techniques, you can break free from the cycle of stress and maladaptive breathing and embrace new habits for a fuller and happier life

    References

    1 – J Martín Nuñez et al, 2024: The effectiveness of breathing exercise in fibromyalgia syndrome: a pain meta-analysis

    2 – Piyush Garg et al, 2024: Effect of breathing exercises on blood pressure and heart rate: A systematic review and meta-analysis

    3 – Y Wu et al, 2023: Effectiveness of yoga for major depressive disorder: A systematic review and meta-analysis

    4 – J Martinez Calderón et al 2023: Yoga-based interventions may reduce anxiety symptoms in anxiety disorders and depression symptoms in depressive disorders: a systematic review with meta-analysis and meta-regression

    5 – Holger Cramer et al, 2018: Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials

    6 – Lindy L. Weaver et al, 2015: Systematic Review of Yoga Interventions for Anxiety Reduction Among Children and Adolescents

    7 – M C Pasco et al, 2015: A systematic review of randomised control trials on the effects of yoga on stress measures and mood

    8 – J A Burges, 2011: Systematic review of the effectiveness of breathing retraining in asthma management

    9 – J L Barrows et al, 2016: Systematic Review of Yoga Interventions to Promote Cardiovascular Health in Older Adults

    10 – H Cramer et al, 2015: A systematic review of yoga for heart disease

    11 – J L Barrows et al, 2016 : Systematic Review of Yoga Interventions to Promote Cardiovascular Health in Older Adults

    12 – M Thomas et al, 2005: The prevalence of dysfunctional breathing in adults in the community with and without asthma

    13 – G W Fincham et al, 2023: Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials

    14 – A Zaccaro et al, 2018: How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing

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    Science Of Healthy Breathing: How To Recognize And Manage Breathing Pattern Disorder

    Science Of Healthy Breathing: How To Recognize And Manage Breathing Pattern Disorder

    man practicing mindful breathing for breathing pattern disorder

    The need to breathe is one of the few certainties in an otherwise uncertain world. But, did you know that how you breathe serves not only to drive energy production, but also impacts your whole mental as well as physical well-being?

    Over and above providing oxygen to extract energy from the food you eat, how you breathe can have a powerful effect on heart, digestive, nerve and muscle functions as well as profoundly influencing your emotional state. Recent times have seen an increased recognition in Breathing Pattern Disorder (BPD), an abnormal breathing pattern resulting from tension, anxiety and other causes, which is responsible for a great number of common health issues

    In this article, we will delve into the science of breathing and explore the concept of Breathing Pattern Disorder, uncovering its symptoms, causes, and consequences, before sharing some valuable insights into how to recognize and manage BPD to improve your health

    Breathing correctly will help you reduce stress and anxiety, boost your energy, and improve your whole quality of life. Journey with us as we unlock the power of breath and take control of your breathing, your wellbeing and your life

    What Is Breathing Pattern Disorder?

    Breathing pattern disorder (BPD) is an abnormal breathing pattern associated with overbreathing, and linked with a number of symptoms ranging from mild to distressing. It may be mild and intermittent with few or no overt symptoms, or, at the opposite end of the scale, hyperventilation syndrome, associated with symptoms including acute breathing difficulty, heart irregularities, muscle pain and spasm, dizziness, acute fear and even fainting

    Most commonly resulting from anxiety and stress, abnormal breathing can also be linked to underlying respiratory and other diseases. In a general population around 8-10% of adults are diagnosed with BPD, though the real figure is likely to be higher. This increases to around 36% in adults with asthma

    The hallmark of dysfunctional breathing is excessive loss of carbon dioxide (CO2), a condition which changes blood chemistry to produce an array of symptoms including generalized muscle pain, fatigue, dizziness, irregular heart beat or pins and needles in the extremities and face. Anxiety is both a common cause, and a common symptom, providing the perfect conditions for a self sustaining vicious cycle

    A normal Breathing Pattern in human adults has 3 basic features

    1. an average resting breathing rate of 12-18 breaths per minute
    2. breathing is done through the nose
    3. the diaphragm is the principle muscle breathing
    image of the diaphragm in normal and dysfunctional breathing

    Essential Anatomy & Function Of The Diaphragm

    The diaphragm is a dome-haped muscle siting at the bottom of the rib cage. It is the main muscle of breathing, attaching to the lower ribs and also serves to separate the chest from the abdominal cavity During inhalation contraction of the diaphragm draws down its central tendon at the top of the dome as well as pulling the lower ribs up and out, to become flatter and wider The downward movement of the chest cavity floor enlarges the cavity (thorax), decreasing it’s pressure which is filled by air entering the lungs During exhalation the diaphragm simply relaxes, the rest being achieved by the elastic recoil of the rib cage, intercostal muscles and lungs. At the end of exhalation the lungs remain filled with a quantity of air, forced exhalation being beyond this being achieved primarily by the abdominal muscles

    Diaphragmatic v Upper Chest Breathing

    Diaphragmatic breathing draws air deep into the lower lungs where their volume is greatest to maximize gas exchange. It is an efficient way to breathe yielding the maximum effect with the least effort Rib breathing happens through the action of the intercostal muscles between the ribs and accessory muscles of the neck (Scalenes). While lower rib breathing assists the action of the diaphragm, upper chest breathing requires a much greater muscular effort. Unaided by the diaphragm the shallower breathing pattern also needs to be faster to compensate Upper chest breathing is associated with greater muscular tension in the upper chest and back as well as the shoulder, scapular and neck muscles. There is also a strong link with head forward posture which, once established, maintains the neck and shoulder muscles tension to produce dull aching pain and fatigue. Tension type headache is a not uncommon consequence of such a postural pattern and is a common symptom of BPD While upper chest breathing is not in itself indicative of overbreathing, its fast and shallow pattern and association with neck and shoulder pain make it a good candidate for setting up dysfunctional breathing. Where BPD is confirmed breath retraining to favour the diaphragm is an imperative

    Mouth v. Nose Breathing

    Mouth breathing may occur as a result of blocked nasal passages, or as a chronic habit, often from childhood. In addition to moistening and filtering inhaled air, nose breathing serves a number of other functions: Nose breathing offers a degree of resistance to air flow which helps inflate the lungs to improve breathing efficiency. This is well illustrated in people with Chronic Obstructive Pulmonary Disease (COPD) who spontaneously adopt a pursed-lip breathing strategy to help keep the airways open The passage of air through the nose also stimulates the mucous membranes to release nitric oxide, or NO (not to be confused with the “laughing gas” nitrous oxide), which is inhaled into the lungs. The effects of NO on the respiratory system include
    • vasodilation – widening of the blood vessels to improve oxygen and carbon dioxide exchange and transport
    • bronchodilation – opening of the airways for improved air flow
    • immune function – NO is anti bacterial, anti-fungal and anti-viral
    In addition to a increased vulnerability to respiratory infections mouth breathing is also strongly associated with stress and anxiety

    Overbreathing produces its effects through the excessive loss of carbon dioxide (CO2) during exhalation. Acidic when dissolved in water (blood), loss of CO2 shifts the blood pH (acid-alkali scale) towards the alkaline, triggering a number of responses in multiple body systems

    Below is a short account of the mechanisms and physiological changes associated with the symptomatology of respiratory alkalosis

    If you prefer, you can skip the section and jump straight to the list of symptoms associated with BPD

    For a broad introduction to the respiratory system check out this 10 minute educational video by Osmosis

    Physiology Of Breathing And Overbreathing: a 3 Minute Crash Course

    • Breathing supplies oxygen (O2) for energy, while expeling carbon-dioxide (CO2), a waste product of energy production
    • Where oxygen is relatively pH (acid-alkali) neutral, CO2 is acidic
    • Your brain has evolved to detect CO2 levels by reading the blood pH: acid = more CO2, alkali = less CO2
    • Detecting excess CO2 the brain quickens the breathing and heart rate to expel more of it and return the blood gases to balance
    • Exertion produces more CO2, which stimulates the breathing to expel CO2 and make the blood less acidic (more alkaline), in turn slowing down the breath back to resting rate – at least that’s what should happen

    Stress, anxiety, and factors including pulmonary disease, postural imbalances and structural issues affecting the neck, upper back, rib cage and diaphragm can all lead to fast shallow breathing, ovewrrideing the body’s corrective mechanisms. Loss of CO2 sends the blood pH too far towards the alkaline range of the scale (respiratory alkalosis)

    Respiratory alkalosis is associated with feelings of anxiety and stress, stimulating the fight-and flight response via the sympathetic nervous system, establishing a perfect viscious cycle

    While decreasing CO2, overbreathing also increases O2 levels: unfortunately alkalosis keeps O2 bound to your red blood cells, rather than being released into the tissues, these becoming oxygen deprived. Alkalosis also reduces the availability of calcium, essential for muscle and nerve function, by in turn keeping it bound to blood proteins (albumin)

    The reduced availability of O2 and Calcium from respiratory alkalosis disturbs muscle and nerve function, with symptoms such as muscle cramps, tingling and dizziness. Smooth-muscle contraction leads to narrowing of the blood vessels and digestive tract, restricting blood flow and disturbing gastro-intestinal function

    The Impact Of Altered Breathing Pattern
    on your physical and mental health

    Symptoms Of Dysfunctional Breathing

    As many as 30 breathing pattern disorder symptoms have been identified. Some of the more common ones include:

    • Frequent sighing & Yawning
    • Air hunger: a sense of not being able to have a satisfying breath in
    • tingling and pins-and-needles in the extremities and face, especially around the mouth, and on occasion even in the tongue
    • abdominal cramping and a general sense of indigestion
    • racing or irregular heart beat
    • sleep disturbance: difficulty falling asleep; waking often
    • sweating, especially in the hands
    • dizziness and light headedness
    • brain-fog, mental confusion, inability to focus
    • anxiety and hypervigilance
    • possible panic attacks if severe
    • general fatigue
    • Sore, aching muscles

    How you breathe can significantly impact on your physical and mental health. Physically, dysfunctional breathing leads to poor oxygenation of tissues and organs, resulting in fatigue and muscle tension. There is also an association with chronic pain syndromes, though comes first is debatable.

    For example, dysfunctional breathing patterns are common in people with fibromyalgia, a chronic condition of unknown origin which produces widespread pain, fatigue and other symptoms. Though it’s likely the breathing disturbance is secondary to being in pain, breath retraining has been shown to help with fibromyalgia associated pain (Núñez et al 2024)

    The interplay between breathing and mental health is complex and profound; the disorder can exacerbate feelings of anxiety, depression, and stress, which in turn leads to altered breathing establishing a vicious cycle

    In the social realm, individuals with BPD may avoid social situations and activities for fear of experiencing symptoms in public, resulting in isolation and reduced social interaction. Such avoidance behavior can exacerbate feelings of loneliness and depression, further impacting mental health

    All of this serves to highlight the importance of dealing with BPD holistically, addressing not just the physical, but also the psycho-social correlates. In addition to breath retraining, effective management will need to explore the individual’s emotional responses, providing a supportive environment where individuals can  safely explore and express their challenges and seek help without stigma

    Diagnosing Dysfunctional Breathing Patterns

    The symptoms of BPD can mimic other medical conditions, making diagnosis challenging. Symptoms such as rapid breathing, for instance, can be mistaken for asthma or other respiratory disorders, while the psychological aspects can resemble generalized anxiety disorder. This overlap highlights the importance of a comprehensive evaluation by a healthcare professional to accurately diagnose BPD and implement appropriate interventions

    The first step in the diagnosis of breathing pattern disorder begins with a thorough understanding of the individual’s medical history and symptoms. This initial conversation is essential in determining whether dysfunctional breathing may be at play, and identifying some of t he major triggers and causes

    Patients often report a variety of experiences that can seem unrelated, such as persistent fatigue, feelings of anxiety, or chest discomfort. By asking you to describe your symptoms in detail, including when they began, their frequency, and potential triggers the healthcare practitioner can identify patterns that suggest BPD and / or the need for further investigations

    Following the history, the practitioner will usually also perform a physical examination.  This may include listening to the heart and lung sounds and assessing respiratory rate, etc.

    More specific diagnostic tools such as pulse oximetry, to measure the oxygen saturation in the blood, and spirometry and peak expiratory outfow rate (PEOR) may be used to more fully evaluate lung function 

    The objective is to rule out underlying respiratory conditions before confirming the symptoms correspond to breathing pattern disorder

    Having established BPD as the cause, more comprehensive evaluations may involve assessing the breathing pattern during various activities, especially under stress or during exercise. Specialized breathing assessments, such as the Buteyko and Papworth method which involve observing the patient’s breathing while they engage in deep relaxation or controlled breathing exercises. These evaluations can help to pinpoint specific dysfunctional breathing habits and point to appropriate corrective intervention

    The diagnostic process may include psychological assessment, as there is often a significant interplay between anxiety and dysfunctional breathing. Mental health professionals can explore whether anxiety, panic attacks, or other psychological factors are exacerbating the breathing issues.

    Also important is to distinguish between acute and chronic forms of breathing pattern disorder. Acute conditions may arise from specific incidents, such as a panic attack or an asthma exacerbation, while chronic conditions stem from long-standing habits or emotional tension

    Where an underlying pathology has been identified,  a multidisciplinary approach is desirable. Collaboration between cardiologists, respiratory medicne specialists, psychologists, and other healthcare professionals ensures that all potential co-factors are explored for a comprehensive diagnosis of the patient’s condition.

    This holistic approach allows healthcare providers to collaborate with the patient in developing a actionable management plan. This may include breathing retraining exercises, lifestyle modifications, and psychological support. The goal is to equip you with the tools necessary to regain control over your breathing and improve your overall quality of life

    Managing Your Breathing Pattern 

    Through Breath Awareness And Mindfulness Techniques:

    One of the most effective ways to manage breathing pattern disorder is through applying breath awareness and other mindfulness techniques. By cultivating an awareness of one’s breathing, individuals can begin to recognize patterns and triggers that contribute to their BPD

    Simple practices such as mindful breathing involve focusing on each inhalation and exhalation, allowing you to become more attuned to your body and the sensations associated with breathing. Better breath awareness can help break the cycle of maladaptive breathing, providing you with a valuable tool to regain control of your breath

    Other mindfulness techniques can also play a crucial role in reducing anxiety and stress, two common contributors to BPD. Engaging in mindfulness meditation or guided breathing exercises encourages relaxation and promotes a sense of calm. These practices focus on grounding you in the present moment, allowing you to acknowledge and accept your feelings without judgment. Beyond a formal practice session, integrating mindfulness into your daily routines will help notice the relationship between your breath and your emotions, helping to break the cycle and developing a greater sense of freedom and peace

    Incorporating breath awareness into physical activities can further enhance the management of BPD. Practices such as yoga, tai chi, or even simple stretching will help connect movement with breath to promote an immediate sense of physical wellness. These activities also encourage deep, diaphragmatic breathing over chest-based breathing to calm the breath, reduce tension and cultivate overall well-being

    Getting Professional Help

    While self-management techniques can be beneficial, seeking professional help may be the better option for individuals struggling to manage breathing dysfunction. Health professionals, such as respiratory therapists, psychologists, or specialized counselors can offer tailored interventions to address both the physical and psychological components of BPD. A thorough assessment by a healthcare provider can help identify the deeper issues contributing to the disorder, allowing for a more comprehensive management plan

    Cognitive Behavioral Therapy (CBT) has shown promise in treating BPD. CBT focuses on identifying and modifying negative thought patterns that contribute to anxiety and stress. By addressing the cognitive aspects of disordered breathing, individuals can learn coping mechanisms and techniques to manage their symptoms more effectively. The therapy can also include exposure techniques to gradually confront situations that trigger anxiety, thereby reducing the fear associated with altered breathing patterns

    Specialized breathing retraining programs led by trained professionals can also provide the skills necessary to develop healthier breathing habits. These programs often include exercises that focus on diaphragmatic breathing, breath control, and relaxation techniques. Working with a therapist can also help with compliance, encouraging participants to stay committed to their journey toward a healthier life

    Life-Style Changes For Preventing And Managing
    Stress Related Breathing

    Preventing and managing stress-related breathing patterns require a proactive approach that encompasses simple lifestyle changes, stress management techniques and regular self-care. One of the most effective strategies is to incorporate stress reduction practices into daily life. Activities such as regular exercise, meditation, and engaging in hobbies can significantly lower stress levels, reducing the likelihood of developing or exacerbating BPD. Finding time for relaxation and self-care is essential for maintaining a balanced mental and emotional state

    Adequate sleep, a healthy nutritious diet, and proper hydration are vital components of overall well-being. Poor lifestyle choices can lead to increased stress and disordered breathing. Simple changes, such as practicing good posture, going for a walk and taking regular breaks between periods of sitting can also help avoid tension and enhance breathing efficiency

    Finally, fostering a supportive environment is crucial for managing stress-related BPD. Surrounding yourself with understanding friends and family and communicating openly about one’s struggles can help alleviate feelings of isolation and encourage others to offer support. A supportive network is a valuable resource for stress management, helping you take significant steps toward preventing and managing BPD

    Conclusion: Embracing a healthy breathing pattern

    The journey toward better breathing is not just about addressing a disorder; it is about cultivating a deeper connection with ourselves. The way you breathe profoundly affects your physical and mental state, impacting our overall quality of life. Understanding the multiple facets of healthy and dysfunctional breathing is essential for achieving optimal health and well-being. By recognizing the symptoms and causes of BPD, you can take proactive action to break free from the cycle of maladaptive breathing and embrace new habits to live a fuller and happier life

      References J Martín Nuñez et al, 2024: The effectiveness of breathing exercise in fibromyalgia syndrome: a pain meta-analysis