Try These Breathing Exercises For Anxiety

Medically reviewed by Andrea Brant, LMHC
Updated April 18, 2024by BetterHelp Editorial Team

Do you live with severe anxiety or panic attacks? If so, then you may be all too familiar with that tight, heavy feeling in your chest, that scary feeling that you just can't quite get enough air. At best, it's unpleasant. At worst, it's painful and terrifying, making your anxiety and the physical symptoms that accompany it even more distressing.

When you are experiencing this distressing event, you may feel desperate to get some relief. Changing some of your behaviors and thinking patterns can bring you relief over time. But sometimes, you need a quick fix. For this reason, many choose medication to bring them relief in an emergency. However, the meds that are prescribed for anxiety can have unpleasant side effects or withdrawal symptoms.

There is another quick and effective method that can bring relief from anxiety symptoms without the use of medication—breathing. Anxiety breathing exercises can calm an individual’s physiological and emotional symptoms and bring them back to a state of calm.

There is one caveat, though. While the right kind of breathing can bring almost instant relief from anxiety, the wrong kind has the potential to make your anxiety worse.

How your breathing technique can influence your mental health

Yes, we understand. Thinking about something as simple as breathing regarding a "right" and a "wrong" way to do it just makes you feel even more anxious! After all, isn't breathing supposed to be a natural act? Do we need to overthink it this much?

Some people with anxiety may practice unhelpful habits when it comes to their breathing. Mindfulness and intentional breathing exercises can help you so that breathing can become the natural and healing act that it's supposed to be.

If you're like most people with anxiety, you may take very rapid, shallow breaths. That's because anxiety can trigger your body's "fight or flight" stress response, preparing you to take drastic action to fight off a threat and start breathing shallowly. While this response can be helpful when facing danger in the short term, our bodies were not meant to sustain this heightened response over a long period. Being in a chronic state of fight-or-flight can contribute to health conditions like high blood pressure.

Several things happen to your body as you continue breathing this way. For one thing, as you breathe from your chest, your chest muscles begin to tighten, causing you to feel increased chest pain and heaviness. If you breathe rapidly without any physical exertion, your blood does not oxygenate properly, leading to the following symptoms:

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Anxiety symptoms can make breathing feel challenging
  • Dizziness/lightheadedness
  • Rapid heartbeat
  • Shortness of breath
  • Tingling or numbness in your hands and feet
  • Muscle tension
  • Hyperventilation

All these symptoms together are part of your body's stress response, which is produced by the sympathetic nervous system. Your breathing signals the presence of danger, and your body prepares itself to take action. But if this emergency response takes place when no immediate threat is present, these symptoms can be a recipe for an all-out panic attack.

Deep breathing and the parasympathetic nervous system

You can reduce the sympathetic nervous system’s stress response by activating the parasympathetic nervous system, which produces feelings of calm and relaxation. This relaxation response can be prompted in several different ways, including by practicing deep breathing techniques.  

Deep, slow breathing can indicate to the parasympathetic nervous system that there is no threat. As the calming response is activated, the oxygenation of your blood improves. This, in turn, causes your breathing and heart rate to slow down. As you take deeper, slower breaths, the muscles in your body become less tense.

Dr. Edmund Jacobson, an early pioneer of relaxation techniques, once famously said: "An anxious mind cannot exist in a relaxed body." This statement is still quoted today by mental health practitioners, and for good reason. The mind-body connection is so powerful that once relaxation is achieved through proper breathing, your mind also becomes calm. The thought patterns that caused you to feel anxious in the first place then become more manageable.

While the calming response takes a bit longer than the emergency response, it is still one of the most efficient and natural ways to combat anxiety. Research suggests that breathing exercises can moderate the effects of several mental health conditions, including anxiety and depressive disorders.  

Abdominal breathing

The calming response begins with abdominal breathing. Abdominal breathing is also referred to as "natural" breathing. That's because it's the way newborn babies breathe. If you observe an infant, you will see that their bellies rise and fall with their breathing. Their chests, however, do not move up and down at all.

By nature, humans breathe from their bellies. It's only when we encounter a "fight or flight" response to danger that we begin to breathe from our chests instead.

Shallow, rapid breathing from the chest (also known as "thoracic breathing") is the kind of breathing to be used during physical exertion. It gives us what we need to survive but does not allow fully for the intake of oxygen and the exhale of carbon dioxide needed for our long-term health and comfort.

Next time you take a deep, relaxing breath, place one hand on your waist and the other on your chest and pay attention to what happens. Which hand rises the most when you inhale? For the kind of natural breathing that best supports day-to-day activities, the hand on your waist should rise and fall. The hand on your chest should rise very little, if at all.

If you find that you are "chest breathing," a simple exercise can help.

  1. Slowly inhale through your nose while keeping your shoulders relaxed. Keep your hand on your belly and note that it rises while your chest remains still during breathing. You don't have to fill your lungs completely; just take in a normal amount of air.
  2. Close your mouth and silently count to three.
  3. Gently exhale through your mouth. Purse your lips, but keep your jaw relaxed.
  4. Take another break for a few seconds. The point of these pauses is to slow down your breathing deliberately.
  5. Repeat these steps for a few minutes, until you notice that your body feels relaxed and calm.

Since it likely took you a long time to get into the bad habit of thoracic breathing, you should also expect that it may take some time to "unlearn" it. To that end, consider practicing this breathing technique several times throughout the day. You can do this exercise at any time, whether standing or sitting.

However, if you find that the breathing exercise itself is making you more anxious, give it a break and try it again some other time. There’s a chance you might "overthink" the breathing process, thereby increasing your anxiety symptoms. 

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More breathing exercises for anxiety

It may also turn out that this one simple breathing exercise isn't enough to alleviate your anxiety. If so, some other simple breathing techniques can also help.

Resonant breathing

Also called coherent breathing or resonance breathing, resonant breathing is a technique in which the participant attempts to take five breaths each minute (six-second breaths in and six-second breaths out is the end goal). 

  1. Gently breathe in and out, counting the number of seconds it takes for each breath. 
  2. Focusing on slower breathing, inhale for four seconds, then exhale for four seconds, until a minute has passed. 
  3. Increase the length of each inhale/exhale to five seconds, until another minute has passed.
  4. Take six-second breaths for a few additional minutes. 

Box breathing

A simple breathing technique, box breathing has been shown to relieve anxiety by decreasing physiological arousal. To start, find a quiet place to sit or lie down, then follow the steps below.

  1. Take a deep breath for a count of four.
  2. Hold your breath for a count of four. 
  3. Exhale for a count of four.
  4. Hold your breath again for a count of four. 

Repeat this process three to four times. Ideally, these breaths will be taken with your mouth closed. 

Countdown to calm breathing

This exercise can take more time than the breathing exercises described above. While it may not be as convenient, it forces you to spend more time focusing on relaxation, making it easier for you to tame anxious thoughts.

  1. Take a deep breath and exhale slowly while repeating a mantra such as "This too shall pass," or even just the word "relax."
  2. Close your eyes.
  3. Take ten gentle breaths and slowly count down from 10 to one on each exhale.
  4. Open your eyes when you get to "one."
  5. Visualize each part of your body relaxing.

Carbon dioxide rebreathing

This exercise is best used if you are in the midst of a panic attack or you are hyperventilating. It rebalances oxygen and carbon dioxide levels so you can calm down quickly.

  1. Slowly breathe into a paper bag. If you don't have one, breathing into your cupped hands can also do the trick.
  2. Take 5-10 slow, natural breaths.

Alternate nostril breathing

A proven method of activating the parasympathetic nervous system, alternate nostril breathing helps participants take measured, controlled breaths. To practice alternate nostril breathing, sit on a chair or the floor and follow these steps: 

  1. Place your index and middle fingers over your nose, so that the tips are touching between your eyebrows, your thumb is above your right nostril, and your ring finger is above your left nostril.
  2. While pressing on your right nostril with your thumb, breathe in through your left nostril. 
  3. Take the pressure off your right nostril and close your left nostril with your ring finger. Breathe out through your right nostril. 
  4. Inhale through your right nostril. 
  5. Remove your ring finger from your left nostril and close your right nostril again with your thumb. Exhale out of your left nostril. 
  6. Repeat this process for five minutes. 

Pursed-lip breathing

Pursed-lip breathing involves taking deep breaths in through the nose and letting air leave the body slowly through partially closed lips. This exercise has been shown to promote anxiety relief.

  1. Sit up straight with your arms and back supported, ideally in a chair with armrests.
  2. Inhale quietly and deeply through your nose for 5-6 seconds.
  3. Hold for 2-3 seconds.
  4. Exhale completely (6-7 seconds), through pursed lips, breathing so that you make a slight whistling sound.
  5. Repeat ten times.

Online therapy for anxiety

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Anxiety symptoms can make breathing feel challenging

While deep breathing may help alleviate your anxiety symptoms, you might need medical advice from a doctor or guidance from a therapist to get to the root cause. Still, traditional therapy might be hard to obtain for individuals experiencing severe anxiety symptoms. These symptoms might spike when you leave the house, for example. Or you may be nervous to talk to a therapist in person. In cases like these, you may find that you’re more comfortable undergoing therapy in an online setting. With internet-based counseling, you can talk to a therapist in a low-pressure setting without ever having to leave the house. 

Online therapy is just as effective as in-person therapy, according to research. In a recent study, college students experiencing mild to moderate anxiety were separated into two different groups. One group received traditional office-based therapy while the other underwent an online intervention. While both groups responded positively to treatment, there was no significant difference between outcomes. 

Takeaway

The physical and emotional symptoms of anxiety can be disturbing, even crippling. But through breath control and awareness, you have the power to reverse these symptoms and take back your life again. For more help with anxiety symptoms, reach out to a BetterHelp counselor.
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