Sunday, 4 August 2013

It Begins With The Breath

To understand the importance of breath in recovering from anxiety, one first has to understand the brain and the function of its parts.

Anxiety, or fear, originates in two areas of the brain.

The first is the Limbic system where, in addition to helping store emotional memories, the amygdala - (about the same size and shape as an almond) - is constantly on the lookout for danger.  Working with the hippocampus, the amygdala compares everything we see, hear, smell, taste, and feel with significant memories of everything we’ve ever experienced.  When it finds a match and the match is labeled as a danger, the amygdala triggers a fear response, preparing the body for flight or fight by activating the release of epinephrine (adrenaline), cortisol, and other chemicals into our system.

And the thing about the amygdala is, it has no cognitive ability, meaning it can’t think and has no sense of time, and being so, it can’t tell the difference between a real current threat or an old memory or nightmare.  That’s why telling yourself you shouldn’t be anxious rarely works.

The second area that fear originates from was discovered by research conducted at the University of Iowa; Fear and panic in humans with bilateral amygdala damage  (2013 - Feinstein, et al).  Their investigation indicated that fear could be induced in persons whose amygdalae were damaged by having them breath an air mixture with low oxygen and high carbon dioxide – and it worked by producing intense fear in people who had never felt fear before.  As one test subject said of the experience; “it was the number one, worst feeling ever.”  This fear reaction takes place in the brainstem, and is a response to a lack of oxygen within the complex Autonomic Nervous System (ANS).  Basically, the ANS detects a lack of oxygen in the bloodstream and sends the fear message that the body is dying.

By looking at these two systems and the body’s reaction to anxiety/fear, one can see how low grade anxiety, originating in the amygdala, can trigger a full out panic attack, launched by the ANS; As we begin to feel anxious, our breathing becomes more rapid and shallow.  Less oxygen reaches the lower part of our lungs and the bloodstream becomes starved for oxygen and polluted with carbon dioxide.  Muscle cells in our body send signals to our ANS and the ANS escalates the moderate anxiety to a full panic attack.  It becomes a cycle of fear that is overwhelming.

Pretty scary stuff.

Through two complimentary systems; the Sympathetic Nervous System (SNS), which is responsible for the fear response, and; the Parasympathetic Nervous System (PNS), which calms things down, the ANS controls respiration, heart rate, blood pressure, blood flow, body temperature, et cetera.  Of all the functions the SNS and PNS control, that control can only be overridden consciously in one area: respiration.  We can control our breathing to speed up or slow down, to be shallow or deep.

And this is where breathing comes in as part of treatment for anxiety and anxiety disorders.

While the SNS might be gearing up for a knee-shaking panic attack, we can counter its effects by practicing measured diaphragmatic breathing, also known as “belly breathing”.  Instead of drawing air into the lungs by expanding the chest, we draw air deep into the lungs by pushing the belly out and pulling down on the diaphragm.  The technique I teach my clients is to breathe in through the nose to a slow count of five seconds while expanding the belly, hold for one second, then blow it out through the mouth as though they were trying to blow the seeds off a dandelion – again, for about five seconds.  The reason for this is twofold; Not only does it draw oxygen rich air deep into the lungs, it also pushes out the carbon dioxide that has pooled in the bottom of the lungs.

In addition to feeding the body the oxygen it needs, it also activates the PNS which reacts to the slower breathing rate and starts to calm other things down by lowering the heart rate and blood pressure, dilating blood vessels, et cetera.

You can try it right now by repeating this measured diaphragmatic breathing method three times. By the end of the third slow, measured, deep breath, you should start to feel it in your body – often as a warming sensation in the large muscles.

In my practice as a Multimodal Therapist, I can employ a wide range of therapeutic approaches so long as they have proven efficacy, and given the positive research into breathing, Mindfulness, and Yoga, I integrate one or more of these when treating clients with anxiety issues to address their symptoms.

Of course, therapy doesn’t end there; once a client has their anxiety under some level of conscious control, we can then begin to explore where the anxiety originates from and choose a treatment plan to address those origins.

Aaron D. McClelland, RPC –