Breathing

Breathing isn’t something we normally think about, we just do it. It’s so intuitive we take it for granted—until we can’t do it anymore. Then suddenly it becomes the only thing we can think about. Just ask anyone who has ever had an asthma attack or who has almost drowned. Ask the people with coronavirus struggling to breathe on ventilators in the hospitals right now.

Breath is life. Consider the rule of threes: You can survive three weeks without food, three days without water, and only three minutes without air. CPR is performed by forcing air into the lungs and compressing the chest in an attempt to circulate the oxygenated blood. We are aware of how important breathing is in emergency scenarios, but many people overlook the benefits of paying attention to your breath in more minor situations. Breathing exercises can help with anything from the mundane stresses of daily life, to overwhelming feelings of anger, fear, or anxiety. It is one of the best coping methods for PTSD, and is always available to you, no matter where you are or what you’re doing.

To understand why breathing exercises are so effective for PTSD, we must first understand what happens to the body during a traumatic experience. When faced with a dangerous situation, our fight-flight-freeze response is triggered. The cognitive, decision-making part of our brains shut down as more instinctual functions take over. “When under immediate threat, digestion, reproduction, cell repair and other body tasks related to long-term functioning are unimportant,” writes Christy Matta in the article How Trauma Can Affect Your Body & Mind published on PsychCentral.

“Of immediate importance is survival.  Increased blood sugar can provide extra energy for muscles. Increases in cortisol counter pain and inflammation. Blood pressure increases. Blood is diverted from our extremities to our major muscles to provide us with extra strength. Increased endorphins can help us ignore physical pain.

“You can see the effects of these changes to the body in many of the symptoms of stress, such as racing heart, dizziness, nausea, shortness of breath, shaking, feeling hot and flushed, and sweating.”

These changes in the body are automatic and unconscious. This stress response can save our lives in an emergency, but what about when the emergency is over? Someone suffering from PTSD will experience the same physical changes when they face certain triggers, even if they are no longer in any real danger. When someone is in this heightened state it can be almost impossible to convince them that the danger isn’t real. Even if you manage to do so, it might not have much of an effect. This is because the rational, thinking part of the brain has taken a backseat, while the medulla, the part of the brain that controls automatic functions, is in control. You might know rationally that there is no threat, but it won’t slow your racing heart.

Studies have shown that spending too much time in a stressed state can have many negative effects on an individual, both mentally and physically. In the same article quoted above, Matta writes that when exposed to repeated or long term trauma, “parts of the brain associated with memory can actually shrink, making it difficult to consolidate and form new memories. Prolonged stress can effect the development of a number of health issues, including diabetes, obesity and hypertension. And repetitive stress affects our moods, brings on anxiety disorders, and affects our experience of chronic pain and our ability to control food intake.”

So how do you get out of a state of acute stress? By focusing on your breathing. Your body breathes automatically, but unlike some other automatic functions (e.g. digestion or your heart beat) you can actually overrule your medulla and control your breathing. And by controlling your breath, you can indirectly effect your other emergency response systems and bring yourself back into a calm and relaxed state.

There are many different breathing exercises out there, the internet and books on meditation are filled with them. This article from Healthline lists ten you can try. One of the most common ones I’ve seen is to inhale for 5 counts, hold your breath for 2 counts, exhale for 5 counts, hold again for 2 counts, and repeat. Many people find this exercise useful because the focus on counting provides the brain with a distraction from whatever may have triggered the stress response. However, sometimes I find that when I’m in a really emotional state and breathing quickly it can be too hard to keep this up for any extended period of time. My therapist has assured me that even simply paying attention to my breathing, not trying to change it, just being aware of it, will naturally cause me to start to relax.

Focusing on your breathing can ground you and help you become more present. It’s a useful coping method for people suffering from PTSD or anxiety or anger management disorders, but you don’t have to be suffering from mental illness to reap the benefits of mindful breathing exercises. There’s a reason why breathing is a huge component of both meditation and yoga. Breath is important in other practices too. In martial arts you will often be instructed to yell or grunt when throwing a punch or kick. Not only does it intimidate the other opponent, it reminds you to not hold your breath. A good physical trainer will tell you how to breathe in and out in coordination with your weightlifting and make sure you don’t hold your breath while planking. We often hold our breath in the heat of some strenuous physical or mental activity.

Learning how to breathe properly is something I was struggling with long before my trauma. In high school, my throat began to close up during volleyball games. A team of doctors eventually diagnosed me with Vocal Cord Dysfunction, or VCD for short. When I became physically stressed (i.e. breathing hard from running) or intensely emotional, my vocal cords would tighten and tighten until they essentially closed and I would choke for air. The only cure was to see a speech therapist, who taught me how to control my breathing when I felt my throat beginning to tighten. She had me breathe in through my nose and exhale forcefully through pursed lips. She had me lay on my back with a box of tissues on my stomach and practice moving that box up and down as I breathed deeply into into my diaphragm, instead of the shallow chest breaths I normally took. When I talked to my therapist last week about coping methods for PTSD, she mentioned these exact same breathing exercises.

It’s taken a lot of practice, but I am so much better at controlling my VCD now. I can even run a couple of miles without having to stop to catch my breath, and when I do stop I no longer feel that painful tightness in my throat. But more importantly, dealing with VCD taught me how not to take my breathing for granted, and it has given me the tools I need to deal with various other problems in my life.

May is mental health awareness month, and what easier way to start taking care of your mental health than to practice some mindful breathing? Everything may be closed due to the pandemic, but learning to meditate does not require going anywhere or spending any money. Look up a couple breathing exercises and keep them in your toolkit for the next time you’re feeling stressed, you never know when it might come in handy!

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