The Stress Solution Read online

  To find out more, the researchers knocked out this specialized group of neurons in mice. When they put the mice in a stressful environment, instead of displaying anxious behaviour and nervously sniffing, which is a form of fast breathing, the mice would sit around, happily grooming themselves. This is a powerful indication of just how much influence breathing has on our perception of stress. The researchers believe that, ordinarily, the neurons which were disabled would have detected information from other neurons within the breathing pacemaker that the mice were sniffing around in a stressful environment. This would have sent messages to the brain’s arousal centre and they would have very quickly become worried and anxious, as their stress response was ramped up. Without the presence of those specialized neurons, those stress signals were unable to get to the brain’s arousal centre, so the mice stayed calm.

  Now, I am not advocating that we all remove this small group of neurons from our brain! The implication of this research is simply this: breathing slowly and deeply will prevent us from activating the neurons in the brain that send messages to the brain’s arousal centre. We will be giving our body the information that everything is calm.

  MEET YOUR DIAPHRAGM

  What does it mean to breathe ‘properly’? I’ve always loved singing and when I had lessons as an eleven-year-old I was taught that when you breathe in your stomach should pop out. If you watch a baby breathe, that’s exactly what happens. The stomach pops out, which initiates the opening of the ribcage. That baby is breathing as we all should, from its diaphragm and then into its chest. The diaphragm is a muscle that sits beneath your lungs and which needs to expand in order for the lungs to fill completely. You might have noticed this happening if you’ve ever watched someone sleep. When you’re in deep slumber your belly goes out as you breathe in. When we breathe with our diaphragm we involve the lower lobes of the lungs. These lobes, which aren’t activated when we don’t breathe properly, are thought to have more of the kind of receptors that activate our thrive state, compared to the upper lobes, which have more receptors that trigger the stress state.

  This is part of the reason why breathing with the diaphragm and filling the lower lungs with air can be so calming. It’s been found that breathing from the diaphragm like this, rather than from the chest, lowers cortisol levels and increases levels of attention and mental function. These are phenomenal findings. If a pharmaceutical company could patent a drug that had these effects, it would surely be worth billions, and yet it’s free and available to all of us 24/7.

  The breathing process is initiated in a part of the brain called the medulla oblongata, which is located deep inside the brainstem. It triggers the diaphragm muscle to contract, and that leads to space being created inside the lungs. This expansion of the lungs creates a pressure differential which causes the air to flood in. When the diaphragm contracts it moves downwards and rotates the lower ribs outwards. When we think about breathing deeply, we often think about a vertical breath – the ribs go up as we breathe in and go down as we exhale. But the diaphragm is actually a 3D muscle that can move in all three planes – upwards and downwards but also outwards around the body. When you breathe in you want to expand your abdomen, your sides and your back as well as your lungs. Only then are you realizing your breath’s full potential.

  When you’re not thinking consciously about your breathing your diaphragm will be moving downwards only, and probably by no more than a centimetre. That’s enough to keep you functional but it’s far from optimal. If we breathe consciously that same diaphragm can move downwards by up to ten centimetres. This is a remarkable difference, and suggests that improving the way you breathe can have a profound impact on the amount of oxygen you’re feeding your body.

  DON’T PANIC

  To understand why breathing quickly and shallowly causes us to feel stressed, it’s important to know exactly why we take air in and out of our bodies. Most of us think breathing is all about oxygen, but this isn’t entirely true. Of course, one of the central roles of breathing is to take oxygen out of the air and deliver it via the blood to our muscles and organs, including the brain. But an equally critical role is removing carbon dioxide from our systems. If you hold your breath you’ll feel an increased desire to breathe, known as ‘air hunger’. What many people don’t realize is that this desperate urge to breathe is not about being short of oxygen. It is, in fact, driven by a build-up of carbon dioxide.

  But, as with so many processes in the body, it’s all about balance. We don’t want too much carbon dioxide building up, but neither do we want too little in our systems. This is what happens when we breathe too rapidly. When we hyperventilate or suffer from anxiety attacks, or even if we’re feeling very stressed, it’s common to feel light-headed, to feel a tingling in the hands or even muscle cramps. These symptoms can be triggered by a shortage of carbon dioxide. This shows why learning how to control your breath is so important.

  THE NOSE KNOWS

  You can compare your nose to a water filter. It works by passing the air you breathe through multiple layers of clever filters. There are fine hairs inside your nostrils that trap particles such as dust and pollutants, ridges called turbinates which help control the humidity of the air, and enzymes within the nasal passages that kill microbes such as viruses. The adenoid glands, which sit on the roof of the mouth, right at the back where the nose meets the throat, produce immune cells to help fight infection. Breathing through the nose is one of the first, and finest, defences we have against the outside world.

  Studies suggest that breathing through the nose, as opposed to the mouth, is more efficient and results in an increase in the amount of oxygen we take into our blood vessels by as much as 10 per cent. It also means we’re making the most of an extremely important molecule called nitric oxide, which is associated with improved brain function and also makes the blood vessels wider, which makes for better blood pressure and goes some way to counteract male impotence. As well as this, nasal breathing helps the brain cells communicate, improves sleep quality and reduces inflammation. Many prescription medications, including blood pressure drugs and drugs such as Viagra, target these pathways, yet we can access them for free with no side effects whatsoever, simply by making sure we’re breathing through our nose.

  Breathing through the nose is also anatomically more correct. It means we don’t utilize our shoulder or neck muscles, which weren’t designed to help us breathe for long periods and can become sore. It also automatically encourages the diaphragm to go down. If all that weren’t enough, nasal breathing has also been shown to increase activity in the hippocampus and the amygdala, which is a part of the brain responsible for regulating emotions and dealing with fear. This suggests that nasal breathing could well be a significant part of the strategy to combat stress and increase resilience.

  Mouth-breathing, meanwhile, turns out to be particularly harmful during sleep. One patient of mine found he never woke up feeling refreshed and always had a dry mouth, so he took a DIY approach to make sure he wasn’t breathing through his mouth by taping it shut! Remarkably, he found himself sleeping much better, which had a significant impact on his health and anxiety levels. A close friend of mine has actually achieved similar results without even having to tape his mouth up. He simply concentrates on breathing through his nose during the day and this has automatically changed his breathing at night. Many people also find benefit from opening up their nasal passages with neti pots, saline sprays and nose strips. If you feel that this is an issue that may be affecting you, it may be worth discussing with your doctor or dentist.

  Six benefits of nose breathing

  Breathing through the nose may result in:

  1. Improved mood and mental state

  * * *

  2. Increased thrive-state activity

  * * *

  3. Better-quality sleep

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  4. Improved oxygen intake into the blood

  * * *

  5. Better oxygen delivery t
o the cells

  * * *

  6. Lower stress levels

  THE YOGIC ART OF BREATHING

  Yoga is much more than a physical practice, and many traditional forms strongly emphasize the power of breathing. One Westerner who’s learned a huge amount from such practices is Dutchman Wim Hoff, sometimes known as ‘The Iceman’. Hoff has managed some truly remarkable feats, such as running 24,500 feet up Everest, swimming in frozen lakes and completing a marathon above the Arctic Circle in just his shorts! He also had LPSs (see here), the incredibly dangerous endotoxins, injected into his body, but rather than this sending him into septic shock, as it probably would you or me, he managed to control his immune-system response with breathing.

  Back in 2017 I had the pleasure of seeing Hoff speak in California. He got the whole audience, myself included, to go through one of his breathing techniques, promising that, by the end, we would be able to hold our breath for three minutes. I thought, ‘No chance. There’s no way,’ but less than half an hour later I was not only able to do it, I was finding it effortless. And so were the two hundred others that were sitting around me.

  Wim asked us to take full deep breaths in followed by full deep breaths out, each time inhaling and exhaling as much air as we possibly could. After doing this for five or six minutes, he asked us to breathe out fully. He then asked us to stop and not to take any further inhalations. He timed us, and most of us were able to hold our breath for about two minutes. We repeated the entire sequence two more times and, by the end, we were all holding our breath for the full three minutes. You can see a video of this technique on my website at drchatterjee.com/wimhoffbreathing.

  Yogic breathing practices can also have an astonishing effect on pain. I have a sixty-four-year-old patient who had been in chronic pain for years and, sadly, took so many opiate painkillers she became dependent on them. When I finally impressed upon her that she was imperilling her life by taking them she became depressed and anxious. She was convinced she wouldn’t be able to cope without them. In order to help, I sent her to an experienced yoga instructor. Today, whenever her pain becomes intolerable, she does deep breathing for five minutes and this reduces her discomfort dramatically. Partly because of this intervention, she’s now off the opiates and happier than she’s been in years.

  ALTERNATE-NOSTRIL BREATHING

  Nadi shodhan is one of the oldest known yogic breathing techniques. The idea is simple. You breathe out and then in through one nostril, and then out and then in through the other. See here for full details. Although yoga practitioners have been extolling the health benefits of nadi shodhan for centuries, modern science has been slow to catch up. One small study in 2011 found that six weeks of practice for thirty minutes a day can lead to reductions in heart rate and blood pressure as well as to an increase in lung capacity. Another suggested that which nostril you inhale with can have a significant effect on your body’s stress-response system. It seems that breathing in through the left nostril may help calm your body down by lowering heart rate and blood pressure.

  These are small, early studies and not of the gold standard we’d prefer for such claims to be considered effectively proven. But this breathing technique has been around for thousands of years, I’ve experienced a difference in my own stress levels when I’ve practised it and I’ve had similar feedback from family members and patients. If you’re exhausted, stressed out and running on empty, this practice may well relax you and start giving your body the information it needs to switch you into thrive state. There are no downsides to it whatsoever, so I encourage you to give it a go and find out if it works for you. You could even make it part of your morning routine (see here.)

  MEDITATION

  Of course, the best-known and arguably most effective form of breathing practice is meditation.

  I’ve noticed that when I meditate I can view my problems and stresses with a lot more clarity. It’s as if I’ve become a detached outsider who can see all the ‘noise’ for what it really is – often a self-created rumpus that exists mostly in my head. The problem is, that noise can so easily become who we are. Regular meditation can help you remove yourself from the ecosystem of stress you’re living in and make you just a bit more aware of what’s happening in your life. So instead of it being ‘I am feeling stressed,’ the experience becomes more like ‘I’m noticing at the moment that there’s a lot of stress in my life.’ This is a subtle but crucially different perspective. Your stress has become something you’re experiencing only temporarily, a passing thought, feeling or circumstance rather than something that overwhelmingly defines you.

  Multiple studies have confirmed the benefits of meditation in combating stress, anxiety and depression. Other studies have reported that meditation can help lower blood pressure and may improve immune-system function. One found that breathing-based meditation helped people with severe depression who had not responded to antidepressants, another that it can buffer the effects of sleep deprivation. Meditation also helps the growth of grey matter and nerve cells in the brain and reduces activity in the amygdala, which is going to be a huge help for anyone seeking to live a calmer life.

  Potential benefits of meditation include:

  Lower blood pressure

  * * *

  Reduced stress levels

  * * *

  Less anxiety

  * * *

  Improved mental health

  * * *

  Better focus and concentration

  * * *

  More efficient immune-system function

  * * *

  Higher energy levels

  * * *

  Less tendency to dwell on negative things

  FIVE-MINUTE MEDITATION

  There are many forms of meditation. Some of them are breath-based, but many are not. I’d encourage you to experiment with different types and find out what works for you. Apps such as Calm or Headspace can be useful to get you started, but they don’t work for everyone. Whatever method you choose, start off with a daily five-minute practice. Set no expectations apart from the fact that you will sit there for five minutes each day at the same time.

  Try to find a quiet space in which to sit comfortably. If it is too hard to sit up with your back straight, don’t. When starting your practice, comfort is key – otherwise, you will spend the whole five minutes with tense muscles and be distracted by trying to maintain your posture. If your mind is busy, that is OK. Many people think this means they haven’t ‘done it right’. This is not true. It is simply a reflection of where your mind is currently at. With regular practice, this will change. Just think, at least you’re observing that your mind is busy – yesterday, you probably didn’t.

  It is important to observe how you feel before and after your practice. However, not all changes brought about by meditation are immediately obvious. Often, the benefits come later on in the day – increased energy, better concentration, lower anxiety and a greater sense of wellbeing.

  To excel at meditation is as difficult as running a marathon. It takes regular practice and patience. Don’t let this put you off. I am only asking you to commit to five minutes a day. That is enough to get you started, and a low enough bar that you have a high probability of achieving it – this in turn helps keep you motivated. For many of my patients, meditation is the perfect antidote to the stresses of twenty-first-century life and its daily practice has been life-changing. What are you waiting for?

  One of my patients, thirty-two-year-old Jenny, worked as a medical secretary in a busy hospital. She found the pressures of the job intense and would often feel anxious, especially when having to attend meetings with colleagues. On a few occasions she was close to having a panic attack. She was understandably concerned about the impact this was having on her job and was scared of losing it. That anxiety and worry in turn affected her home life.

  I advised her to take up a regular breathing practice. She selected two items from my breathing menu: alternate-nostril breathing and the 3–4�
�5 breath. She started to practise first thing in the morning and when she got home from work. In addition, on particularly stressful days at work, she would go into an empty meeting room and spend ten minutes doing one or the other. It made a huge difference. She felt more capable and less anxious, which had a feed-forward effect and improved her self-confidence and work performance. And the treatment couldn’t have been simpler, cheaper or come with fewer side effects.

  A DAILY PRACTICE OF BREATHING

  Take a look at my breathing menu on the following two pages and choose one or two items that appeal to you. Aim to do at least one of these practices every day. Even one minute per day of focused, intentional breathing can make a big difference.

  Breathing practice is especially worth considering if you’re the kind of person who finds meditation difficult. You don’t have to stick to the same practice each time. Play around. Listen to your body. Experiment. I’m sure that, within a few days, you’ll find a technique that works for you.