Anxiety speeds up breathing and heart rate. Slowing the breath sends a signal of safety to the brain.
These skills work best when practised daily, not only during a crisis.
Key concepts
- Longer out-breath than in-breath calms the body
- Grounding brings attention back to the present
- Skills reduce anxiety but do not replace treatment of a disorder
Symptoms and signs
- Fast breathing, tight chest, racing thoughts
- Restlessness and muscle tension
- Feeling detached or overwhelmed
Causes
- Fight-or-flight response to stress
- Worry about the future
- Caffeine, poor sleep
Risk factors
- Anxiety disorders
- High-pressure exams or jobs
- Trauma
Evidence-based management
- Box breathing: in 4, hold 4, out 4, hold 4 — repeat 4 times
- 4–6 breathing: in through the nose for 4, out slowly for 6
- 5-4-3-2-1: five things you see, four you touch, three you hear, two you smell, one you taste
- Progressive muscle relaxation before sleep
When to seek professional help
- Anxiety on most days for weeks
- Panic attacks or avoidance
- Techniques do not help despite practice
Frequently asked questions
How often should I practise?
Two short sessions a day (5 minutes) build the skill so it works when you need it.
Are pranayama and these techniques similar?
Slow, controlled breathing in pranayama has similar calming effects; avoid forceful techniques if they increase dizziness.
Medical references
Guidelines and official sources used for this article.
- Generalised anxiety disorder and panic disorder in adults: management (CG113). NICE, UK, 2011.
- mhGAP Intervention Guide for mental, neurological and substance use disorders in non-specialized health settings, version 2.0. World Health Organization, 2016.
- Author
- Dr. Kuldeep Budania, MBBS, MD Psychiatry
- Medical reviewer
- Dr. Kuldeep Budania, MD Psychiatry
- Last reviewed
This article is for general information and is not a substitute for personal medical advice.
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