How Can Breathing Balance the Stress Response System?
Note: We are not permitted to give specific medical advice through this website. Most of the information you need and your doctor need to make medical decisions about adding complementary treatments to your health care plan can be found in our book, How to Use Herbs, Nutrients, and Yoga in Mental Health Care, RP Brown, PL Gerbarg, and PR Muskin (WW Norton 2009). More information about the book, including the table of contents is available on our book page. You may order the book at: www.wwnorton.com.

Patricia L. Gerbarg, MD
Assistant Clinical Professor in Psychiatry
New York Medical College

There are numerous ways in which breathing practices may balance the stress response system. One important part of the stress response system is the autonomic nervous system consisting of two branches. The sympathetic branch turns on quickly whenever we feel threatened. It increases the heart rate, respiratory rate, and metabolic rate preparing for fight or flight. When the threat has passed, the sympathetic system is supposed to quiet down while the parasympathetic system is activated to slow down the heart and respiratory rates, repair cellular damage, calm the mind, and replenish energy supplies. However, for many people, chronic stress keeps the sympathetic system in overdrive such that it is very hard to turn off. At the same time, the parasympathetic system tends to be under active. Consequently, the system stays out of balance leading to exhaustion of energy supplies, cumulative cellular damage, inflammation, anxiety, illness, and eventually depression.

Many medicines can temporarily dampen the sympathetic system, for example, anti-anxiety drugs, sedatives, tranquilizers, and some antidepressants. However, there are no medications available to boost the parasympathetic system. This is where mind-body practices can be helpful. Gentle stretching, certain breath practices, and meditation all can potentially strengthen the parasympathetic, soothing, recharging part of the nervous system. For most people, breath practices are the most rapidly effective method to balance the activity of the sympathetic and parasympathetic systems.

The autonomic nervous system carries messages back and forth between the body and the brain so that the brain is constantly informed about the ever changing internal state of the body. The vagus nerves are the main parasympathetic pathways carrying information about pain, temperature, gut sensations, organ functions, air hunger, and respiratory functions. These body perceptions are called interoceptions.

All of the functions affected by the autonomic system occur automatically: heart beat, blood flow distribution, blood pressure, breathing, digestions, glandular functions, reactions of the immune system. There is only one that can be controlled either voluntarily or involuntarily: breathing.

The lungs, airways, throat, chest wall, and diaphragm contain thousands of receptors (pressure, stretch, chemical) sending thousands of messages about your breathing through the vagus nerve. These messages travel through pathways leading to the emotion processing centers (limbic system, amygdala, hippocampus), hormone regulation centers (hypothalamus), and processing centers for perceptions and thoughts throughout the cortex (via the thalamus). Through these routes, breathing patterns exert a strong influence on how we think, feel, react, and perceive ourselves and others. By voluntarily changing the pattern of the breath, we can change the messages the body is sending to the brain and thereby change the way we think and feel.

Skillful control of breath patterns can be used to calm the emotions, eliminate anxiety, stop obsessive worry, reduce stress over-reactivity, and induce greater mental clarity and focus. For more information on how to use breath patterns to improve stress resilience, mental health, clarity, and focus, see How to Use Herbs Nutrients, and Yoga in Mental Health Care, by Richard P. Brown MD, Patricia L. Gerbarg MD, and Philip R. Muskin MD.