Breathing exercises for mild anxiety

Key Points

• Evidence shows breathwork and breathing techniques may ease the symptoms of mild anxiety.
• Breathing techniques include box breathing and the 4-7-8 exercise.
• Exercise, good sleep, a healthy diet and modalities such as CBT are also helpful to manage anxiety.

Many Australians experience mild anxiety, but the good news is there’s evidence that breathwork, which is free and simple to learn, may ease some of the symptoms. So, what is breathwork and how do you do it? We asked Health Psychologist and Healthylife Advisory Board member Dr Moira Junge about breathing exercises for anxiety and how to practice breathwork for best results.

Are breathing exercises for mild anxiety effective?  

According to Dr Moira, that’s a big yes!

“Breathwork and breathing techniques are terms used to describe the use of breathing exercises to bring about an improvement in mental, physical and spiritual health. Breathing exercises have been a longstanding helpful technique for people experiencing anxiety. The physiological effects of using controlled breathing techniques are vast.” She says these include:

• Significant improvements in the respiratory system, helping more oxygen reach the brain.
• Potential improvements in the heart rate and blood pressure.
• Regular, controlled breathing is a parasympathetic system response which can calm the sympathetic nervous system. This sympathetic/parasympathetic system is also known as the fight/flight system.

Studies have shown that slow breathing techniques and breathing exercises for anxiety may lead to increased feelings of relaxation and alertness and reduced feelings of anger, confusion and depression. 

What is the box breathing technique? 

One breathing technique you might have heard about is box breathing, also known as square breathing. “It’s a simple technique and involves four steps of breathing,” says Dr Moira. “In my clinical practice, I would always sit someone down in front of a window or door frame or artwork.” 

Here are the steps of the box breathing technique:

1. Focus on a square object in front of you, such as a window, door, artwork or picture frame.
2. Inhale slowly through your nose for four seconds while looking at the top left part of the square.
3. Hold your breath for four seconds while looking at the right side of the square.
4. Exhale slowly through your mouth for four seconds while looking at the bottom right side of the square.
5. Hold your breath for four seconds while looking at the left side of the square. Repeat this cycle for several minutes. 

What other breathing exercises for mild anxiety may help?

“In my experience and in terms of the research literature, there is not one particular breathing exercise that is better than another,” says Dr Moira, who lists deep breathing, diaphragmatic or belly breathing, pursed lip breathing, and glossopharyngeal breathing as other techniques.

Another technique shown to be effective in easing anxiety and reducing blood pressure is the 4-7-8 exercise, developed by US doctor Andrew Weil. Like box breathing, with this technique, you count your breath. Here’s how you do it. 

1. Sit with a straight back and put the tip of your tongue behind your top front teeth. You’ll need to keep your tongue in place throughout the exercise.
2. Exhale through your mouth while making a ‘whoosh’ sound. It might help to purse your lips as you do this to keep your tongue in place.
3. Close your mouth and count to four as you inhale softly through your nose.
4. Hold your breath while counting to seven.
5. Then exhale through your mouth again, making that whooshing sound to the count of eight.
6. That’s one cycle of breath. Inhale and repeat the entire cycle three more times.

How effective are breathing exercises for anxiety compared with other methods?

Dr Moira says this is largely subjective, and more research is needed to discover the most effective ways to treat mild anxiety. 

“It largely depends on the extent of the anxiety, whether someone has mild symptoms or whether there is a serious anxiety disorder,” she says. “I would encourage a combination of exercise, meditation, modalities such as CBT (cognitive behavioural therapy), getting good-quality sleep and eating healthy food to manage anxiety.”

More advice for breathing easy

Considering using breathing exercises for mild anxiety? Dr Moira says it’s important to form a habit when using these techniques. “Some kind of regular practice is recommended so when anxiety strikes, the breathing techniques will be far more effective.” 

If you’re experiencing mild anxiety or want to learn more relaxation techniques, such as breathwork, visit your healthcare professional for advice. 

Related:

• How to get more deep sleep
• Practising mindfulness without meditation – learn how!
• Understanding the different types of stress

Dr Moira Junge, a healthylife Advisory Board member, is a registered, practising health psychologist with the added specialty of sleep. She has been in private practice for over 20 years and is the CEO of the Sleep Health Foundation and was a founding member of the Behavioural Management of Sleep Disorders Committee within the Australasian Sleep Association (ASA). Dr Moira was also Chair of the ASA Insomnia and Sleep Health Council (2008-2015) and is a full member of the Australian Psychological Society.

Reviewed by the Healthylife Advisory Board November 2023.