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2 Practices To Try If "Focusing On The Breath" In Meditation Make You Anxious

Aditi Nerurkar, M.D., MPH
December 10, 2020
Aditi Nerurkar, M.D., MPH
By Aditi Nerurkar, M.D., MPH
Aditi Nerurkar, M.D., MPH., is a Harvard-trained mind-body medicine doctor with an expertise in resilience and stress
Woman Mediating At Home, Wrapped in a Cozy Blanket
Image by Micky Weswedel x mbg Creative
December 10, 2020

This year has been one of the most challenging years in modern history, one that has taken a toll on our mental and physical health. To help you through it, we launched Experts On Call, a new series in which top-tier health and well-being experts answer your questions—however big or small—to help you find solutions, put together a game plan, and make each day a little bit easier. Don't forget, you can ask questions anytime, and we'll do our best to find the right expert to point you in the right direction. Without further ado, here's another edition of the series with a question from reader Scott G.

My anxious thoughts seem to center on my breath, in the form of not being able to take full breaths or a desire—but inability—to capture that ‘last sip’ of breath. This makes it difficult to use meditation to manage my anxiety. What can I do?

—Scott G.

As an integrative medicine physician focused on mind-body health, this is one of the most common questions I receive. To help answer it, I first want to address why anxiety affects breath and assure you that you are not alone in this feeling. 

Why anxiety affects breath. 

When we feel anxious, whether it's a momentary sense of anxiety or a formal diagnosis of anxiety, that feeling stimulates the sympathetic nervous system, also known as the "fight-or-flight" mode. When we're feeling anxious, cortisol levels increase, the heart starts beating faster, and the pace of the breath quickens. 

Breath is just one aspect of fight-or-flight, so it is very common for people with anxiety to experience an inability to catch or slow their breath, or to increase their awareness of that breath.

Fight-or-flight is a natural self-preservation technique, and it actually means the body is functioning appropriately. Our job is to figure out what's causing that stress response and begin to manage it. 

How to manage the breath when breathing makes you anxious. 

Meditation and slowing of the mind can be challenging for a lot of reasons. My best advice if you're struggling with it? Don't do it. 

That may sound surprising, given the mental benefits sitting mindfulness meditations can have, but there are plenty of stress and anxiety-management tools out there that may be more effective. 

Anyone who becomes more anxious while focusing on the breath may benefit from movement meditation instead. The process of moving helps the anxious person get out of their head and into their body. 

How to practice movement meditation:

  1. Set a timer for 20 minutes on your watch or your phone. 
  2. Put on a mask and go outside. 
  3. Walk slowly, articulating your feet on the ground as you walk. 
  4. Think about heel-toe, heel-toe with each foot, or just bring your awareness to your feet on the floor as you're walking. 

After spending a few minutes focusing on your feet, you can bring a gentle awareness to your breath. If that feels scary or uncomfortable, go back to focusing on the feet. Not only is this exercise grounding, but it also encourages time in nature, which can further benefit mental health and de-escalate cortisol levels1

Therapeutically, that 20-minute walk is all it takes to reduce anxiety. If you want to try another strategy, breathwork could also help. Opposite of sitting meditation, which focuses on the natural pace of the breath, breathwork requires you to actively change the natural breath. Here are a couple of breathwork techniques I recommend: 

Diaphragmatic breathing:

  1. Place both hands on the belly. 
  2. Close your eyes.
  3. Take a deep inhale through your nose, letting your belly rise.
  4. Exhale with pursed lips through your mouth. 

Why it's helpful: When we feel anxious, we take shallow, fast breaths through our chest, known as thoracic breathing. By engaging in diaphragmatic breathing, we stimulate the parasympathetic nervous system, which gets us out of the fight-or-flight mode. 

Heart-centered breathing:

  1. Put one hand on your heart and the other hand on your belly. 
  2. Close your eyes. 
  3. Inhale for four counts through your nose. 
  4. Exhale for seven counts through your mouth. 

Why it's helpful: The breath is the only bodily function that is under voluntary and involuntary control. Since feelings or moments of anxiousness feel so out of control, this practice helps get to the root of that. 

Bottom line.

Sitting mindfulness meditation is a wonderful tool, but it is just one tool out of many to help manage anxiety. If the practice doesn't feel comfortable to you, try practicing grounding movement meditations instead. If you're able, consider practicing breathwork as well, to help you feel more in control.

Aditi Nerurkar, M.D., MPH author page.
Aditi Nerurkar, M.D., MPH

Aditi Nerurkar, M.D., MPH., is a Harvard-trained physician with an expertise in resilience and stress. She’s a frequent on-air medical correspondent. Her work has been featured in Oprah Magazine, The Today Show, CNN and The Wall Street Journal. She’s been a headline speaker at Forbes 30 Under 30, Harvard Business School, and Dell Technologies, and speaks internationally to audiences about optimizing mental health, productivity & resilience during COVID-19 and beyond. She also writes about resilience in her weekly newsletter, with readership in over 52 countries.