Beat Stress One Breath At A Time

As her email inbox fills with messages and frustrations about COVID-19 infiltrate her mind, Mimi Davis sits up straight at her desk, closes her eyes and inhales through her nose 10 times. 

The tension in her shoulders ease, and she is able to relax.

“Two minutes of deep breathing, and I come back to the task at hand feeling focused and collected,” said Davis, grants and contracts manager for the Duke Campus Grants Management Team.

Davis turned to deep breathing exercises after the pandemic outbreak for stress-relief when her regular activities such as indoor roller skating and dinner with friends became inaccessible. 

Deep breathing – not typical short, shallow breaths – triggers your body’s relation response by sending signals to your brain to slow the heart rate, decrease blood pressure and relax muscles, according to the American Institute of Stress, a non-profit that provides science-based stress management research.

“Breathing is essentially a tool that alerts part of a brain if our fight or flight mechanism needs to activate,” said Rafia Rebeck, a counselor with Duke Personal Assistance Service. “Shallow breaths are going to contribute to or activate feelings of anxiousness, impatience and nervousness. Deep breaths send a signal to the brain that everything is going to be OK.”

Here are four steps to improve your breathing to relax more.  

Use your nose

Rafia Rebeck of Duke Personal Assistance Service said breathing exercises can be done anywhere and should be isolated through your nose because the technique of breathing in through your nose and out through your nose fills your lungs with oxygen to distribute around the body. Oxygen provides our body with energy, kills bacteria and powers muscles. 

“Nasal breathing has this calming effect because of the increased oxygen that protects you physically and psychologically,” Rebeck said. “The more oxygen you can fill your lungs with, the stronger the signal is to calm down.”

1, 2, 3 … 

Start your exercise by inhaling once for four seconds and exhaling once for four seconds. Repeat the cycle three to five times.

Mobile apps such as “Breathe +” for Apple devices and “Breathe” for Android devices can help you get started. The apps display prompts for how long to inhale and exhale. 

“How long you inhale and exhale and how many times you repeat is ultimately up to you,” Rebeck said. “Do it until you feel your heart rate slow down or your stress settle.”  

Mimi Davis, Duke Campus Grants Management Team, closes her eyes at her desk and inhales once for five seconds then exhales once for five seconds. She repeats the cycle until she feels her stress dissipate.

“Counting helps breathing become this moment of mindfulness where you forget about everything else,” Davis said. “I feel my mind stop running. I don’t feel rushed any longer. I feel like I can now handle everything on my to-do list.”

Fill your belly 

During her practice, Arunima Srivastava places one hand on her stomach, inhales for about five seconds and feels her stomach rise. As she exhales, her stomach lowers. 

“My stomach moving up and down is giving me an indication that I’m breathing deeply,” said Srivastava, a patient services associate for Duke Lifestyle and Weight Management Center. and certified yoga instructor and meditation instructor.

Diaphragmatic breathing, or abdominal breathing, is an exercise in which you breathe to fill your diaphragm, a muscle at the base of your lungs that assists with breathing. As the diaphragm fills with air it pushes against the stomach, causing the organ to rise and fall.

Diaphragmatic breathing allows for more oxygen to enter your body, resulting in a lower heart rate and blood pressure.  

Here are steps for diaphragmatic breathing.

1. Lie flat on your back with your knees bent and head supported. You can also sit in a chair so your knees are bent and your shoulders, head and neck are relaxed.
2. Put your left hand in the center of your chest and right hand on your stomach. 
3. Breathe in through your nose and direct the air toward your stomach. Your right hand should rise. Your left hand should remain still.
4. Let your stomach and right hand lower as you exhale. 

“Diaphragmatic breathing reminds the body where the breath should be going,” Rebeck said. “Breathing so your chest or shoulders move indicates you’re not inhaling as much as oxygen as you should. That may cause shortness of breath and trigger your mind to think something anxiety-provoking is happening.” 

See the Duke Personal Assistance Service website for resources of breathing exercises, including videos.

Set up a routine 

Now that you have the mechanics of breathing exercises figured out, it’s time to establish a routine. 

Rebeck suggests practicing deep breathing for about five minutes each day. Making it part of your morning, lunch or bedtime routine will help in stressful moments.  

“Doing a little bit each day is building a cheat code into your nervous system that taking deep breaths will alleviate stress, anxiety and weariness when you encounter a difficult situation,” she said.

Both Sarah P. Duke Gardens and the Duke Center for Healthcare Safety and Quality have published meditation resources to help you enter a calm state. 

Srivastava’s daily breathing exercises for the last 10 years came in handy when she worked as a symptom monitoring screener at various entrances to Duke Health facilities from June to the end of August. 

Srivastava asked as many as 30 guests per hour if they were experiencing any COVID-19 symptoms. The constant dialogue tired her out, but deep breathing is a quick remedy. Srivastava took three minutes away from a check-in table for a few rounds of deep breathing while sitting or standing in a quiet place. 

“I’ve become more mindful of my body since starting deep breathing exercises,” Srivastava said. “If I notice myself losing concentration, I pause and take a few deep breaths. Breathing is my way to give my brain a quiet moment, center myself and get a boost of energy.”

Watch this video to learn about mindfulness from Duke Personal Assistance Service Counselor Rafia Rebeck:  

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