World Asthma Day, organized by the Global Initiative for Asthma, is held each May to raise awareness of Asthma worldwide. In this special feature story for World Asthma Day, we take a deep dive into the science of breathing with Dr. Emma Seppälä. How can breathing help us cope with stress and find greater health and happiness in life? What does science show us about breathing as a tool for emotional regulation? And how do you practice breathing if you have asthma? Read, breathe and find out.
There’s a video clip that quickly went viral in March 2021. In it, we see two little boys, Noah and Cory West, in front of a TV set. Four-year-old Cory, the little brother, is agitated, crying out in frustration, clearly on the verge of a temper tantrum. His older brother Noah, however, calmly coaxes him to ‘breathe’. He lifts his hands in tune with his breath, in and out; and asks Cory to do it ‘again’, inhaling and exhaling in sync with his little sibling. By the end of the second breath cycle, Cory’s tantrum has quieted down, as if evaporating with each long exhale. “See, that’s a calm-down,” says Noah, and pats his brother on the shoulder proudly.
The video currently has over 17 million views, and has been retweeted over 119,000 times. Something about it touched a nerve with the global public. Perhaps because a full year into the COVID-19 pandemic, we’re all in need of a good calm-down. Living in times of great uncertainty, stress and anxiety are running high all over the globe. So seeing a six-year-old calmly Zen-mastering his brother out of emotional turmoil seems like something we all could learn from.
In fact, the lesson Noah is passing on to his brother is also a tried-and-tested scientific fact that a growing body of evidence supports: breathing is a highly effective tool for emotional regulation and stress relief. It can even help us find greater happiness.
Dr Emma Seppälä
We caught up with one of the scientists looking into these effects, Dr. Emma Seppälä. She’s a psychologist and researcher who has studied the science of happiness at Yale and Stanford University’s Center for Compassion and Altruism Research and Education. Her book, The Happiness Track, first released in 2016, summarizes a decade of research happiness. One of the book’s key insights is that breathing directly impacts our emotions. “Breathing is one of the most effective and quickest ways to really change the response of your nervous system,” Seppälä says over a video call from her home in Connecticut, New York. “We are seeing this result in more and more studies. It’s a powerful tool we all have to regulate emotion, deal with stress, even with severe trauma. Breathing can help you show up as the best version of yourself.”
It’s a big promise for such a simple process: air flowing in and out of your lungs. But how exactly does all this work? We asked Seppälä to walk us through the science of breathing – and how to utilize it in our daily lives.
To understand why breathing is such a powerful tool, it’s first interesting to look at how emotion and breathing are interconnected. Seppälä refers to a study by Pierre Philippot and his team from 2010 in which participants were first made to feel a certain emotion – joy, anger, fear, sadness – and then asked to describe the breathing pattern linked with each feeling. The result: each emotion had a distinct pattern of breath. Angry breathing is fast and shallow, relaxed breathing is slow and deep, for instance. Even more interesting, however, was the second part of the study, where participants were asked to breathe in the patterns related to each emotion. “Can you guess what the result was?” Seppälä asks.
Indeed, the study showed that the pathway between emotion and breathing is a two-way street. Just as emotions change breathing, particular patterns of breathing will produce particular feelings. Breathe calmer, feel calmer, just as Noah and Cory demonstrated. “The simplest version of this is just lengthening your exhale,” Seppälä confirms. “Because our heart rate and blood pressure naturally increase when we inhale, and decrease when we exhale, just consciously exhaling longer will bring your pulse down and lower your body’s stress response.”
You can give it a try right now:
Feel calmer? According to studies, your body does. That’s because calm breathing will activate your parasympathetic nervous system – the part of your body that is responsible for the so-called "rest-and-digest" responses. In contrast, when we’re under stress, our bodies are controlled by the sympathetic nervous system, inducing a “fight-or-flight” mode. “When you’re in this stimulated fight-or-flight response, you quickly lose access to your prefrontal cortex, which guides higher cognition and behavior,” Seppälä says.
That’s why under stress and anxiety, we often lose control of our own behavior: yell at our kids, make bad decisions at work, eat unhealthy things or give up on exercise routines. This can easily spiral into worsening stress, leading to even more unwanted behavior.
The way to get back on the happiness track, however, isn’t to punish oneself for lack of will power. But to simply breathe and relax. “Calm breathing can take you right back into the parasympathetic nervous system, to rest-and-digest,” Seppälä says. “It’s actually quite amazing that we have this tool to hand that lets us consciously impact the autonomic nervous system: we just need to be aware of it and use it. People have much more say over their feelings than they think,” Seppälä says.
Seppälä came to understand the power of breathing almost a decade ago, when she first moved to New York in 2001. “I came to the city two days before 9/11, and after the attacks I had really high anxiety and stress. I tried yoga, I tried meditation, I tried all of it. But it wasn’t until I started practicing a breathing protocol called SKY breath meditation that things started to get better.”
Once she joined Yale University to research effective wellbeing interventions for undergraduates, she included breathing practices. In the study, Seppala and her team looked at the beneficial impact of three classic wellbeing interventions: the SKY breath meditation, mindfulness, and emotional intelligence. “It wasn’t that surprising to me when the studies showed breathing to have a larger impact on wellbeing than the classic cognitive (emotional intelligence) or mindfulness intervention. There’s a bias in our culture for using mental, cognitive tools. We try to solve our problems with thinking. But in an agitated fight-or-flight state, thinking isn’t necessarily all that helpful. With conscious breathing, you can train your own nervous system to calm down, which will actually help you think more clearly.”
In another one of Seppälä’s studies, a group of US veterans of the Iraq and Afghanistan wars were taught to do daily SKY breathing practices. The result: the veterans’ symptoms of post-traumatic stress disorder decreased and their depression and anxiety levels were reduced, and in fact, normalized. “And what’s even more amazing is that we found the effects lasted, not only a month but a full year after the experiment,” Seppälä says.
Seppälä points out that the techniques are beneficial for most people. You do not need to be a war veteran to have anxiety and trauma. “I think most of us are walking around with some sort of trauma,” she says, and adds that the pandemic has only heightened tendencies towards anxiety. “We’ve really been taught in the past year to be hypervigilant, to constantly scan for danger. It would be good to counter-balance that with exercises that train your brain to relax.”
So, can anyone start using their breath to relieve stress and find happiness?
“Absolutely,” says Seppälä. “That’s the beauty of it, we all breathe. It’s the one thing you do from the day you’re born until the day you die. The idea is to just start using the breath consciously.”
For people living with asthma, it’s especially important to strengthen the respiratory system and relieve stress, which commonly acts as a trigger for asthma attacks. Psychologist and psychotherapist Minna Martin has worked for years as a physiotherapist with people who have asthma. She says that the most important thing for asthmatics too, is to just learn to calm down the breathing. “There’s three simple things you can start with. Practice breathing through the nose to activate the diaphragm. Learn to relax with the exhale, and to recognize the small resting pause after each exhale.”
Diaphragmatic breathing has been shown to help patients with asthma, as it strengthens the diaphragm, slows down breathing, and decreases your body’s oxygen needs. You can find specific exercises for diaphragmatic breathing here.
Martin adds that asthma attacks often include hyperventilating or ‘over-breathing’. “Once you learn to pay attention to the breath, and control it in ways that feel soothing to you, it is easier to prevent hyperventilation.”
The best time to start practicing is when your breathing is already quite calm. “It’s good to get the know the breath when there are no asthma symptoms. Once you learn to be with the breath in a safe way, it’s easier to affect it also during asthma symptoms or attacks.”
For anyone, who wants to try out the impact of a simple breathing practices, here are two basic breathing exercises for calming the nerves:
This easy technique is based on alternating the nostril through which the breath flows. The effect should be calming and balancing, and improving concentration. Preliminary research suggests this may be because activating the breath through each nostril allows for better airflow to both sides of the brain.
This slow breath technique involves experiencing the conscious sensation of the breath touching the throat. It controls airflow so the inhale and exhale can be lengthened to an exact count. The experience should help with physical and mental calmness and alertness.
As six-year-old Noah would say: “See, that’s a calm down.”
Orion invests in research and development of treatment options for people with asthma and COPD while also developing the design and usability of the Easyhaler® inhaler device platform. The focus is on safety and quality in each step of the product life cycle while taking care of the environment. All aspects of sustainability - social, economic and environmental - are carefully considered in the whole product life cycle. Sustainability is entwined in the whole process from R&D through manufacturing, including patient use and the disposal of old inhalers.