November 2022 - BOBI

Help for Childhood Anxiety: The Power of Proper Breathing

It is often said we live in an era of fear and anxiety.  As a frontline mental health professional, father, and business owner, I’m often reminded of how we’re affected by ever evolving changes to our lifestyle, and how this impacts our children. 

It seems the aspects of our lives that claim to improve or support our engagement in day-to-day activities actually evoke additional stress or complexity.   

Smartphones have given us many benefits, however it has become increasingly clear there is a direct and unambiguous cost for the convenience and access these devices provide. That cost is often levied against our mental health, including rapid increases in childhood anxiety.  

Other broader environmental factors have had a tremendous bearing on our lives, as witnessed during the COVID-19 pandemic. The reasons for the increase in childhood anxiety are many, including changes to routine.

The history of childhood anxiety

Childhood anxiety is not a new or novel concept. The issue has been studied and written about for centuries. Ancient philosophers, by way of example, referred to the concept of anxiety in many teachings. The experience of anxiety is also considered a normal and valuable part of life.  

From an evolutionary perspective, anxiety was, and remains, extremely beneficial as it allows us to react with alertness to physical threats. Therefore, it is typical for children to experience anxiety throughout their upbringing. Some children, however, will develop high levels of anxiety that starts to interfere with their relationships, behaviours, and routine.

Primary childhood anxiety disorders

There are three main anxiety disorders for children:

  • Social anxiety: Social anxiety is characterised by an intense fear of social situations in which the child believes they will be judged and scrutinised by others.
  • Separation anxiety: Separation anxiety is when a child becomes excessively concerned or distressed, when separated from their parents.
  • Generalised anxiety: Children with generalised anxiety typically experience excessive or uncontrollable worry about numerous events or activities.

Common risk factors for childhood anxiety disorders have been researched and identified over many decades. These risk factors include:

  • Exposure to stressful environments. 
  • Dysfunctional parenting styles. 
  • Exposure to unstable living conditions. 

Genetic factors also contribute towards the likelihood of a child developing an anxiety disorder. A child that has a family member with a diagnosed anxiety disorder is more likely to experience the same. Anxiety disorders are the most common mental health conditions. Approximately 40 million people in the US, and up to 20% of Australians, suffer from a diagnosable anxiety disorder.

These numbers continue to climb despite the continued focus on mental health initiatives by governments, schools, and employers. Worryingly, the rate of childhood anxiety continues to rise and it’s estimated to be as high as 40%.  Around the world, rates of anxiety in children have reportedly doubled since the start of the Covid-19 pandemic.

Childhood and adolescence are the most typical times individuals start to display early signs, or predisposition, to an anxiety disorder.  

Signs of anxiety in children

There are many behaviours that an anxious child may exhibit, including: 

  • Clinginess.
  • Experiencing stomach problems.
  • Avoidance.
  • Breathing dysregulation.
  • Rapid, short breathing from upper chest (hyperventilation). 

Childhood anxiety and hyperventilation

Identifying children whose anxiety is impacting their breathing is important.  Sustained changes to breathing patterns may indicate that anxiety symptoms are worsening.

When children engage in hyperventilation there are several accompanying behaviours that co-occur. You might notice frequent sighing or attempts to take an exaggerated deep breath. These behaviours relate to a little understood phenomenon known as ‘air hunger’.  From experience, these symptoms are frequently overlooked as being related to childhood anxiety and therefore are easily missed by parents and medical professionals alike.

When we are anxious our body’s natural response, through the sympathetic nervous system, is to increase our rate of breathing. This increased rate of breathing (hyperventilation), often results in too much carbon dioxide being expelled by the body.  This sensation of expelling too much carbon dioxide feels the same as if we are not taking in enough oxygen.

Most children respond to this feeling by trying to take deeper breaths, making the condition worse by further expelling too much carbon dioxide. 

This is also made worse if the child is breathing through the mouth rather than the nose, and through the upper chest instead of the diaphragm. 

The sensation is often called ‘air hunger’ and has also been described as ‘being unable to get on top of a breath’. Children often find it difficult to express  the feeling of ‘air hunger’ and many parents put it down to other breathing difficulties or unrelated ailments.

Changes in breathing patterns are amongst the first signs a child is experiencing anxiety. This is particularly important to know as it allows parents to engage in early intervention and treatment. Research shows that early intervention for childhood anxiety is essential. 

Helping childhood anxiety with conscious breathing

In most cases anxiety disorders are highly treatable. As with many medical conditions, the earlier anxiety is identified and treatment undertaken, the better the outcome for the person involved.  

Bobi Student

Most children, however, don’t receive any professional support for anxiety. Often symptoms related to anxiety are put down to other causes. Limited availability and access to qualified mental health professionals is also another issue and contributes to the reduced likelihood of a child engaging in early treatment for anxiety. Slow, controlled, breathing through the nose remains one of the most effective anxiety prevention and early intervention treatments for children. There is overwhelming research support that breathing training gives children a highly effective technique for managing stress and anxiety. This is why kids’ yoga classes, by way of example, can be so beneficial. 

Unsurprisingly, the habit of better breathing requires repeated practice and early support, especially where children are concerned. 

Better breathing with bobi 

My experience, both professionally and personally, has led me to believe the skill of slow, controlled nasal breathing can be easily integrated into a child’s daily routine. Just as reading is often considered the foundational skill for a child’s education, breath training should be considered the same for children’s mental health.

bobi helps facilitate the habit of better breathing and is a great device to help children ground and create a positive emotional response during times of stress or anxiety. For more information on bobi, contact us online at admin@meetbobi.com.

Emotional regulation and the benefits of conscious breathing

Bobi Conscious Breathing

Breathing is widely considered one of the most crucial mind-body emotional regulation skills to help you master anxiety and cope with stress.

What is Emotional regulation?

Why do most people enter therapy with a psychologist?  

The most common reason for seeing a psychologist is to help manage emotions.  This includes sadness, anxiety, stress, anger and depression.   The term emotional regulation, also known as self-regulation, describes a person’s ability to appropriately control one’s emotional state.  

Emotional regulation is considered the skill of thinking before acting.

For example, take the case of an adolescent boy, Jake, playing an online computer game with friends. Jake’s character happens to die during gameplay and he becomes the focus of ridicule. Jake’s response is to launch the computer console at the wall and to scream profanities.  

This story is one many households would be familiar with and is an example of emotional dysregulationEmotional dysregulation is the uncontrolled expression of emotions, typically in response to a situation that is perceived to be inconvenient, uncomfortable, or stressful.

Some examples of emotional dysregulation include:

  • Angry outbursts.
  • Anxiety.
  • Depression.
  • Frustration.
  • Self-harm and other self-damaging behaviours.

In my experience, emotional dysregulation can greatly disrupt relationships and is a predictor of substance abuse in late adolescence and adulthood.

Conversely, controlling one’s emotions has long been identified as a path to contentment and stability in life. The ancient Stoic philosophy, which now forms the basis of modern cognitive behaviour therapy (CBT), has endured and flourished owing to its emphasis on emotional regulation.  

Perhaps the most famous of Stoic concepts currently used today is the ‘dichotomy of control’ (refer Epictetus); put simply, this places emphasis on identifying the things that are within, and outside of, our control.

“The chief task in life is simply this: to identify and separate matters so that I can say clearly to myself which are externals not under my control, and which have to do with the choices I actually control.”

Epictetus, The Discourses

Epictetus
Epictetus, The Discourses

Other factors influencing emotional dysregulation

Unfortunately, many children don’t develop the capacity for emotional regulation without engaging in overt coaching or specialised education.  

Other factors can contribute to displays of emotional dysregulation, including if a child is on the autism spectrum, or has a diagnosis of attention-deficit/hyperactivity disorder (ADHD).  Previous studies suggest that up to 70% of adults with ADHD exhibit emotional dysregulation.

For neurodivergent children, the manifestations of emotional dysregulation largely contribute to social limitations.  The ‘meltdowns’, sometimes associated with children on the autism spectrum, refer to an inability to effectively regulate emotional states.  Behaviours associated with meltdowns often lead to a marked deterioration in relationships and a reduced quality of life within families.

A recent autism-related study identified the critical importance and impact of emotional dysregulation to adaptive functioning in children.  Adaptive functioning simply refers to coping with everyday environmental demands.  In this context, the development of emotional regulation strategies may be viewed as a critical life skill for any child, but in particular, those who are neurodivergent.

Emotional dysregulation in adults

Emotional dysregulation is also experienced by many adults.  Outward expressions of physical aggression, such as road rage, are the most obvious examples of emotional dysregulation.  However, emotional dysregulation incorporates a broad spectrum of emotions and behaviours that may include:

  • Severe depression.
  • Anxiety.
  • Anger.
  • Self-harm.
  • Excessive substance use.
  • Extreme perfectionism.
  • Conflict in interpersonal relationships.
  • Engagement in problematic gambling.

Strategies for improving emotional regulation

Many emotional regulation strategies are intrinsically taught to children, most commonly through observing the behaviour of others. For example, a child that grows up in a household where each member of the family displays respect and empathy will often develop positive coping behaviours when faced with adversity. Children learn by observing and this remains especially the case for emotional regulation.

Another core emotional regulation skill is the capacity to be self-aware, including through interoception. Interoception is defined as the perception of sensations from within the body that includes heart rate and breathing. 

Recent scientific research has highlighted how our interoceptive skills, simply our brain’s perception of our body’s state, can determine our susceptibility to depression and anxiety.  People with anxiety may misinterpret a small change in their heart rate and immediately conclude some kind of threat is imminent.  This overreaction is a hallmark of anxiety and is often observed as somebody ‘being on edge’ or ‘highly strung’.

Many children and adults have poor interoceptive skills. Fortunately, a few simple exercises, repeated often, can improve these skills. A recent research study of autistic adults found that providing interoception training to the participants could effectively reduce anxiety.

How Conscious breathing can help emotional regulation?

In my experience, of all the strategies available for an individual to develop emotional regulation, conscious breathing (also referred to as slow or controlled breathing) is the most effective.  

In fact, most psychologists deploy conscious breathing techniques during therapy. 

There are several key features of conscious breathing that directly impacts emotional regulation:

  1. Because of the connection between breathing and the autonomic nervous system, you are able to immediately reduce stress and anxiety through scientifically supported breathing exercises.
  2. Slow, controlled breathing stimulates our vagus nerve and this increases our heart rate variability, a core component of our body’s ability to combat and reduce stress.
  3. Breathing involves a physical action that often overrides our cognitive processes (thoughts). This can be incredibly beneficial when a person is in a state of agitation.
  4. Controlled breathing creates a space between our thoughts and our actions. This is crucial for anyone who is prone to act impulsively.

Conscious breathing should be considered the foundational skill for developing emotional regulation. If somebody is in a state of hyperventilation, psychological strategies will have little impact.  Our fight-or-flight response triggers a cascade of physiological changes that are designed to ready the body for physical action. For this reason, it’s very difficult to initially think our way out of the triggering event.

The skill of conscious breathing is the most readily available, and the most effective, intervention for calming our body’s response. By slowing our breathing we can exert a highly effective measure that is recognised by our brain as a sign of reassurance and safety.

Learning conscious breathing 

The benefit of learning and engaging in conscious breathing is well-recognised within many parts of society, including schools.  The challenge, however, is how to effectively provide education and training so that more people can develop and utilise the skill of conscious breathing for use during times of stress.

Once somebody has developed the capacity to engage in the practice of conscious breathing it provides a sense of efficacy in relation to managing difficult emotions.  Self-efficacy is simply the belief in one’s ability to succeed in a specific task.  

When you develop an understanding that you’re in control of your emotions, irrespective of the triggering event, remarkable changes in behaviours often follow. This is especially the case in how we communicate and interact with those around us.  

The fundamental emphasis on how our thoughts determine our emotional responses – a central tenet of cognitive behaviour therapy (CBT) – develops as a feature of one’s capacity to self-regulate.

Developing the foundational skill of conscious breathing helps to challenge and change unhelpful thinking patterns.  Having the capacity to consider a situation logically, prior to simply reacting, remains a core aspect of emotional regulation.  Getting to that position, however, often involves engagement in a process which has conscious breathing at its foundation.

Conclusion 

Breathing is a fundamental tool for emotional regulation, offering a direct pathway to manage anxiety and cope with stress. The article emphasizes the importance of conscious breathing in emotional regulation, highlighting its ability to immediately reduce stress and anxiety, stimulate the vagus nerve, override cognitive processes during agitation, and create a space between thoughts and actions. Conscious breathing acts as a foundational skill, allowing individuals to challenge unhelpful thinking patterns and respond logically to situations rather than reacting impulsively.

Incorporating tools like “bobi” can further enhance the practice of conscious breathing. Bobi is designed to promote better breathing habits, serving as an effective device to help children and adults ground themselves and foster positive emotional responses during stressful situations. By integrating bobi into one’s daily routine, individuals can further harness the power of breathing for emotional regulation, ensuring a more balanced and controlled emotional state. Get your bobi here!


bobi laying down

FAQs

  1. What is Emotional Regulation?

Emotional regulation, also known as self-regulation, describes a person’s ability to appropriately control one’s emotional state. It is essentially the skill of thinking before acting and plays a crucial role in managing emotions like sadness, anxiety, stress, anger, and depression.

  1. How does conscious breathing help in emotional regulation?

Conscious breathing, also referred to as slow or controlled breathing, is a foundational skill for emotional regulation. It helps reduce stress and anxiety, stimulates the vagus nerve, overrides cognitive processes during agitation, and creates a space between thoughts and actions, allowing individuals to respond logically to situations.

  1. Why is emotional dysregulation a concern?

Emotional dysregulation is the uncontrolled expression of emotions, typically in response to stressful situations. It can manifest as angry outbursts, anxiety, depression, frustration, self-harm, and other self-damaging behaviors. It can disrupt relationships and is a predictor of substance abuse in late adolescence and adulthood.

  1. How does bobi help with conscious breathing?

Bobi facilitates the habit of better breathing, serving as a tool to promote conscious breathing practices. It aids in grounding individuals and fostering positive emotional responses during stressful situations.

  1. Who can benefit from using bobi?

While bobi can be beneficial for anyone looking to improve their emotional regulation through conscious breathing, it is especially helpful for children, helping them create a positive emotional response during times of stress or anxiety.

References:

  1. Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion Dysregulation in Attention Deficit Hyperactivity Disorder. American Journal of Psychiatry. Link.
  2. Davico, C., Marcotulli, D., Cudia, V. F., Arletti, L., Ghiggia, A., Svevi, B., Faraoni, C., Amianto, F., Ricci, F., & Vitiello, B. (2022). Emotional Dysregulation and Adaptive Functioning in Preschoolers With Autism Spectrum Disorder or Other Neurodevelopmental Disorders. Frontiers in Psychiatry. Link.
  3. Quadt, L., Garfinkel, S. N., Mulcahy, J. S., Larsson, D. E. O., Silva, M., Jones, A.-M., et al. (2021). Interoceptive training to target anxiety in autistic adults (ADIE): A single-centre, superiority randomized controlled trial. eClinicalMedicine. Link

 

How a better breathing technique can change your life

The importance of how we breathe and our breathing technique has gained increased public attention over recent years. There’s now overwhelming scientific support for the adoption of correct breathing technique. Increased rates of dysfunctional breathing, a phenomenon observed in most Western nations, is a matter of concern for those within the medical community.    

What is dysfunctional breathing? 

chestbreathing,Aged,man,with,chest,pain,touching,inflammated

Dysfunctional breathing is defined as abnormal respiratory patterns, most often related to over-breathing, upper chest breathing, or breathing through the mouth.

Dysfunctional breathing is associated with various mental states, including stress, anxiety, depression and also impacts on emotional regulation ability.  In his New York Times bestseller, James Nestor remarked of this phenomenon: “Those with the worst anxieties consistently suffer from the worst breathing habits”.  

Upper chest breathing, a dysfunctional way of breathing in which you breathe too fast, too shallow, and too high in the chest remains pervasive across many sections of the population. This is commonly known as hyperventilation and is one of the earliest physical signs of anxiety.

 

Correct breathing technique 

Slow controlled breathing has been used throughout history as an effective relaxation tool to manage stress and anxiety. It has been shown that changing the rhythm of your breathing can signal relaxation, slowing your heart rate and stimulating the vagus nerve. The vagus nerve is the main component of the parasympathetic nervous system which controls our capacity to move into a state of rest and enhance a sense of calm.

A good way of looking at this process is to use a real-life example:  

James, a final year high school student, sought my assistance to manage his experience of stress and anxiety during exams. He described his stress response as including a rapid heart rate, fast shallow breathing and increased sweating.  

James becomes aware of these changes and this awareness often results in further anxiety.  Importantly, James’ awareness of an increased heart rate does not automatically result in slowing his heartbeat.  

By learning to focus on his breath and slow it down, James has discovered how to actively calm himself and normalise his heart rate.  James has essentially discovered that slowing down the breathing rhythm has positively influenced a number of bodily functions including the autonomic, central brain, and parasympathetic systems.

The impact of breath on the body

The body’s nervous system regulates our involuntary actions such as heart rate and digestion. These actions are split into two parts. Your sympathetic nervous system controls your fight or flight response, and your parasympathetic nervous system, as previously noted, controls your rest and relax response.

Stress and anxiety simply indicate our body is in a state of fight or flight (sympathetic nervous system). The quickest and most effective way to reduce sympathetic nervous system activation is through slow, gentle, breathing.

Unfortunately, it’s not a natural bodily response to slow one’s breathing during a period of stress or anxiety. In fact, our brain has developed over thousands of years to respond by doing the opposite: making our breathing rate increase under perceived threat or exposure to stressful circumstances.

But, as identified in the case of James above, breathing becomes such a powerful tool because it is something that each of us can control.  Research suggests that breathing at a rate of six breaths per minute is optimal when attempting to move to a state of calm. At this rate there appears to be a positive feedback loop between the heart, brain, and the lungs.

Why is dysfunctional breathing so common?

Many people question the reasons why dysfunctional breathing habits such as hyperventilation have become so common.    

There are many causes of hyperventilation and they are often interrelated.  But, it is generally accepted that changes to our lifestyles, such as moving less and eating more, are critical factors.  

Other important changes to our breathing occur when we open an email or engage in endless scrolling on social media.  In an article published in 2008, Linda Stone coined the phrase ‘e-mail apnoea’ to describe how our breathing changes in response to our interaction with technology.  

Subsequent studies have also shown the connection between the use of social media and increasing anxiety within adolescents. In cases where someone is experiencing stress, or anxiety, they will almost certainly experience dysfunctional breathing.

Whatever the causes of our drift into dysfunctional breathing habits, the problem is pervasive. Most clients in therapy display some form of breathing dysfunction, most notably hyperventilation.  

My experience as a psychologist, in this respect, is not unusual.  It remains overwhelmingly common that psychologists and other mental health professionals will use conscious breathing training as a frontline tool for the management of many psychological disorders, including anxiety and depression.

Learn the perfect breathing technique

While the number of breathing techniques and methods available can seem confusing and at times contradictory, there is consensus on the benefits of attempting to achieve six breaths per minute.  As James Nestor stated in his New York Times bestseller:

“The perfect breath is this: Breathe in for about 5.5 seconds, then exhale for 5.5 seconds.  That’s 5.5 breaths a minute for a total of about 5.5 litres of air.”

bobi for better breathing

bobi helps facilitate the habit of better breathing and is a great device to help children ground and create a positive emotional response during times of stress or anxiety. For more information on bobi, contact us online at admin@meetbobi.com.

References

Refer: Streeter et al., 2012; Brown et al., 2013). In Zaccaro A, Piarulli A, Laurino M, Garbella E, Menicucci D, Neri B, Gemignani A. How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing. Front Hum Neurosci. 2018 Sep 7;12:353. doi: 10.3389/fnhum.2018.00353. PMID: 30245619; PMCID: PMC6137615.

 

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