Managing the Calm: Box Breathing

Let’s be honest—the majority of us are under a lot of stress right now. Stress comes from a multitude of sources and while a little can be useful in motivating us to get tasks done or in running away from a saber-toothed tiger; over a long time, chronic stress wreaks havoc on our bodies.

When we perceive something stressful, the hypothalamus, a tiny part at the base of your brain, turns on the alarm. This alarm signals the release of adrenaline and cortisol. Adrenaline increases heart rate and blood pressure to boost energy. Cortisol, our stress hormone, increases glucose availability for our brains and muscles. These are all critical functions when there is an actual threat—when we really do need to run from that tiger! Once the threat has passed, adrenaline and cortisol levels drop, our heart rate and blood pressure go back to normal, and we proceed with life.

However, given the enormous amount of stress we experience every single day and our bodies and brains feel like we are constantly under attack, that fight-or-flight response never gets the chance to turn off and reset. This increases risk for many chronic and debilitating health problems including:

• Anxiety
• Depression
• Stomach problems
• Headaches
• Heart disease
• Sleep deprivation
• Weight gain
• Memory and concentration impairment

One practice that I discuss with many of my patients is box breathing. Box breathing is a technique of slow, deep, and intentional breathing. By practicing this, it is just about impossible for our bodies to stay in the fight-or-flight mode.

Start by finding a comfortable posture.

Step 1: Close your eyes and then breathe in through your nose while counting slowly to four. You should feel the air coming into your lungs.

Step 2: Now hold your breath while slowly counting to four. Try not to clamp your mouth or nose shut. Avoid inhaling or exhaling for 4 seconds.

Step 3: Then begin to slowly exhale for 4 seconds.

Repeat steps 1-3 at least 3 times. Over time, you should aim to complete steps 1-3 for 4 minutes, allowing your body and brain to reset. Sometimes people may feel a little dizzy, which can be completely normal. Just stay seated for a few minutes until the feeling passes.