February 28, 2022 8 min read
Stress is the process through which environmental demands result in detrimental outcomes to a person's physical and/or mental health and it is a global epidemic. In 2011, the World Health Organization developed guidelines to support primary care providers in the care of their patients who experience stress. 
In 2016, a global assessment conducted by the World Health Organization recognized that sources of stress varied internationally and identified that 350 million people were affected by stress worldwide. 
A stressful experience encompasses both a physiological and psychological response.
Physiologically, stress activates the sympathetic nervous system through the secretion of cortisol  which causes an increase in the respiratory rate, heart rate and systolic blood pressure. The stress response can be immediate or delayed, acute or long term. Psychological stress also activates the sympathetic nervous system and is pro-inflammatory which leads to the development of mental and physical disease states. 
Stress is a major risk factor for the development of many chronic diseases, both physiological (e.g. cancer and cardiovascular disease) and psychological (e.g. anxiety and depression). 
In work and college environments, stress can lead to the development of cardiovascular disease, hypertension, depression, anxiety, social dysfunction, drug and alcohol abuse, and in extreme cases can result in death. 
The International Labor Organization's 2016 report on workplace stress identified that global workplace stress is only beginning to be quantified. 
In the United States, the cost of stress to employers has been reported to be over 300 billion.
The overall financial burden of stress reported globally is staggering. 
The high costs of stress is well documented. In a study investigating anxiety and depression by the World Health Organization, the estimated cost of treatment worldwide from 2016 to 2030 using psychosocial counselling and medication is 141 billion. 
Identifying evidence-based stress reduction interventions that are low cost, easy to use and can be self-administered is essential to the overall treatment and management of this global health issue.
Deep breathing is a simple yet powerful relaxation technique. It’s easy to learn, can be practiced almost anywhere, and provides an expedient method to get your stress levels in check. Deep breathing is the cornerstone of many other relaxation practices and is one of the best ways to lower stress in the body.
Deep breathing sends a message to your brain to calm down and relax.
The brain responds by sending this message to your body. The physiological responses that occur when you are stressed, such as increased heart rate, respiration rate, and high blood pressure, all decrease as you breathe deeply to relax.
Tips to practice deep belly breathing:
If you are struggling breathing from your abdomen while sitting up, try lying down. Put a small book on your stomach, and breathe so that the book rises as you inhale and falls as you exhale.
Alternate nostril breathing:
Alternate nostril breathing, known as nadi shodhana pranayama in Sanskrit, is a breathing practice for relaxation. Alternate nostril breathing has been shown to enhance cardiovascular function and to lower heart rate. Nadi shodhana is best practiced on an empty stomach. Avoid the practice if you’re feeling sick or congested. Keep your breath smooth and even throughout the practice.
Here's how to do it:
Buteyko Breathing technique - The Control Pause:
The Conscious Breathing Anchor:
Decongest the Nose:
Roll breathing helps you to develop full use of your lungs and to focus on the rhythm of your breathing.
It can be performed in any position. It is best to lie on your back with your knees bent while you are learning this technique.
Your autonomic nervous system, which controls involuntary actions like heart rate and digestion, is split into two parts. There is one part, the sympathetic nervous system, which controls your fight-or-flight response.
The other part, the parasympathetic nervous system, controls your rest-and-relax response. While both parts of your nervous system are always active, deep breathing can help quiet your sympathetic nervous system and therefore reduce feelings of stress or anxiety.
Breathing exercises reduce stress by increasing oxygen exchange, which reduces your blood pressure, slows the heart, and releases any tension held in the abdomen. These physical changes also benefit your mental state - concentrating on your breath can bring you into the present, in a state of mindfulness.
When a person is relaxed, they breathe through their nose in a slow, even and gentle way. Deliberately copying a relaxed breathing pattern seems to calm the nervous system that controls the body’s involuntary functions.
Controlled deep breathing can cause physiological changes that include:
A likely mechanism of action is that voluntary slow deep breathing functionally resets the autonomic nervous system through stretch-induced inhibitory signals and hyperpolarization currents spread through both neural and non-neural tissue.
This synchronizes neural elements in the heart, lungs, limbic system and cortex.
During inspiration, stretching of lung tissue produces inhibitory signals by action of slowly adapting stretch receptors and hyperpolarization current by action of fibroblasts. Both inhibitory impulses and hyperpolarization current are known to synchronize neural elements leading to the alteration of the nervous system and decreased metabolic activity indicative of the parasympathetic state. 
The evidence to date indicates that deep breathing may decrease physiological stress as measured by blood pressure, respiration and cortisol levels, and also decrease psychological stress.
Given the potential benefits of deep breathing for physiological and psychological stress reduction, ongoing research is needed to continue to establish the evidence base for this self-administered, low-cost and non-pharmacologic intervention. 
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6. Organization., W.H. Investing in treatment for depression and anxiety leads to fourfold return. 2016.
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