How Effective Are Breathing And Relaxation Exercises For Anxiety?
In a related article I summarized some commonly recommended breathing and relaxation exercises that can help with stress and anxiety. That article stuck to describing how they work. This one will go into more detail about the scope of their effectiveness and what their limitations are, particularly with how well they help with anxiety.
Breathing and relaxation exercises alone won't cure your anxiety
Breathing and relaxation exercises have their uses. They're not recommended so often for no reason. They're a good way to help reduce anxious or stressed feelings once they've begun. They're also useful for keeping yourself in a state of calmness before you face a nerve-inducing situation. Regularly setting time aside to deeply relax can also reduce the overall amount of anxiety in your system.
Breathing and relaxation exercises are pretty reactive and focused on symptom relief though. It often takes more to get past anxiety in the long term. People often have to change their attitude to it, to where they no longer see it as this horrible thing that they have to rearrange their lives to avoid. If someone's anxiety is based around fears they have, they probably need to face them at some point. In some cases it's useful to work through the childhood baggage and difficult life experiences that fuel nervousness.
The exercises won't always fully reduce your anxiety in the moment
If you're feeling mildly nervous or stressed, taking some time to breathe and relax may do the trick. If you're moderately worked up, the techniques may not totally eliminate your anxiety, but they may take the edge off. That may be enough to make the difference between, say, talking to someone at a party while you still feel a bit uneasy vs. avoiding them entirely. If you're extremely anxious, your nerves may totally overpower any benefits that breathing can provide. You may be too keyed up to be able to even stop to try to breathe slowly in the first place.
The exercises won't work very well if you try to do them for the first time when you're really anxious
If you're in the middle of panic attack that's not the best moment to try out that breathing or visualization technique you read about a few months ago. It might help a bit, but you can't count on it. Ideally you spend some time practicing and getting a feel for relaxation exercises when you're already calm. That way you're already familiar with what to do when the stakes are higher.
For some people, trying to breathe or relax will make them more anxious
Some people who grapple with anxiety are overly vigilant for any changes in their body. If they notice anything out of the ordinary, they worry that they're getting anxious, which in turn makes them even more nervous. This is particularly common in people who fear having panic attacks, or that they'll do something like get so anxious they'll throw up and embarrass themselves.
Deep breathing can cause changes in how your body feels. Some "sensation triggered" anxiety sufferers primarily associate changes in their breathing with thoughts of, "This is a sign I'm getting nervous. Oh no, oh no, oh no, what if it gets worse?!?" Asking them to really concentrate on their breathing during some exercise is looking for trouble. Similarly, people often instinctively try to slow their breathing when they're nervous. Their improvised breathing exercises may not have worked too well in the past, and now they've built up an association of, "I only ever try to control my breathing when I'm already super anxious." If they consciously try to practice breathing deeply, it may cue all those distressing emotions.
Some anxious people find their worrisome thoughts quickly spiral out of control if they're asked to sit quietly and focus on themselves. Their usual coping method is to constantly distract themselves from their own mind, through things like keeping busy with work, playing video games, or always talking to someone else.
Finally, some people who have lived through trauma find breathing and relaxation exercises trigger them. There's something about the bodily sensation of deep breathing or loosening particular muscles that reminds their mind of the traumatic event and causes them to become agitated. Also, trauma survivors can have a deep seated sense that it's never safe to relax or let down their guard, so any calming exercises upset their system.
If a certain kind of relaxation skill makes things worse you may be able to find an alternative. There are lots of options. For example, you might find focusing on an outside object like a gently ticking clock works better than tuning into the rythm of your breath.
The techniques aren't always as practical for social situations
If someone has a fear of flying it's easy for them to lie back in the plane's chair, close their eyes, and use some breathing techniques to soothe themselves. You can still employ breathing exercises in some social situations, like a group conversation when you're not actively participating. As long as you're quiet about it, no one will really notice you doing them. However, you obviously can't use them everywhere. If you're in the middle of a conversation, and you start to feel nervous, you can't just go, "Hold on a sec" and then close your eyes and spend five minutes imagining yourself on a serene beach.
There's a school of thought that anxiety-reducing exercises can actually sustain anxious feelings over the long term
I cover this idea more in this article on being able to accept and roll with maladaptive thoughts and feelings rather than always trying to fight them off. One view is that by seeing anxious symptoms as things that are terrible and unmanageable, and which must be eliminated at all costs - breathing and relaxation techniques being one method to do this - you're actually giving your anxiety more power to control you. You're also strengthening the thing you want to avoid, by devoting so much mental energy to it (e.g., if I tell you not to think of zebras for the next ten seconds, you won't be able to).
I think it all depends on how you're using any breathing and relaxation exercises. If your overall attitude toward anxiety is healthy (e.g., anxiety is uncomfortable, but it won't kill you, and you shouldn't dramatically constrict your life over it), and you use breathing and relaxation techniques as the occasional spot treatment or as a way to generally relieve stress, that's not going to hurt anyone. However, if your philosophy behind employing them is that feeling nervous is terrible and you'll do anything to eliminate it, then that may be feeding a mentality that ironically keeps it around.