Deep Breathing Exercises

Relaxation

Deep breathing can reduce your anxiety

It only takes a few minutes and it is easy to learn. The main idea is to breathe deeply and slowly from your stomach. Breathing this way will mean you will be less tense, you can breathe easier and you feel less anxious. Once you have learned how it’s done, the next time you feel stressed out, take a minute to slow down and breathe deeply.

Here’s how it’s done:
  • Sit comfortably with your back straight. Put one hand on your stomach.
  • Breathe in slowly through your nose and you should feel your stomach rise up.
  • Hold your breathe for a couple of seconds.
  • Breathe out slowly through your nose, pushing out as much air as you can while contracting your stomach muscles. You should feel your stomach move down.
  • Continue this exercise and count slowly to 3 as you breathe out – your stomach should always move more than your chest. As you get better at deep breathing you might want to count for longer.

If you feel that you are not comfortable sitting up or that you can’t feel your stomach moving then try lying down on the floor – this works just as well and it may help you to relax more.

Symptoms of OCD

What are the symptoms of OCD?

The most common obsessions involve thoughts and fears of contamination, and fears of harm to self or others. Other obsessions include thoughts, images and impulses associated with symmetry and orderliness, illness, religious or moral issues, sexual concerns, and needs to save, collect or remember things. These obsessions can vary from time to time both in nature and severity. Obsessions do not respond to logic, and produce feelings from annoyance and discomfort to acute distress, disgust and panic.

Common compulsions include excessive hand washing, showering, cleaning and checking. Other compulsions include hoarding, repeating routine activities and actions, touching and tapping, applying rigid rules and patterns to the placement of objects, needing to constantly ask or confess, and a range of mental compulsions such as counting and repeating words. The compulsions generally are excessive and ritualised behaviours, involving constant repetitions.

For example, a person with OCD may spend 2-3 hours every day in the shower, and several more hours hand washing, or washing clothes, food and household items. Their anxiety may not only be that they are dirty themselves, but that they may infect others, contaminate foodstuffs and so forth. They may know that further washing is unnecessary, but they cannot stop the feeling of needing to wash and re-wash. Similarly, compulsions to check may involve repeatedly checking light and power switches to ensure that they are off, or checking locks to ensure that they are secure, despite knowing that they had just checked them.

These compulsions and obsessions may take up many hours of a person's day. They can intrude into many routine activities and actions - for example, walking, eating, opening a door and reading may involve complex rituals.

The following OCD Checklist describes common obsessions and compulsions experienced by people with OCD, and includes a short questionaire which you can fill in and take with you when you see your health care professional.

Treatment for OCD

Treatment for OCD

Empirically-validated treatments for obsessive compulsive disorder are available in the form of psychological treatments involving cognitive-behaviour therapy (CBT), and can produce marked improvement that is commonly maintained in the long term. Specific pharmacological treatments may also be helpful, however the effects of medication used on their own are generally maintained only as long as the medications are continued.

Cognitive Behaviour Therapy

Group Therapy

Anxiety Management such as deep breathing exercises

Medication

Support Groups and Education

Self-help for Panic

Simple Techniques

1. Education

Many patients first seek help in a crisis or for incidental reasons often after suffering symptoms for many years. Lack of basic information and irrational beliefs about anxiety are common problems and require education. Detailed explanation of general aspects such as links between physical and mental fitness is vital. More specific information such as the panic cycle, the learned association between panic attacks and agoraphobia and the link between social phobia and physical and cognitive symptoms is also required. Simple information needs to be provided verbally, while reference to useful texts for information and self-help techniques is also recommended (see references).

2. Relaxation Training

Relaxation can be an effective way for patients to demonstrate to themselves that they have control over their symptoms while also helping other cognitive behavioural techniques. One of the simplest ways of achieving some relaxation is through planning enjoyable and relaxing activities and planning breaks in busy routines. Formal training is useful for some and a range of relaxation techniques is available. One of the best approaches is the applied relaxation (AR) method of Ost (1983) which starts with progressive muscular relaxation involving alternating tension and relaxation phases. This method directly teaches discrimination between the two states in order to allow a patient to become more aware of tense body parts. The later stages of AR focus more on slow regular breathing and self instruction to relax, whilst generalising the technique to everyday activities and later anxiety provoking situations. Demonstration of the technique in the sessions (and taping of it) is more effective than provision of pre-recorded tapes. Alternative methods include self-hypnosis, yoga and meditation.

3. Slow Breathing Techniques

This simple technique is of great benefit for those suffering from both generalised anxiety and panic attacks. It is based on the principle that anxiety and hyperventilation are commonly associated both in generalised anxiety (chronic hyperventilation 16 to 20 rpm) and panic attacks (acute hyperventilation 20 to 30 rpm), with recognition that decreasing respiratory rate decreases expired carbon dioxide, returns acid base balance to normal, decreases anxiety symptoms and increases the threshold for panic attacks. The method can be applied both acutely or chronically although is best learned by regular practice over 2 to 3 weeks, 4 times each day. The aim is for 10 respirations per minute (or less) and is achieved by 5 minutes of breathing using a six-second cycle of inspiration and expiration (Page 1993). Breathing should be slow, steady and involve abdominal musculature.

Link to Breathing Workshop information.

4. Pleasurable Activities

It has been well demonstrated that patients with anxiety and depression are no longer active or enjoying life. A simple behavioural approach involves monitoring activities, pleasure and mastery (often with other indices of mood and anxiety) and thereafter actively scheduling pleasurable activities or planning graded task assignment to increase activities and level of enjoyment.

5. Exercise

Similarly increased exercise is known to be associated with decreased anxiety levels, decreased depression and increased pleasure and enjoyment of life. Many patients who describe a recent increase in their anxiety have turned from their previously active lives to low levels of activity and exercise.

6. Supportive Psychotherapy

The standard support and counselling provided by psychiatrists, psychologists and other counsellors is an important adjunct to other CBT treatments.