(Clarice Tang and Karen Liu Western Sydney University)

SYDNEY, Dec 8 (The Conversation) Treatment of people with long COVID, who have experienced symptoms for more than four weeks following a COVID infection, can be extremely complex due to the variety of problems associated with the condition.

This is a condition in which all cannot be treated in the same way. Allied health professionals such as physiotherapists and occupational therapists are gaining importance in providing better treatment to people at different stages of COVID.

We’re still learning about the long Covid, but these experts can recommend exercise training, breathing techniques and ways to safely manage fatigue to help people ease back into their normal roles and routines .

Although the exact mechanism by which people develop chronic COVID is unclear, current evidence suggests that the COVID virus can trigger ongoing inflammation and immune responses in the body.

This results in signs and symptoms in many body systems, including the respiratory system, which controls functions such as heart rate, breathing, and digestion. This can manifest as long-lasting Covid symptoms like brain fog, fatigue, headache, difficulty breathing, and changes in taste and smell.

Estimates suggest that between 5 percent and 50 percent of people infected with COVID develop long COVID.

Allied health professionals – who are not doctors, dentists, nurses or midwives but provide specialized care – such as physiotherapists and occupational therapists can be particularly effective in managing the signs and symptoms of long Covid.

Exercise training is the most common treatment prescribed by physiotherapists to help people with long-term Covid.

Studies have found that exercise programs can help people with chronic COVID overcome fatigue, muscle weakness, shortness of breath.

Pulmonary rehabilitation is an exercise and education program often led by a physiotherapist and designed to help people with lung diseases. Programs like this have proven effective for people with long Covid.

However, not all exercise programs are suitable for all people with chronic COVID. For some people experiencing fatigue, starting with a graded exercise program can also be effective in improving fitness and reducing fatigue levels.

Repetitive range of motion exercises may be performed for joint and/or muscle pain and stiffness, with range of motion exercises prescribed. Other treatments such as fall prevention, muscle strengthening and balance training are also suitable for people with reduced mobility due to prolonged COVID.

It is important to consult a physiotherapist before starting exercise as over exertion can hinder your recovery. A thorough assessment of your heart function and symptoms of fatigue before exercise — and close monitoring during exercise — is essential because symptoms can fluctuate over time.

In addition to prescribing an exercise program, physiotherapists can provide strategies on how to manage shortness of breath, which is a common symptom of prolonged COVID.

People with prolonged COVID may also feel a constant need to cough or clear their chest. Active chakra breathing techniques such as the secretion evacuation technique may be useful for such people.

Respiratory muscle training involves specific exercises designed to strengthen the muscles of the respiratory system. This often involves taking deep breaths through a device that provides resistance.

This form of training has long been shown to be useful for some people with Covid, but not for all sufferers.

It is important to consult a physiotherapist about this along with your symptoms, as for people with prolonged Covid, treatments that suit the individual’s symptoms work best.

As well as rehabilitation exercises, physiotherapists and occupational therapists can provide personalized strategies to manage both symptoms and increase participation in work and daily life for people with prolonged COVID.

For example, they may develop strategies to enhance or compensate for poor attention and memory, or to deal with fatigue and help plan daily routines so that people can re-engage in their normal roles and routines. .

Other health professionals may also provide individualized treatments to help address deficiencies in the body. Psychologists can offer non-drug treatments to improve anxiety and depression. Speech pathologists can help someone whose voice has become hoarse.

If you are experiencing chronic COVID, ask your doctor to refer you to a multidisciplinary chronic COVID program, where different types of health professionals work together.

While long Covid symptoms can be distressing, it appears that many symptoms improve over time. You may recover more quickly with the help of a physiotherapist or occupational therapist.

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“Box breathing is a form of yogic deep breathing employed by the United States Navy SEALs and by stressed-out people everywhere,” according to the Cleveland Clinic, one of the top hospitals in the country. “It’s also known as sama vritti pranayama, born of the yogic practice of pranayama, or focusing on the breath.”

Here are the simple steps you can follow and the health benefits you may notice when you try box breathing.

How to Do Box Breathing

The name box breathing comes from the four steps—like a square. Each step takes 4 seconds:

  1. Breathe in through your nose.
  2. Hold your breath.
  3. Breathe out through your mouth.
  4. Hold your breath.

Repeat each step at least three times. If the technique is too challenging, try doing each step for 3 seconds. Once comfortable, increase the number of sets or the time you spend on each step.

The box breathing technique is versatile, as you can do it while standing, sitting, or lying down. The location is also up to you.

“You can practice it at work, at home, in public, or in a stressful situation,” according to WebMD. “However, you don’t have to practice box breathing only when you are stressed. You can do it to calm your mind and body, allowing yourself to reset and stay fresh.”

Active young woman taking a break after working out at home, sitting on exercise mat taking a deep breath with her eyes closed. Sports and exercise routine. Health, fitness and wellness concept

Photo – Getty Images

Tips for Practicing Box Breathing

  • Find a quiet space with minimal distractions. Put on headphones or earplugs to soften or eliminate any background noise. Alternatively, play calming music without lyrics, which has the added benefit of providing a rhythm you can use when counting.
  • Start alone or in a room with familiar people. Otherwise, you may feel self-conscious about being around strangers and focus on them instead of yourself.
  • Place your hands on your chest and stomach to feel the movement of your breath in your diaphragm. This will also help you visualize your breathing.
  • Relax your muscles instead of using them to push air. This should help you stay calm.

Because focused breathwork is a skill, regularly practicing will make it easier to lean on box breathing when you need to cope with panic or stress.

“Counting helps to take the focus from the panic-producing situation, enabling you to handle and control your response,” according to WebMD.

Health Benefits of Box Breathing

Breathing exercises can lower your stress levels and feelings of depression and anxiety, according to research published in Frontiers in Psychology. When you are stressed, your body goes into a fight-or-flight state that can increase your heart and breathing rates. A conscious breathing exercise can revert your body to a resting state.

Additionally, breathing exercises can help you pay attention longer than usual, improve your memory, and boost your mood, according to a study by researchers at the University of Wisconsin.

Beyond the stress of daily life, breathing exercises may help if you have post-traumatic stress disorder, according to research published in the Journal of Investigative Medicine.

Focused breathing also has physical benefits. For example, it can reduce inflammation, according to research published in BMC Complementary and Alternative Medicine. Some athletes have even started to work mindful breathing into their training. You don’t have to be an athlete to benefit from this effect, though—if you have arthritis, you can add box breathing into your routine.

You also may be able to lower your blood pressure with box breathing, according to research published in the JBI Database of Systematic Reviews and Implementation Reports.

Incorporate a routine of daily box breathing, and you may begin to notice a decrease in your stress levels and blood pressure and boost your overall well-being.

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The HumanWisdom app unlocks the wisdom within for stress-free living

“HumanWisdom – Find joy in life”

Life is full of stress & anxiety at seemingly every corner. While we often look to others for assistance, the power to find a solution lies much closer. In fact, it lies right within us. We already have the wisdom we need to overcome the challenges we face. The HumanWisdom app can help you access your own wisdom through a simple guided process of self-discovery and understanding, and this wisdom can be life-changing.

According to the charity MIND, about 1 in 4 people in Britain will experience a mental health problem every year. Moreover, 1 in 6 people in England report experiencing a mental health problem, including depression and anxiety every week. This diminishes their enjoyment of life, and also affects those they interact with. A simple modern solution, based on self-awareness, could turn this around.

The HumanWisdom app helps users deal with the challenge of stress and anxiety through a guided program that includes breathing exercises, meditations, and easy to implement tips. It then takes users deeper to understand the root cause of their stress for long-term benefit. By changing how we perceive and react to external challenges we can alter how we feel. This deeper understanding can prevent problems arising in the first place.

The app helps users learn new skills which can contribute to their success in the world – communication and relationship skills, empathy, courage, integrity, and a positive attitude. All these skills are essential for the workplace.

Thriving in life is all about learning to control your emotions rather than the other way around. The HumanWisdom app enables users to nurture their self-awareness to understand and manage their emotions – this can help their relationships and boost their emotional intelligence, which also contributes to their success in the world. In its entirety, the app tackles common challenges that disrupt our balance at work and at home. It is a daily companion that users can dip into to deal with the challenges they face, and also go on a journey of learning about themselves. This leads to wisdom which can be life-changing and help us live in peace, with ourselves, others, and the earth.


  • Listen to podcasts: Global conversations which inspire and offer fresh ways of dealing with life’s challenges.

  • Read a story or a blog: Real-life stories where wisdom was used to overcome a challenge or read a blog to explore a fresh perspective.

  • Watch motivational videos: Get the extra push you need with a range of motivational videos 

  • Meditations: A wide range of audio meditations to help deal with life’s challenges and grow to be the best version of yourself

  • An online journal with guided questions: Your own journal to jot down your thoughts, and explore a set of guided questions, like a coach in your pocket

  • Check your wisdom score: Answer a set of 10 questions to calculate your wisdom score, and track your progress through the app

  • Share your thoughts on the forum: Join a community of users and ask questions or share your thoughts with them

Android Device Requirements: 

* Requires Android 3.0 and above

iOS Device Requirements: 

* Requires iOS 11.0 or later

Pricing and availability: 

The Human Wisdom app is presently available for Android devices on the Google Play Store and for iOS devices as well on the App Store. Users can download and use the app for free, although there is an option to unlock access to premium content through a subscription.

Human Wisdom

Download from Google Play

Download from App Store

App Demo Video

App Icon


The Human Wisdom app is a wellness initiative that seeks to help us discover and rediscover our true potential through the power of innate wisdom. Like a gym provides regular workouts for the body, the app provides and builds strong wellness habits for the mind. It enables users to better deal with stress, anxiety, and other shortcomings that come with being human. In many ways, it is the app that leads everyone to their own definition of happiness.

Media Contact
Company Name: The HumanWisdom Project
Contact Person: Dr. Manoj Krishna
Email: Send Email
City: Yarm
Country: United Kingdom
Website: www.humanwisdom.me

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Puff Point of Healthy Breath
7 Tips for Healthy Breathing

Acıbadem Dr. Sinasi Can (Kadıköy) Hospital Ear, Nose and Throat Diseases Specialist Dr. Ecem Sevim Akı explained the benefits of healthy breathing and 7 tricks, gave warnings and suggestions.

It contributes to the strengthening of immunity, improves sleep quality, and regulates blood pressure… Breathing, which is one of the sine qua non for sustaining life, also plays an important role in the proper and healthy functioning of many systems in our body. Studies show that healthy breathing has positive effects on human health, while also increasing the quality of life.

Puff Point of Healthy Breath

Dr. Ecem Sevim Akı stated that there are many causes of nasal congestion, from upper respiratory tract diseases such as flu and cold to allergies, from bone or cartilage curvature in the nose to tumors, and said, “The problem in any of the respiratory structures prevents healthy and correct breathing. Nasal congestion is the most common example of this. Nasal congestion is a common problem in our country. Today, one out of every 3 people cannot breathe properly due to nasal congestion. The most important cause of temporary nasal obstructions is upper respiratory tract infections, and such problems are common, especially in the winter season.

ENT Specialist Dr. Ecem Sevim Akı says that both children and adults experience nasal congestion problems due to structural factors, and says:

“Anatomical stenosis, that is, cartilage/bone curvature, nasal concha enlargement and intranasal masses narrow the air passage and require treatment. Air from the nose reaches the lungs after passing through the pharynx and trachea. In the pathologies located here and narrowing the passage, the air is prevented from reaching the lungs and causes respiratory problems. In addition, some nervous system diseases or muscle diseases indirectly make breathing difficult. Diseases that reduce lung capacity prevent enough air from filling the lungs. It should not be forgotten that obesity, smoking and low humidity of the environment can have negative effects on breathing.

Puff Point of Healthy Breath

Emphasizing that healthy breathing is of great importance for both our physiological and mental health, Dr. Ecem Sevim Akı “In addition to smelling, the nose also plays an active role in heating, humidifying and filtering harmful particles. In addition, the turbulence of the air in the nose allows higher air to reach the lungs. A healthy breath; It lowers the heart rate and regulates blood pressure, helps the excretion of toxins, ensures the proper functioning of the nervous system and hormones, facilitates digestion by increasing stomach and intestinal activity, improves sleep quality, helps immunity by increasing cell renewal and efficiency, and facilitates coping with stress.

ENT Specialist Dr. Ecem Sevim Akı pointed out that breathing through the mouth rather than the nose can cause serious problems and said, “In people who breathe through the mouth, breathing accelerates and the number of breaths per minute increases. Rapid and inadequate breathing reduces oxygenation in the blood and increases the workload of the heart and lungs. This causes headache, changes in heart rhythm and blood pressure, and increases the level of anxiety. On the other hand, people who breathe through the mouth frequently have respiratory tract infections, and dry mouth and bad breath are encountered. In addition, it is seen that gingival diseases have increased significantly.

Puff Point of Healthy Breath

Stating that many people in our country do not breathe properly although they do not have a physiological problem, ENT Specialist Dr. Ecem Sevim Aki lists the tricks of correct and healthy breathing as follows:

  • “For a healthy and correct breathing, the diaphragm is used.
  • Breathe through the nose and care should be taken to keep the mouth closed.
  • While breathing, the shoulders should not be raised and care should be taken to keep them low.
  • Breathing should be taken as needed, not taking a more shallow and deeper breath than normal.
  • After inhaling, placing one hand on your chest and one hand on your abdomen will help you understand how you breathe.
  • It should be noticed that the abdominal region, not the rib cage, expands outward during diaphragmatic breathing, and it should be noted that it is pulled inward when exhaling.
  • In order to ensure adequate oxygenation in the posterior region of the nose, the breath should be given through the nose.

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According to experts, ashwagandha works in blocking the stress pathway in the brains of rats. It has been particularly found to work by regulating chemical signaling in the nervous system.

(Newswire.net -- December 8, 2022) Orlando, FL -- Stress and anxiety are normal occurrences, but when they get chronic they can be harmful. 

According to experts, when stress and anxiety start interfering with one’s daily functions and performance it could result in a serious issue. It is strongly recommended to seek help when there are also irrational fears, severe anxiety, and constant worrying.

It is worth noting that there are physical symptoms of stress and anxiety. These include headache, rapid breathing, stomachache, rapid breathing, muscle tension, dizziness, shaking, sweating, frequent urination, and rapid heartbeat.

Some experts recommend learning about the common culprits of stress and avoiding them. The common stressors are starting a new school or job, moving, having a medical condition, illness, or death.

In the United States, there are an estimated 40 million individuals who live with some type of anxiety disorder. 

Generalized anxiety disorder (GAD) is the type characterized by uncontrollable worrying. Panic disorder, on the other hand, leads in panic attacks. 

There are steps found to be helpful against stress and anxiety, such as having a balanced and healthy diet. It is worth realizing that certain foods are scientifically found to work wonders in battling with these conditions. 

When it comes to fighting anxiety and stress, experts have been strongly recommending the use of medicinal herbs like ashwagandha. Various research studies have revealed that the use of this medicinal herb produces various health benefits. 

According to experts, ashwagandha works in blocking the stress pathway in the brains of rats. It has been particularly found to work by regulating chemical signaling in the nervous system. 

Some human-controlled studies have suggested that the use of this remedy has resulted in reductions in the symptoms suffered by individuals with anxiety disorders and stress. In addition to these benefits, ashwagandha is also popularized by the healing agents it contains. 

Diseases are undeniably widespread nowadays, and this is why more and more experts are looking into ways to help people combat these ailments. 

It is worth noting that in some research studies, the use of all-natural remedies has been time and again found to be useful in battling diseases. It is important to realize that the use of these plant-based ingredients could significantly help combat these conditions. 

There are many research studies recommending that this natural healing ingredient offers a myriad of healing effects.

To benefit from the healing goodness of this remedy, it is wise to take into account using formulas like Divine Bounty Ashwagandha (amazon.com/Organic-Ashwagandha-Capsules-Absorption-Ashwaganda/dp/B072KFLL6X).

About Divine Bounty

Divine Bounty is a family-owned brand that manufactures high-quality turmeric curcumin supplements. Passionate about the potential health benefits of turmeric, the team behind Divine Bounty has carefully researched and sourced only the best ingredients to create the ideal blend of turmeric curcumin. More details are available at www.DivineBounty.com.

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We will also discuss the importance of setting realistic goals and expectations when beginning a meditation practice.

What is the meaning of meditation?

Meditation is an ancient practice that has been used to help individuals find inner peace, cultivate mindfulness, and gain insight. It is a powerful tool for personal development, physical wellness, mental clarity, and emotional wellbeing. This guide will provide an overview of the various types of meditation practices available today and provide practical tips on how to start meditating. We will also discuss the importance of setting realistic goals and expectations when beginning a meditation practice.

The Types of Meditation:

There are many different types of meditation practices available. They range from simple breathing exercises to more complex mindfulness techniques. Each type of meditation can have different benefits depending on what you are looking to achieve from your practice.

Here is a brief overview of some common forms of meditation:

  • Mindfulness Meditation: This type of meditation focuses on becoming aware of your thoughts and feelings in the present moment. It encourages you to simply observe your experience without judgment or attachment.
  • Loving-Kindness Meditation: This type of meditation is focused on cultivating compassion and kindness towards yourself and others. It can help you to cultivate a sense of connection with others and promote positive emotions such as joy, love, and peace.
  • Breath Awareness Meditation: This practice involves focusing your attention on your breath as it moves in and out of the body. It can be used to calm the mind and reduce stress levels.
  • Visualization Meditation: This type of meditation involves creating mental images in order to bring about physical relaxation or emotional healing. It is often used to help people achieve personal goals or improve their self-image.

Starting Your Practice:

Now that you know the different types of meditation available, it’s time to start your practice! Here are some tips on getting started:

  • Find a comfortable place to sit or lie down in and focus on your breathing.
  • Set realistic goals for yourself and don’t expect immediate results. Remember that it takes time and patience to master any skill.
  • Start small try meditating for 5 minutes each day and gradually increase the duration as you become more comfortable with the practice.
  • If your mind starts wandering, gently bring your attention back to your breath without judgment.
  • Don’t be discouraged if your practice doesn’t go as you had hoped simply start again the next day.

We all experience moments of doubt and fear when we feel overwhelmed by life’s demands or uncertain about our future. These times can be difficult to manage, but meditation can help us find balance and harmony within ourselves so that we can find clarity in even the most chaotic situations.

This guide will provide some tips on how to get started with meditation, techniques to use, and the benefits you can expect from this practice.

Getting Started:

The first step to beginning a meditation practice is to find a comfortable space where you won’t be disrupted by outside noise or distractions. You don’t need any props or special tools just yourself, your breath, and an open mind. Once settled in your space, it’s time to start breathing deeply and slowly. Focus on each inhalation and exhalation of your breath, allowing yourself to relax into the present moment.


There are several different techniques that can be used in meditation, depending on your individual needs and preferences. One common technique is mindful meditation, which involves paying attention to the present moment without judgment or expectation. This can be helpful in learning to accept yourself and your circumstances without trying to change anything. Other techniques include visualizations, mantras, body scans, and guided meditations. Learn short stories online to get knowledge.


The benefits of meditation are vast, from improved emotional wellbeing to better mental clarity. It has been shown to reduce stress levels, increase focus and concentration, and even improve physical health by lowering blood pressure and reducing chronic pain. Meditation also helps us become more mindful of our thoughts and actions so we can make wiser decisions that come from a place of peace rather than fear or anxiety.


Meditation is a powerful practice for unlocking our inner potential and finding peace amidst life’s chaos. It can be used as a tool for improving mental and emotional wellbeing, reducing stress levels, and finding clarity in our lives. By taking the time to learn different techniques and getting started with a practice of your own, you can begin to experience the many benefits that meditation has to offer. Good luck on your journey!

Press Release Distributed by The Express Wire

To view the original version on The Express Wire visit Unlocking the Meaning of Meditation: A Guide to Finding Inner Peace

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Long-term management of people with COVID — that is, symptoms that persist beyond four weeks after COVID infection — can be extremely complex due to the wide variety of problems associated with the condition.

While there is no ‘one size fits all’ treatment, it is increasingly recognized that allied health professionals, such as physiotherapists and occupational therapists, are important in treating people in different stages of COVID.

We’re still learning about long COVID, but these experts can adapt exercise training, breathing techniques, and ways to safely manage fatigue to help people get back to their normal roles and routines.

Long COVID and the body

While the exact mechanism why people develop long-term COVID remains unclear, current evidence suggests that the persistent COVID virus may trigger a cascade of sustained inflammatory and immune responses in the body.

This results in signs and symptoms in multiple body systems, including the respiratory and autonomic systems, which control functions such as heart rate, breathing, and digestion. This could explain common symptoms of long-term COVID, such as brain fog, fatigue, headaches, difficulty breathing, and changes in taste and smell.

Estimates suggest that anywhere from 5 to 50 percent of those infected with COVID develop long-term COVID.

Allied health professionals — who are not doctors, dentists, nurses or midwives but provide specialized care — such as physical therapists and occupational therapists can be particularly effective in managing the signs and symptoms of long-term COVID.

This may be in part because they are used to working with patients to develop strategies and work towards functional goals.

Practice training

Exercise training is the most common treatment prescribed by physiotherapists to help people with long-term COVID. Studies have shown that exercise programs can help people with long-term COVID reverse the effects of fatigue, muscle weakness, shortness of breath and exercise intolerance.

Pulmonary rehabilitation is an exercise and education program often led by a physical therapist and designed to help people with persistent lung disease. Such programs have been shown to be effective for people with long-term COVID.

However, not all exercise programs are suitable for everyone with a long COVID. For some people with ongoing fatigue issues, starting a graded exercise program that progresses through a variety of poses can also be effective in improving exercise fitness and reducing fatigue levels.

Repetitive range-of-motion exercises such as range-of-motion exercises may be prescribed for joint and/or muscle pain and stiffness. Other therapies such as fall prevention, muscle strengthening and balance training are also suitable for people with reduced mobility, deconditioning and muscle wasting due to long-term COVID.

It is important to seek advice from a physiotherapist before starting any exercise, as overexertion can hinder your recovery. Thorough assessment of your heart function and fatigue symptoms before returning to exercise — and close monitoring during exercise — are essential because symptoms can fluctuate over time.

Breathing techniques and inspiratory muscle training

In addition to prescribing an exercise program, physical therapists can provide strategies for managing shortness of breath, a common symptom of long-term COVID. For example, physical therapists often teach people how to practice relaxed controlled breathing to recover from episodes of shortness of breath.

People with long COVID may also feel the persistent need to cough or empty their chest. Secretion clearance techniques such as the active cycle breathing technique may be helpful.

Inspiratory muscle training includes specific exercises prescribed to strengthen the respiratory (respiratory) muscles. This often involves taking a deep breath through a device that provides resistance.

This form of training has proven helpful for some people with long-term COVID, but is not beneficial for all patients.

It is important to consult a physiotherapist about the best breathing technique for your symptoms, as therapies for people with long-term COVID work best when they are tailored to the person.

Breathing exercises should be closely monitored as they are not helpful for everyone with a long COVID. Photo: Getty

Fatigue management and other treatments

In addition to rehabilitation exercises, both physiotherapists and occupational therapists can provide personalized strategies to manage symptoms and improve participation in work and daily life for people with long-term COVID.

For example, they can develop strategies to improve or compensate for poor attention and memory, or help plan a daily routine to cope with fatigue so that people can resume their usual roles and routines.

Other health professionals can also provide individualized treatment to help with recovery. Psychologists can offer non-drug treatments to improve anxiety and depression. Speech pathologists can help someone who has a persistent hoarse voice.

Functional goals and strategies can help people with long-term COVID return to their usual routines. Photo: Getty

How do you get help for long COVID?

If you have long-term COVID, ask your doctor to refer you to a multidisciplinary long-COVID program where different types of health professionals work together, or specific health professionals depending on your symptoms.

Multidisciplinary programs have been shown to be most effective in treating people with long-term COVID. In Australia, there are some long COVID clinics that provide monitoring and treatment. However, there is an urgent need to establish more of them across the country.

While long-term COVID symptoms can be debilitating, many symptoms appear to improve with time. That said, you may be able to recover more quickly with the help of a physical therapist or occupational therapist.


Clarice Tang, Senior Lecturer in Physiotherapy, Western Sydney University, Karen Liu, professor of occupational therapy, Western Sydney University, Curry SalibaUniversity of Western Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Treating people for long COVID – that is, symptoms that last longer than four weeks after COVID infection – can be extremely complex due to the wide variety of problems associated with the condition.

While there is no “one size fits all” treatment, there is increasing recognition of the importance of allied health professionals such as physiotherapists and occupational therapists in providing treatment for people throughout various stages of COVID.

We are still learning about long COVID, but these experts can tailor exercise training, breathing techniques and ways to manage fatigue safely, to help people get back to their normal roles and routines.

Read more:
Long COVID should make us rethink disability – and the way we offer support to those with 'invisible conditions'

Long COVID and the body

While the exact mechanism of why people develop long COVID remains unclear, current evidence suggest lingering COVID virus may trigger a cascade of ongoing inflammatory and immune responses in the body.

This results in signs and symptoms across multiple body systems, including the respiratory and autonomic system, which regulates functions such as heart rate, breathing and digestion. This could explain common symptoms of long COVID such as brain fog, fatigue, headaches, breathing difficulties and changes in taste and smell.

Estimates suggest somewhere between 5% and 50% of those infected with COVID go on to develop long COVID.

Read more:
When does COVID become long COVID? And what's happening in the body when symptoms persist? Here's what we've learnt so far

Allied health professionals – who are not doctors, dentists, nurses or midwives but provide specialised care – such as physiotherapists and occupational therapists can be particularly effective at managing the signs and symptoms of long COVID.

This might be partly because they are used to working with patients to develop strategies and work towards functional goals.

Exercise training

Exercise training is the most common treatment prescribed by physiotherapists to assist people with long COVID. Studies have found exercise programs can help people with long COVID to reverse the effects of fatigue, muscle weakness, shortness of breath and exercise intolerance.

Pulmonary rehabilitation is an exercise and education program often led by physiotherapist and designed to help people with ongoing lung diseases. Such programs have been shown to be effective for people with long COVID.

However, not all exercise programs are suitable for everyone with long COVID. For some people with ongoing fatigue issues, commencing with a graded exercise program that progresses through different positions can also be effective in improving exercise fitness and reducing levels of fatigue.

Repetitive movement exercises such as range of motion exercises may be prescribed for joint and/or muscle pain and stiffness. Other therapies such as falls prevention, muscle strengthening and balance training are also suitable for people with reduced mobility, deconditioning and muscle wastage due to long COVID.

It is important to seek advice from a physiotherapist before commencing exercises as over-exertion can set your recovery back. Thorough assessment of your heart function and fatigue symptoms before returning to exercise – and close monitoring during exercise – are essential because symptoms can fluctuate over time.

Read more:
Regaining fitness after COVID infection can be hard. Here are 5 things to keep in mind before you start exercising again

Breathing techniques and inspiratory muscle training

Apart from prescribing an exercise program, physiotherapists can provide strategies on how to manage shortness of breath, a common symptom of long COVID. For example, physiotherapists often teach people how to do relaxed controlled breathing to recover from episodes of breathlessness.

People with long COVID may also feel the ongoing need to cough or clear their chest. Secretion clearance techniques such as active cycle breathing technique can be useful.

Inspiratory muscle training involves specific exercises prescribed to strengthen respiratory (breathing) muscles. This often involves taking deep breathes through a device that provides resistance.

This form of training has proven useful to some people with long COVID, but is not beneficial to all sufferers.

It is important to consult a physiotherapist regarding the best breathing technique for your symptoms, as therapies for people with long COVID work best when they are tailored to the person.

woman blows into respiratory equipment

Breathing exercises should be closely monitored, as they are not helpful for everyone with long COVID.

Fatigue management and other treatments

As well as rehabilitation exercises, both physiotherapists and occupational therapists can provide personalised strategies to manage symptoms and enhance participation in work and daily life for people with long COVID.

For example, they might develop strategies to enhance or compensate for poor attention and memory, or help plan a daily routine to deal with fatigue so people can re-engage in their usual roles and routines.

Other health professionals can also provide individualised treatment to assist with recovery. Psychologists may offer non-drug treatments to improve anxiety and depression. Speech pathologists may help someone who has an ongoing hoarse voice.

man lies on couch

Functional goals and strategies might help people with long COVID get back to their usual routines.

How to get help for long COVID?

If you have long COVID, ask your doctor to refer you either to a multidisciplinary long COVID program where different types of health professionals work together, or to specific health professionals depending on your symptoms.

Multidisciplinary based programs have been found to be the most effective in managing people with long COVID. In Australia, there are some long COVID clinics providing monitoring and treatment. However, there is an urgent need to establish more of them across the nation.

While long COVID symptoms can be debilitating, it appears many symptoms improve with time. That said, you may be able to recover more quickly with the help of a physiotherapist or an occupational therapist.

The authors wish to acknowledge the contribution of Kerrie Saliba, who is a senior physiotherapist in the intensive care unit at Liverpool Hospital, South Western Sydney Local Health District and a Western Sydney University masters student, to this article.

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Having had asthma since I was a small child, I know a thing or two about breathing problems. For years now mine has been controlled, and I can't remember the last time I had to use a rescue inhaler. However, recently, from seemingly out of nowhere, I started having more forced breathing and wheezing. This prompted me to make an appointment with a doctor buddy of mine.

My immediate thought was allergies. After all, airborne allergies are one of the most powerful triggers for wheezing and labored breathing. I've had all the allergy tests you could imagine, even consulting with specialists. After being thoroughly checked over, my doctor friend turns and tells me my wheezing may not be related to airborne allergens at all but some of the food I eat.

This is something I hadn't thought of but made sense being that I had to recently change up my diet. Take it from me and my asthma, your lungs are vital. Protect them at all costs. Wise Thoughts sought out five different foods that may trigger breathing problems. Asthma or not, breathing issues are something nobody needs. Let's get you in the know and look at these potential trigger foods.


Fresh Baked Bread

Photo: Greg Miller/Getty Images


Foods like pasta and white rice are also included here. These foods produce higher carbon dioxide when metabolized - not beneficial for your lungs. They also tend to aggravate phlegm production resulting in difficulty breathing.


Fresh broccoli isolated on white background

Photo: Azure-Dragon/Getty Images


Though vegetables have nutrients and vitamins that are good for you, they can sometimes cause breathing problems. The problem is these kinds of vegetables cause bloating and gas which can result in respiratory issues. If you're feeling wheezy, try limiting vegetables like cauliflower, cabbage, and broccoli.


Photo: xfotostudio/Getty Images

Photo: xfotostudio/Getty Images

Alcohol and Wine

Be cautious of red wine. Wine contains sulfates that are not good for the lungs and can trigger asthma attacks. Party responsibly. Drinking excessive alcohol can also affect your breathing.


potato chips snack in foil bag

Photo: Kwangmoozaa/Getty Images


With all the salt and saturated fat, processed foods are among the culprits that can trigger breathing issues. Excessive salt intake can cause water retention in the body, resulting in fluid leaking into your lungs and making breathing difficult and painful.


Homemade Dark Chocolate Ice Cream Cone

Photo: bhofack2/Getty Images

Ice Cream/Dairy

These foods produce more mucus in the respiratory tract that can cause breathing complications. If you encounter any kind of stuffy nose, sinus infection, or other congestive symptoms, limit your intake.

So, if you're dealing with wheezing the breathing issues, it may be as simple as analyzing your diet. Once you've narrowed down the culprit, you may also consider asking your doctor if you might be allergic to that food.

On the other hand, there are foods that are very beneficial to the body. They can even help with stress. Look below to check out these superfoods.

LOOK: These Food Items May Calm Stress, Anxiety, and Depression

These foods are said to help calm and possibly eliminate stress, anxiety, and depression.

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Stress is defined as the body’s response to a perceived threat or challenge. Everyone experiences stress and knows it can be difficult to manage. Stress can negatively impact your health. Chronic stress is especially harmful to your quality of life and overall well-being. Stress can lead to physical symptoms, such as gastrointestinal issues, as well as mental symptoms, such as depression and brain fog. 

This article discusses how stress can make your mind and body sick, as well as ways to cope.

Jay Yuno / Getty Images

Stress, Sickness, and Different Aspects of Health

When we are faced with a stressor (any source of stress, whether internal or external), our body is prompted to produce more stress hormones. 

For example, cortisol—a hormone made in the adrenal glands—plays a role in our body’s stress response. Meanwhile, adrenaline controls our fight-or-flight response, raising heart rate and increasing blood pressure. Long-term, exposure to excess cortisol and other stress hormones can affect our physical, mental, and cognitive health.

Physical Effects of Stress

When your body releases stress hormones, it starts working harder to avoid (or fight off) the perceived danger. Cortisol prompts your body to release more glucose, (blood sugar) while adrenaline makes your heart beat faster and increases your blood pressure. 

This process can lead to several physical symptoms of stress, including:

  • Muscle pain: When faced with stress, we instinctively go on guard, which makes our body tense up. This tension may lead to chronic muscle pain, often in the lower back, neck, and shoulders. 
  • Headache: Stress-related tension in the neck, head, jaw, and shoulders can trigger headaches, including migraines.
  • Shortness of breath: The airways in our lungs constrict when we’re stressed, which makes us breathe more rapidly and less deeply. Stress sometimes triggers asthma attacks in people with asthma or allergies.
  • Gastrointestinal issues: The brain-gut connection refers to the many communication pathways between the nervous system and the neurons in the gut. Stress-related changes in gut bacteria may cause a host of gastrointestinal problems, from diarrhea and constipation to nausea, vomiting, bloating, and stomach pain.
  • Insomnia: Extreme and/or chronic stress can cause dysfunction in the hypothalamus-pituitary-adrenal (HPA) axis, a system responsible for regulating our physical stress response. Overactivation of the HPA axis can cause various problems with sleep, such as poor sleep quality, insomnia, and frequent sleep disturbances.

Emotional Effects of Stress

Stress also impacts your emotional well-being and mental health. The emotional effects of stress may include:

  • Anxiety: Stress can trigger or worsen anxiety, which involves overwhelming feelings of dread, fear, and apprehension. Even if the source of your stress goes away, you may continue to experience anxiety.
  • Irritability and anger: Stress activates the sympathetic nervous system (SNS)—the system of muscles, nerves, and glands that enhances the fight-or-flight—and the HPA axis, both of which can also affect your experience of emotions like irritability, anger, and fear. Research suggests that there’s a strong association between stress and anger, especially among men. 
  • Relationship issues: Studies have found that stressed-out couples are more likely to fight regularly, to be dissatisfied with their relationships, and to be verbally or physically aggressive with each other. Chronic stress may also make you feel isolated and withdrawn, leading you to opt out of social events and family gatherings.

Cognitive Effects of Stress

When you’re stressed, your brain doesn’t have as many resources to devote to other processes, such as thinking, planning, and focusing. Here are some of the cognitive effects of stress:

  • Brain fog: Brain fog refers to various cognitive issues, including difficulty concentration, lowered attention span, slower thinking processes, and inability to multitask. Research indicates that brain fog may be caused by neuroinflammation (inflammation in the brain and/or spinal cord). Stress can trigger chronic low-grade inflammation throughout the brain and body, leading some researchers to link stress to brain fog symptoms. 
  • Impaired memory: Possibly due to the body’s inflammatory response and stress-induced changes in the brain, stress can also affect our short- and long-term memory, as well as our ability to form new memories and learn new information. 
  • Decreased problem-solving skills: Acute and chronic stress have been linked to decreased problem-solving and planning skills. This may be because we tend to eat a less nutritious diet and sleep less soundly when we’re stressed.

The Effects of Chronic Stress

If left untreated, chronic stress can lead to, or increase your risk for, serious health problems. including:

  • Heart disease: Over time, the release of stress hormones can raise your risk for several different cardiovascular issues, such as hypertension (high blood pressure), high cholesterol, heart disease, heart attack, and stroke. 
  • Sex and fertility issues: Chronic stress can cause hormone imbalances, such as low testosterone, that can lead to various sexual and reproductive health concerns. These may include erectile dysfunction (ED), low libido, infertility, severe premenstrual syndrome (PMS), and irregular menstrual cycles. 
  • Autoimmune disorders: Due to stress hormone exposure and inflammation, chronic stress may increase your chance of developing an autoimmune disorder. Studies have found that stress is associated with the onset and severity of autoimmune disorders like rheumatoid arthritis (RA), multiple sclerosis (MS), Graves’ disease, and more. 
  • Depression: Stress prompts the release of cytokines—proteins that are involved in the body’s inflammatory response. Research suggests that pro-inflammatory cytokines may play a role in the development of depression and other mental health conditions. 
  • Diabetes: Research indicates that chronic stress can increase your risk of type 2 diabetes. This may be because of the release of cortisol, which increases your blood sugar.
  • Alzheimer’s disease: Over time, chronic stress can alter your brain activity and cognitive function, increasing the chance of developing various neurodegenerative diseases, including Alzheimer’s disease. 
  • Cancer: Chronic stress may promote the growth of malignant (cancerous) tumors. According to recent research, this is likely due to the over-activation of the HPA axis and the sympathetic nervous system.

Ideal Ways to Cope With Stress

There are many effective ways to cope with stress and prevent potential stress-related health problems, including:

  • Cutting back on work: Cutting back on unnecessary tasks can be a significant first step to lowering your stress level. Try to lighten your workload if possible, or ask for help with household chores and childcare. 
  • Relaxation and mindfulness techniques: Mindfulness practices and relaxation techniques—such as meditation, yoga, and deep breathing exercises—have been shown to help to reduce stress and anxiety levels. They can also help lower blood pressure and improve sleep, reducing the risk of stress-related health complications. 
  • Peer support groups: Social support can go a long way in relieving day-to-day stress. There are plenty of online and in-person peer groups where you can find support and enjoy positive activities together.
  • Exercising regularly: You might not feel like exercising when stressed. However, getting enough physical activity can help you clear your mind, boost your mood and reduce physical health risks. 
  • Improving sleep quality: Better sleep can help to improve your physical health, cognitive function, and emotional well-being. Create a sleep routine that helps you get the rest you need to stay healthy. You can start by going to sleep each night consistently and shutting off your phone, computer, and TV at least an hour before bedtime. 
  • Journaling: Keeping a journal can be a great stress relief. Try writing down several things you’re grateful for each day or reflecting on positive memories. 
  • Limiting alcohol and tobacco intake: When stressed, it can be tempting to self-medicate with alcohol and other drugs. Limiting your intake of alcohol, tobacco, and other drugs – as well as unhealthy foods, caffeine, and sugary drinks – can help to reduce inflammation and improve sleep quality. 

If you’re having trouble dealing with stress, talk to your healthcare provider.

Psychotherapy, such as cognitive-behavioral therapy (CBT), may help you develop better coping strategies and problem-solving skills. Your healthcare provider may also recommend biofeedback, a therapy that can help you learn to relax your muscles, lower your heart rate, and lower blood pressure. Anti-anxiety medications can relieve some of your symptoms.


Stress is your physical and/or psychological reaction to any potentially difficult event, condition, or environment. When you’re stressed, your body releases stress hormones, such as cortisol and adrenaline, that prompt your fight-or-flight response. Over time, exposure to these stress hormones can affect your physical, emotional, and cognitive well-being.

You can cope with stress by joining a peer support group, reducing your workload, practicing relaxation techniques, or cutting back on alcohol and caffeine. Psychotherapy and anti-anxiety medications may help if you have difficulty dealing with stress on your own.

A Word from Verywell

Both short-term and chronic stress can affect your physical, emotional, and social well-being. If you’re dealing with the health effects of extreme stress, talk to a healthcare provider about potential coping strategies and treatment options.

Frequently Asked Questions

  • How do you tell anxiety apart from stress?

    Stress is your response to challenging internal or external forces, environments, events, or situations. Sometimes, you may experience temporary anxiety—overwhelming worries or fears—as a response to stress. If your anxiety continues or gets worse even when your source of stress goes away, you may have an anxiety disorder.

  • What helps reduce chronic stress symptoms?

    Building a strong support network, eating a healthy diet, getting enough sleep, journaling, taking time out to relax, and practicing mindfulness techniques are all possible stress relief strategies. Reducing caffeine, alcohol, and sugar may also help you manage stress and anxiety more effectively. If stress persists, you may want to talk to a loved one or healthcare provider about your symptoms.

  • What do doctors do about stress?

    To treat the effects of stress, doctors may recommend lifestyle changes and self-care strategies. Your healthcare provider might also refer you to a therapist for cognitive-behavioral therapy (CBT). Anti-anxiety medications may help to treat certain stress-related symptoms.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Stress.

  2. American Psychological Association. Stress effects on the body.

  3. National Institute of Diabetes and Digestive and Kidney Diseases. Definition & facts of adrenal insufficiency & Addison's disease.

  4. American Psychological Association. Hypothalamus-pituitary-adrenal axis (HPA axis).

  5. Kalmbach DA, Anderson JR, Drake CL. The impact of stress on sleep: pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. J Sleep Res. 2018;27(6):e12710. doi:10.1111/jsr.12710

  6. National Institute of Mental Health. I'm so stressed out! fact sheet.

  7. American Psychological Association. Sympathetic nervous system.

  8. Lupis SB, Lerman M, Wolf JM. Anger responses to psychosocial stress predict heart rate and cortisol stress responses in men but not women. Psychoneuroendocrinology. 2014;49:84-95. doi:10.1016/j.psyneuen.2014.07.004

  9. Timmons AC, Arbel R, Margolin G. Daily patterns of stress and conflict in couples: associations with marital aggression and family-of-origin aggression. J Fam Psychol. 2017;31(1):93-104. doi:10.1037/fam0000227

  10. Campagne DM. Stress and perceived social isolation (loneliness)Arch Gerontol Geriatr. 2019;82:192-199. doi:10.1016/j.archger.2019.02.007

  11. Harvard Health Publishing. Protect your brain from stress.

  12. Kverno K. Brain fog: a bit of clarity regarding etiology, prognosis, and treatmentJ Psychosoc Nurs Ment Health Serv. 2021;59(11):9-13. doi:10.3928/02793695-20211013-01

  13. Theoharides TC, Stewart JM, Hatziagelaki E, Kolaitis G. Brain "fog," inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin. Front Neurosci. 2015;9:225. doi:10.3389/fnins.2015.00225

  14. Klier C, Buratto LG. Stress and long-term memory retrieval: a systematic review. Trends Psychiatry Psychother. 2020;42(3):284-291. doi:10.1590/2237-6089-2019-0077

  15. Korkmaz S, Kazgan A, Çekiç S, Tartar AS, Balcı HN, Atmaca M. The anxiety levels, quality of sleep and life and problem-solving skills in healthcare workers employed in COVID-19 services. J Clin Neurosci. 2020;80:131-136. doi:10.1016/j.jocn.2020.07.073

  16. MedlinePlus. Stress and your health.

  17. Sharif K, Watad A, Coplan L, et al. The role of stress in the mosaic of autoimmunity: an overlooked associationAutoimmun Rev. 2018;17(10):967-983. doi:10.1016/j.autrev.2018.04.005

  18. Mariotti A. The effects of chronic stress on health: new insights into the molecular mechanisms of brain-body communication. Future Sci OA. 2015;1(3):FSO23. doi:10.4155/fso.15.21

  19. Harris ML, Oldmeadow C, Hure A, Luu J, Loxton D, Attia J. Stress increases the risk of type 2 diabetes onset in women: a 12-year longitudinal study using causal modelling. PLoS One. 2017;12(2):e0172126. doi:10.1371/journal.pone.0172126

  20. Saeedi M, Rashidy-Pour A. Association between chronic stress and Alzheimer's disease: therapeutic effects of saffronBiomed Pharmacother. 2021;133:110995. doi:10.1016/j.biopha.2020.110995

  21. Dai S, Mo Y, Wang Y, Xiang B, Liao Q, Zhou M, Li X, Li Y, Xiong W, Li G, Guo C, Zeng Z. Chronic stress promotes cancer development. Front Oncol. 2020;10:1492. doi:10.3389/fonc.2020.01492

  22. National Health Service. 10 stress busters.

  23. National Health Service. Stress.

  24. National Center for Complementary and Integrative Health. Stress.

  25. National Health Service. Treatment - generalised anxiety disorder in adults.

  26. American Psychological Association. What's the difference between stress and anxiety?

  27. American Psychological Association. Stress won't go away? Maybe you are suffering from chronic stress.

By Laura Dorwart

Laura Dorwart is a health journalist with particular interests in mental health, pregnancy-related conditions, and disability rights. She has published work in VICE, SELF, The New York Times, The Guardian, The Week, HuffPost, BuzzFeed Reader, Catapult, Pacific Standard, Health.com, Insider, Forbes.com, TalkPoverty, and many other outlets.

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The holiday season is often referred to as the happiest time of year. Words like “joy” and “merry” are a part of the season and show up in songs, advertisements and decorations. However, we may not always feel joyful or merry as the holidays approach. For many, stressors abound this time of year.

Financial strain may cause stress as we try to purchase gifts for everyone on our list, shop for groceries for all of our holiday baking and cooking, and find just the perfect decorations to fill our homes with holiday cheer.

We may experience familial stress as we spend more time with extended family members — some of whom may not get along very well.

We might also overload our to-do list, trying to get everything done just in time for the holidays. This can also put quite a bit of strain on our mental well-being.

Unchecked stress can lead to a variety of physical, mental and emotional troubles. Headaches, stomachaches, muscle tension, forgetfulness, irritability and anxiety are all potential symptoms of stress. If not properly managed, excessive or ongoing stress can lead to more serious problems.

Fortunately, there are things we can do to help manage our stress before it gets out of control. Practicing mindfulness is one of those things. Dr. Jon Kabat-Zinn, a mindfulness expert, defines it as “paying attention in a particular way: on purpose, in the present moment and nonjudgmentally.”

Here are some mindfulness strategies that you might try as you start to notice yourself becoming stressed:

  • Mindful breathing. Pay close attention to your natural breath. Notice the movement of the air as you inhale the oxygen and exhale the carbon dioxide. Notice how it feels moving through your nose or mouth. As you breathe in, notice the beginning, middle and end of that breath. Notice the pause before you breathe out. Then notice the beginning, middle and end of your exhale. You can also pay attention to other things, like the expansion and retraction of your stomach as you breathe, or the sound the air makes as it goes in and out of your body. Do this as many times as you’d like.
  • The body scan. Get in a comfortable position either sitting or standing. Notice the way your body feels on the furniture or floor. Then bring awareness to one body part at a time, breathing in and out, imagining you are pulling your breath in through that body part and then pushing it out through that body part. Here is an order that you might like to use: left foot, left leg, right foot, right leg, abdomen/belly, upper body/chest/shoulders, back, hands/arms, head/face. Do at least three breaths for each body part. When you’ve finished, check in with your entire body to see if any areas have more stress or tension than others and may need a bit more attention.
  • Mindful walking. You can do mindful walking at any time — as you are walking as a part of your daily activities, or as a part of your exercise routine. Synchronize your breath with your steps as you walk. You can experiment with the rhythm and the number of steps you take with each inhale and exhale. Do not let your mind wander. Pay attention to your surroundings. Notice the air, the light, the people, the structures, etc. Appreciate these things as you notice them — we usually take them for granted!

For more information on stress management, contact Christina Rittenbach, NDSU Extension agent in Stutsman County, at

[email protected]

or (701) 252-9030


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Stress can trigger ankylosing spondylitis (AS) flare-ups when symptoms like increased inflammation, stiffness, or pain in the neck, back, and pelvis worsen. Living with a chronic illness can be challenging and creates a vicious cycle when stress triggers flare-ups. Managing your stress can be an essential tool to help provide relief.

This article will discuss ways to identify stress triggers and offer stress management techniques.

Delmaine Donson / Getty Images

Identify Triggers of Your Stress and Ankylosing Spondylitis

Triggers are internal or external factors that cause a stress response. Common triggers include:

  • Coping with chronic disease or illness
  • Finances
  • Home or school responsibilities
  • Major life events
  • Work pressures

Understanding the factors that trigger stress is an essential part of managing flare-ups.

Once you have identified your stress triggers, try reducing or eliminating them from your daily life. Managing stress may include delegating specific responsibilities, or changing your home, work, or school expectations.

Studies show that people living with one or more chronic illnesses feel more stress than those without, which is why managing stress is essential to living with AS. However, stress is also a potential trigger for AS. Therefore, AS can be triggered by stress, but it can also cause stress, creating a vicious cycle.

Follow Your Treatment Plan

Treatment of AS involves medication, exercise, physical therapy, nutrition, and other pain and stress management forms. If you have a severe case of AS, you may require surgery. Following a healthcare provider-prescribed treatment plan will help reduce flare-ups.

Use Breathing Exercises

Breathing exercises, known as diaphragmatic breathing, are a slow and controlled breathing method. Diaphragmatic breathing involves inhaling deeply through the nose into the belly and exhaling slowly and fully.

This breathing method impacts the fight-or-flight stress response by reducing cortisol (stress hormone) levels in the body. Diaphragmatic breathing effectively reduces stress and anxiety and improves overall health and well-being. Deep breathing also helps keep the spine more flexible since it involves contracting and expanding the ribcage.

Stay Active With Low-Impact Workouts

AS primarily affects the spine and can lead to stiffness or loss of mobility in the affected vertebrae. Stretching and movement of the spine are important parts of AS treatment and management.

High-intensity workouts can temporarily increase inflammation, which may worsen AS symptoms. Gentle stretching and strengthening exercises may be a better choice, especially if you are experiencing an AS flare-up.

Exercise With AS

Here are four types of exercise recommended for people with AS:

  • Aerobic or cardiovascular
  • Balance
  • Range of motion or stretching
  • Strengthening

Rely on Your Social Support System

Most experts agree that social and emotional support is vital for well-being. Social and emotional support means having close relationships with friends, family, or mentors who believe in you and see you as capable.

Social support helps improve your ability to cope and manage stressful situations, such as living with a chronic illness like AS or experiencing painful flare-ups.

Practice Mindfulness

There is some evidence that mindfulness practices can be beneficial in reducing stress and anxiety for people with different types of arthritis.

Mindfulness practice focuses on what is happening in the present with acceptance and without judgment. Practicing mindfulness can help you:

  • Stay present
  • Gain awareness of what is happening in your body, mind, and emotions
  • Increase your ability to manage stress
  • Regulate your emotions
  • Improve your overall well-being

Prioritize Self-Care

Self-care is taking the time to do things that help you live and feel better regularly. It is a way to care for your physical and mental health. Ways to incorporate self-care could include:

  • Eating a balanced diet
  • Exercising regularly
  • Getting enough sleep
  • Listening to music
  • Reading or writing
  • Doing a hobby that you enjoy

Practicing self-care can help you learn to reduce or manage stress. Self-care looks different for everybody; what works for one person won't necessarily work for the next.

Starting slow and trying different strategies to find self-care that works for you and your life can lead to long-term benefits of reduced stress. Overall, reduced stress can help decrease the frequency and duration of AS flare-ups.

Consider Seeing a Mental Healthcare Provider

If you feel that your stress is unmanageable on your own, a mental healthcare provider may be able to help. Mental healthcare professionals, such as psychiatrists, are experts in human behavior and can work with you to create an individualized plan with strategies to manage your stress.


Flare-ups are unavoidable when you have a chronic condition such as ankylosing spondylitis. However, stress is a common factor in causing flare-ups, making managing stress an important aspect of treatment. There are many strategies for coping with a stressful illness that can help lower your stress, help you become more resilient during stressful situations, and ultimately help reduce AS flare-ups.

A Word From Verywell

There is no denying that living with a chronic condition is stressful, especially when stress triggers symptoms, creating a vicious cycle. If you feel that your stress and resulting AS flare-ups have become unmanageable, reach out to a trusted healthcare provider. Your healthcare provider or a mental healthcare professional can support you to better cope with AS and stress.

Frequently Asked Questions

  • How does stress cause ankylosing spondylitis flares?

    Stress activates an immune response that causes the release of hormones epinephrine and cortisol. These hormones exacerbate inflammation and can worsen symptoms of ankylosing spondylitis. Stress can trigger an ankylosing spondylitis flare by increasing inflammation and pain.

  • What else can trigger ankylosing spondylitis?

    Researchers are uncertain of what exactly triggers ankylosing spondylitis, but genetics are thought to play a role in the disease along with an environmental trigger, such as bacterial infection.

  • What does an ankylosing spondylitis flare-up feel like?

    An ankylosing spondylitis flare-up can include stiffness or pain, most commonly in the neck, low back, hip, and buttock, but could affect other joints. You may also experience a systemic response, including mild fever and mood changes. Symptoms vary from person to person and can change depending on how long you've had the condition.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: a review. EXCLI J. 2017;16:1057-1072. doi:10.17179/excli2017-480

  2. Vancampfort D, Koyanagi A, Ward PB, et al. Perceived stress and its relationship with chronic medical conditions and multimorbidity among 229,293 community-dwelling adults in 44 low- and middle-income countriesAm J Epidemiol. 2017;186(8):979-989. doi:10.1093/aje/kwx159

  3. Arthritis Foundation. How stress affects arthritis.

  4. NIH National Institute of Arthritis and Musculoskeletal and Skin Disease. Ankylosing spondylitis: diagnosis, treatment, and steps to take.

  5. Ma X, Yue ZQ, Gong ZQ, et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adultsFront Psychol. 2017;8:874. doi:10.3389/fpsyg.2017.00874

  6. Hamasaki H. Effects of diaphragmatic breathing on health: a narrative reviewMedicines (Basel). 2020;7(10):65. doi:10.3390/medicines7100065

  7. Spondylitis Association of America. The link between stress and chronic illness: tools for stress management.

  8. American Psychological Association. Manage stress: strengthen your support network.

  9. DiRenzo D, Crespo-Bosque M, Gould N, Finan P, Nanavati J, Bingham CO. Systematic review and meta-analysis: mindfulness-based interventions for rheumatoid arthritisCurr Rheumatol Rep. 2018;20(12):75. doi:10.1007/s11926-018-0787-4

  10. Keng SL, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: a review of empirical studiesClin Psychol Rev. 2011;31(6):1041-1056. doi:10.1016/j.cpr.2011.04.006

  11. National Institutes of Mental Health. Caring for you mental health.

  12. Zhu W, He X, Cheng K, et al. Ankylosing spondylitis: etiology, pathogenesis, and treatments. Bone Res. 2019;7:22. doi:10.1038/s41413-019-0057-8

  13. NIH National Institute of Arthritis and Musculoskeletal and Skin Disease. Overview of ankylosing spondylitis.

By Rebecca Valdez, MS, RDN

Rebecca Valdez is a registered dietitian nutritionist and nutrition communications consultant, passionate about food justice, equity, and sustainability.

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Most people know the common anxiety symptoms, like nervousness, rapid breathing and a pounding heart. One lesser known symptom is chest pain. But it's actually more common than people may think.  

Tightness in the chest is often a physical manifestation of panic or anxiety attacks. According to a 2018 study, 30 to 40% of visits to the emergency room for chest pain unrelated to a heart attack are due to anxiety. For many, recognizing the difference between anxiety chest pain and a heart attack can be difficult. Let's dig into how to tell the difference and some strategies you can use to alleviate the pain. 

Read More: 6 Best Teas for Anxiety and Stress for 2022

Why does anxiety cause tightness in the chest?

Anxiety is our body's natural response to stress. When we experience fear, our autonomic nervous system's fight-or-flight response is activated to protect us. This response includes both brain and body changes. Our brains are flooded with adrenaline and cortisol, while physical changes include sweating, shortness of breath or tightening muscles. As muscles tense and your heart rate increases, you may begin to hyperventilate and contribute to chest pain.

What does anxiety chest pain feel like?

Chest pain is a common symptom of panic attacks. Tightness in the chest caused by anxiety can present in several ways. For some, the onset of chest discomfort may be gradual, while others may feel it very quickly. 

Common descriptions of anxiety chest pain include:

  • Tightness or tension in the chest
  • Sharp, stabbing or shooting pains
  • Persistent chest aching 
  • Numbness or a dull ache in the chest
  • Muscle twitches or spasms 

If you haven't experienced tightness in the chest from anxiety, it can be an alarming experience. For many, the symptoms seem very similar to a heart attack. While they are similar, there are significant differences between the two. 

Woman with both hands on top of chest experiencing pain

SDI Productions/Getty Images

4 ways to get rid of tightness in the chest from anxiety

Getting rid of chest pain can be difficult at the moment. However, these simple tactics can help you regain control over the situation.

1. Recognize what's happening

When you are experiencing anxiety or panic attack symptoms, it's important to recognize they are happening and accept them -- it will help you work through what you are experiencing. Recognition can also help you determine what decisions to make about the situation. If you realize you're overstimulated, you can remove yourself from the situation to manage symptoms. 

2. Focus on your breathing

Calming breathing exercises can help neutralize the shortness of breath or increased heart rate symptoms associated with anxiety. Focusing on breathing can help you end the stress response. You should expect it to take a few minutes of intentional breathing to feel relief. You can use breathing exercises and techniques anywhere, as often as needed. 

Common breathing exercises for anxiety:

  • 4-7-8 breath: This simple yet effective breathing technique can reduce stress. To perform 4-7-8, inhale for four counts, hold the breath for seven counts and exhale for eight counts. 
  • The box breath: Box breath is used to slow your breathing. Start by exhaling fully, inhale four counts, hold for another four counts, then exhale for another four counts. Repeat the process three to four times. 
  • Belly breathing: Also known as diaphragm breathing, bellying breathing offers a deep sense of relaxation. To practice, place your left hand over your heart and then your right hand over your belly. Inhale slowly and feel your belly expand. Then exhale slowly and feel your belly contract. 
Woman concentrating on breathing exercises sitting on a yoga mat at home

10'000 Hours/Getty Images

3. Use the 3-3-3 technique

Sometimes, you're able to catch anxiety symptoms creeping up. You can use the 3-3-3 anxiety technique to curb physical symptoms. Using this technique can help you feel grounded and more in control. It's simple to do and an effective way to distract yourself from triggers that may be causing anxiety and redirect your focus. 

Here's how to use the 3-3-3 rule:

1. Name three things that you can see around you. Focus on what they are and take note of identifying characteristics like their color and texture. 
2. Next, name three things you can hear. Are they high-pitched or loud?
3. Finally, choose three parts of your body to move. 

4. Seek therapy

Short-term techniques to help you manage anxiety symptoms at the moment are essential. However, they don't treat the underlying cause of your anxiety. When anxiety attacks or chest pain from anxiety symptoms becomes a regular occurrence, it's time to speak with a doctor. Working with a therapist and cognitive behavioral therapy will be able to help identify triggers and equip you with adequate coping methods. Coping techniques will help you feel more confident and in control of the situation, which can lessen symptoms. CBT uses multiple techniques to identify and reprogram negative thoughts and behaviors that trigger anxiety. 

CBT is an effective treatment for the following conditions:

  • Panic disorder
  • Generalized anxiety disorder
  • Social anxiety disorder
  • Obsessive-compulsive disorder
  • Post traumatic stress disorder
  • Prolonged grief disorder

What's the difference between a panic attack and a heart attack?

Sometimes it can be difficult to differentiate anxiety chest pain from other types of chest pain, especially if you're predisposed to heart attacks or other cardiac conditions. Heart attacks result from blockages in the coronary artery

The most significant and identifiable difference between tightness in the chest from anxiety and a heart attack is the location of the pain. Most often, pain and tightness from anxiety are located in the chest while heart attack pain travels to other parts of the body -- like down your arm or to your shoulder. How you experience chest pain is also different. Anxiety chest pain tends to feel sharper, while heart attack chest pain has been described as heavy pressure or tightness. Another important difference is when these attacks occur -- heart attacks are more likely to occur during exertion, whereas panic attacks frequently happen during rest.

If you're experiencing chest pain, it's best to seek medical treatment, even if it's associated with anxiety. It's better to know and address your anxiety than risk it being something more serious that goes untreated. 

What's the difference between anxiety and a panic attack?

The terms panic attack and anxiety are often used interchangeably, though they are two very different experiences, especially when discussing chest pain. Daily anxiety typically doesn't usually result in chest pain for most people. Panic and anxiety attacks are more severe and can be debilitating while they are happening. Tightness in the chest is one of the most common symptoms of a panic attack or a panic disorder

Another distinction to make is between an anxiety attack and a panic attack. Anxiety and panic attacks are similar, though anxiety attacks are generally less intense and brought on by a specific trigger. Panic attacks can occur with seemingly no source. Panic attacks can last anywhere from 5 to 20 minutes. The duration and frequency will depend on the severity of your panic disorder. 

Too long; didn't read?

Tightness in the chest anxiety can be alarming, especially if you've never experienced it. In-the-moment techniques such as deep breathing and the 3-3-3 rule can help but not solve the issue. When anxiety or panic attacks are the sources of your chest tightness, it's best to treat the underlying cause of what is making you anxious.   

You should see a medical doctor immediately if:

  • The tightness in your chest lasts longer than 10 minutes.
  • The pain begins to radiate out from your chest and into your arms. 
  • You begin to develop other physical symptoms. 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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Kerry Katona has revealed that she was rushed to A&E after suffering from breathing difficulties due to a swollen throat.

The former Atomic Kitten singer and I'm A Celebrity... Get Me Out of Here winner explained that she called her doctor after her throat and chest felt 'tight' while she was having a consultation for an eyelid lift.

After saying that she'd take herself to A&E if her condition worsened, Kerry revealed that she did just that -- later revealing that she had a swollen throat.

Kerry Katona
Kerry Katona has revealed that she was rushed to A&E after suffering from breathing difficulties due to a swollen throat. Pic: Stuart C Wilson/Getty Images

'I'm really swollen and it hasn't got any better,' Kerry wrote in her latest new! magazine column. 'I ended up going to A&E as I was so worried about it.

'They've told me that they need to investigate further. So for now, my doctor at Pall Mall Cosmetics has given me some water tablets which will hopefully help with the swelling.'

Kerry also revealed that she suffered from a panic attack that stems from health anxiety, as she's set to undergo corrective surgery on a tummy tuck and an eye lift. As a result of her swollen throat and nervousness about the procedures, she reached out for help.

Kerry Katona
Kerry said that she had felt her throat close up when at a consultation for an eye lift, having to go to A&E as a result. Pic: Dave J Hogan/Getty Images

'I had a massive panic attack last week,' she told OK!. 'It was the first one I’ve had in a while. My body has been swollen since I had surgery last year. My whole body is sore and puffy – my legs, my stomach, my face, my neck. I feel like I need popping.

'I was lying down in bed and I felt like I couldn’t breathe. My throat and chest felt really tight, it was awful. I felt like I was going to die. I’ve arranged a call with my doctor but if it gets worse I’ll go to A&E. I suffer from health anxiety and I'm really scared.'

Kerry's anxiety comes as she recently made a brutal dismissal of her ex-husband, former Westlife member Brian McFadden, joking that he was 'the worst thing' she ever put in her mouth.

Brian McFadden Kerry Katona
Kerry recently joked about her time in the jungle when she won I'm A Celebrity... Get Me Out of Here, joking that the worst thing she put in her mouth was her ex-husband Brian McFadden. Photo by Cameron Laird/REX/Shutterstock

Speaking on the Back Then When podcast with Keith Lemon, Kerry spoke about winning I'm A Celebrity...Get Me Out Of Here in 2004.

'For me, when it was three of us in the final on the last day, the night before I just kept thinking "I'm going home tomorrow, so I don’t care."

'I got nicknamed the Warrington Whinger because I cried a lot, I just wanted to go home and go back to my mansion.'

When Keith spoke about the eating trials while in the jungle, he asked Kerry what the worst thing she put in her mouth was -- and, without missing a beat, Kerry said 'I was going to say Brian McFadden.'

Elsewhere, Kerry revealed that her and Brian's eldest daughter Molly is pursuing a career in Ireland -- studying in drama school The Lir in Dublin in the hopes of becoming an actor.

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Adjusting to the physical demands of life with cancer or managing your wellbeing as a cancer survivor is no easy feat. You need support and guidance to help you achieve optimal health during your cancer journey.

Understanding this need, Iredell Health System has recently launched an outpatient cancer rehabilitation program. The main goal of this program is to increase quality of life while increasing physical function for individuals diagnosed with cancer. The program is made possible in part thanks to the EnergyUnited Foundation, who awarded a $10,000 grant to the Iredell Health Foundation to provide necessary funding for the new program.

“For nearly 40 years, Iredell Health System has led the community in innovative and effective rehabilitation programming. Beginning in 1985 with cardiac rehab, pulmonary rehab in 2015, and supervised exercise therapy for peripheral artery disease in 2019, Iredell Health System has now expanded its rehab programming to meet the complex needs of our oncology patients at all stages of diagnosis,” said Lisa Warren, Director of Cardiopulmonary Rehabilitation at Iredell Health System, who is overseeing the program.

Patients at any part of their cancer journey — whether they are newly diagnosed, currently undergoing treatment, or have finished their treatment — may seek care in the program. Services in the cancer rehab program include exercise training and support for medical, nutritional, and emotional needs.

“Supported by the American College of Cardiology, exercise has been proven as a non-pharmacological treatment for cancer and is positively associated with improved quality of life and reduction of some cancer-related symptoms such as fatigue, pain, constipation, dyspnea, weight, and sleep problems,” said Warren.

Among the many benefits, cancer rehabilitation may:

  • Improve quality of life.
  • Address cancer-related problems that affect mobility.
  • Ease the side effects of chemotherapy or radiation treatment.
  • Support mental and physical wellbeing.

Components of Iredell Health System’s cancer rehab program may include:

Exercise. This part of cancer rehab takes place in Iredell’s cardiopulmonary rehab gym. The equipment located in this area provides both seated and standing exercise options for people of all abilities, including those who use mobility devices like canes, walkers, and rollators.

While patients exercise, Iredell Health System’s highly-qualified team will monitor their vital signs to help ensure that the exercise is safe for each individual patient. This telemetry monitoring is something not all cancer rehab programs offer.

Nutrition. The cancer rehab team will also teach patients about healthy foods to eat during their cancer journey and help them manage any challenges that may prevent them from eating well.

Psychosocial care. This may include counseling to help with the stress and anxiety of a cancer diagnosis.

In addition, this program will also give patients a chance to interact with other individuals who are going through a similar journey.

“We have learned from our other programs that the support the program offers sometimes outweighs the benefit of exercise. Being in an environment with others who have similar diagnoses provides emotional support like no other. The camaraderie is amazing,” said Warren.

To provide this beneficial program, Iredell Health System has assembled a highly trained team of dedicated experts, including registered nurses, certified respiratory therapists, clinical exercise physiologists, licensed dietitians, and licensed clinical counselors.

Upon admission to the program, each patient will complete a medical and exercise assessment. Data from the assessment will be used to develop their individualized treatment plan and determine the amount of time the patient will participate

Classes will take place on Tuesdays and Thursdays at 10 a.m. The cost is $25 per session. Iredell Health System can offer financial assistance as needed to participate.

Patients can begin enrolling in the program now, and classes begin January 10. To enroll, patients will need a referral from their provider.

“Our goal for the cancer rehab program is no different than that for the other programs we offer under the umbrella of Cardiopulmonary Rehab Services. That is to provide the patient an experience that allows them to improve their quality of life, give them an opportunity to exercise in a medically supervised environment, and support them on their journey through one of the more challenging times in their lives,” said Warren.

If you would like to learn more about the cancer rehabilitation program, please call 704-878-4558.

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Breath work has gained popularity in recent years. The self-care tool can improve mental and physical health, helping you combat everyday stress and anxiety. There’s some evidence that it can have a positive effect on your long-term energy levels and cognitive function, too. 

It’s a mindful practice that breathing expert and peak performance coach Stuart Sandeman (opens in new tab) swears by. Known as Breathpod (opens in new tab) to his 54K Instagram followers, the author of Breathe In Breathe Out has worked as a breath coach to award-winning artists, Olympic athletes and top business executives.

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DECEMBER 6 — If you, like me, think that breathing is primarily and simply about taking in oxygen (O2) and discarding carbon-dioxide (CO2) then, oh boy, you really need to read this book.

It’s one of the nominees for the 2021 Royal Society Science Book Prize, an annual award for the top science non-fiction books of the previous year.

By a cute coincidence, I happened to start reading it after I started on episode one of Chris Hemsworth’s Limitless TV series, which briefly recommended breathing techniques to help deal with stress.

Anyway, this book — Breath: The New Science of a Lost Art by James Nestor   —  was an eye-opener.

Sure I had seen the odd kung fu movie where the monks or masters displayed stellar breathing and of course who hasn’t watched Incredible Hulk (2008) where a MMA and Jiu Jitsu champion Rickson Gracie taught Bruce Banner how to breathe as a means of controlling his anger.

But I never imagined that — according to Nestor — I had been breathing “wrongly” and “poorly” my whole life!.

In this sense, Nestor’s book does not just share “profound” information (eg, “In a single breath, more molecules of air will pass through your nose than all the grains of sand on all the world’s beaches   —  trillions and trillions of them.”) it’s also very practical.

So here are some insights which were entirely new to me before I read the book (see note 1):

1. Breathing is best done via the NOSE, not the mouth

The nose has a lot of “equipment” (turbinates, nasal erectile tissues, etc.) which help to both extract more oxygen per breath and release nitric oxide which impacts everything from immunity, to weight, circulation, and mood to sexual function.

Also, nose-breathing fights sleep apnoea and snoring (which is a, uh, bad thing it seems).

Nestor discusses some research done with native tribes from Missouri whose kids are taught how to breathe through the nose from young.

The Native Americans attribute these qualities to breath “breath inhaled through the nose kept the body strong, made the face beautiful, and prevented disease.”

Note: I found many references to exhaling via the mouth throughout the book s o my guess is that nose-breathing is focused more on inhalation.

2. EXHALING is more important than inhaling

In the Hemsworth TV series, the breath guru taught him “box-breathing.” You can Google it but the thing which stood out for me (even before I read the book) was Hemsworth was asked to exhale longer than he inhaled.

What was up with that? The TV series didn’t explain but the book does. Something to do with how exhalation is the process whereby oxygen is transported to the rest of your body i.e. it is exhalation which constitutes the “nurturing” or “building” part of breathing. Inhalation is simply the taking in of O2.

Apparently, if we can train our diaphragm to rise and fall in greater capacity, it does wonders:

“A typical adult engages as little as 10 per cent of the range of the diaphragm when breathing, which overburdens the heart, elevates blood pressure, and causes a rash of circulatory problems. Extending those breaths to 50 to 70 per cent of the diaphragm’s capacity will ease cardiovascular stress and allow the body to work more efficiently. For this reason, the diaphragm is sometimes referred to as ‘the second heart,’ because it not only beats to its own rhythm but also affects the rate and strength of the heartbeat.” (Bolded emphasis added.)

As I understand, he’s saying that powerful breathing requires intentional and controlled breathing through the belly and the diaphragm. We must treat this “second heart” the way a body-builder treats his muscles; it must be nurtured, trained and utilised towards a purpose.

3. SLOW breathing is good breathing

This principle combines with the next one in that it prioritises CO2 over O2. Yes, fancy that.

I didn’t know that CO2 was important for providing the equilibrium which ensures sufficient amounts of O2 (more below), and also to dilate blood vessels so more O2-rich blood can flow. So, whilst our body doesn’t “use” CO2 the way it uses O2, it 100 per cent “needs” CO2 just as urgently.

Fast and panicky kinds of breathing purges CO2 which in turn leads to poorer blood flow to our organs, muscles, tissues, etc.

Note that “soft” breathing is also important because if you breathe too aggressively you risk damaging alveoli and tissues  —  we’re not steam engines.

So how slow is slow enough? Nestor recommends “5.5-second inhales followed by 5.5-second exhales, which works out almost exactly to 5.5 breaths a minute. This was the same pattern of the rosary.”

He also makes a (breath-taking?) point about how breathing slowly corresponds to many forms of prayer among the world religions:

“Japanese, African, Hawaiian, Native American, Buddhist, Taoist, Christian  — these cultures and religions all had somehow developed the same prayer techniques, requiring the same breathing patterns (all requiring about 5.5 to 6 seconds to inhale and exhale). And they all likely benefited from the same calming effect.”

In his book 'Breath: The New Science of a Lost Art', author James Nestor talks about how breathing less increases the amount of CO2 in our blood. — AFP pic

In his book 'Breath: The New Science of a Lost Art', author James Nestor talks about how breathing less increases the amount of CO2 in our blood. — AFP pic

4. Breathing LESS helps

This was quite a shocker, especially to someone like me who , over the past few years,  had developed the habit of gulping in tonnes of air (during workouts, after a bout of over-eating, etc). But Nestor talks about modern culture as a culture of over-breathers and how we need the “respiratory equivalent of fasting.”

Alright, sure, but what did all this mean?

Nestor talks about how breathing less INCREASES the amount of CO2 in our blood and this is necessary because too little CO2 in our body means that O2 molecules are unable to get to our vital internal body parts.

The analogy used in the book is that CO2 is like the divorce lawyer which helps separate O2 molecules from the hemoglobin molecules; if there are too FEW lawyers then, alas, there will be fewer O2 released to our cells.

This principle  —  that more CO2 equates to greater health  —  aligns well with the 3rd principle that exhalation is key because when we inhale less and exhale more that raises CO2 levels which in turn gets more O2 circulating through our insides.

Another argument for breathing less (and thus raising CO2 levels) is that CO2 is needed to maintain a certain level of acidity in our bodies:

“When we breathe too much, we expel too much carbon dioxide, and our blood pH rises to become more alkaline; when we breathe slower and hold in more carbon dioxide, pH lowers and blood becomes more acidic. Almost all cellular functions in the body take place at a blood pH of 7.4, our sweet spot between alkaline and acid.”

All the above is available in the first section of the book, what I consider the more practical portion.

In the second section Nestor discusses some “advanced” breathing methods. These include breathing crazy-hard to induce quasi-psychedelic life-changing experiences and/or produce temporary stress so your body can handle stress in the future and inhaling carbon-dioxide to simulate panic. Techniques here include the Tibetan approach known as Tummo, the Wim Hof method, hypoventilation, pranayama and numerous other approaches.

I must say I found this second section to read more like some National Geographic article. On one hand, the writing sounds credible, on the other it stops short of fully validated science.

Finally, in case anyone is tempted to suggest that breathing is a super miracle cure for everything, Nestor throws in some realism:

“Breathing fast, slow, or not at all can’t make an embolism go away. Breathing through the nose with a big exhale can’t reverse the onset of neuromuscular genetic diseases. No breathing can heal stage IV cancer.”

Still, everyone can benefit at least a little by reflecting on how we’re breathing. I’ve found that merely thinking about my breathing already helps reduce my anxiety (at least a whiff) — now imagine if I do more?

* Note 1: Obviously, I wouldn’t recommend anyone attempt any serious modifications in breathing without first consulting a doctor or medical advisor, especially those with respiratory issues.

** This is the personal opinion of the columnist.

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According to Life Works latest Mental Health Index,
48% of employed adults say work is their primary source of stress, and it
impacts them in a variety of ways: 30% are unable to relax, 29% have difficulty
sleeping, and 24% have experienced emotional changes.

While it’s important to recognise chronic stress
and take steps to address those triggers, sometimes what you really need are
speedy ways to calm your racing heart and mind at the moment, so you can then
get on with the rest of your day.

We asked well-being experts for their top tips on
how to alleviate stress in just 10 minutes…

1. Mindful breathing

Taking a few minutes for a mindful breathing
exercise can be really helpful, says qualified coach Moyra Mackie, aka
TheJournal Coach.

“Find somewhere by yourself,” she suggests. “It can
be indoors or outdoors and it doesn’t have to even be quiet. Sit down, close
your eyes, put one hand on your heart and the other on your belly and just
breathe, feeling your belly expand on your in-breath and contract on your out-breath.”

This might be enough to ‘reset’. But if not, try a
quick blast of journaling: “If your head still seems full, grab a notebook and
pen, set your phone’s timer for three minutes, and get those feelings out on
paper,” says Mackie. “Lean in and let go!”

2. Soothing words

“When we’re stressed, we can easily get carried
away in negative self-talk,” says Dr. Elena Touroni, a consultant psychologist
and co-founder of The Chelsea Psychology Clinic.

To counteract your inner critic, try giving
yourself a mental pep talk with words of encouragement, she suggests: “Examples
might be, ‘I’ve got this’, ‘I’m here and I’m OK’, or ‘I’m strong – I can cope’.

“You can also try offering yourself compassion
through soothing touch,” adds Tournoi. “Try giving yourself a hug, gently
stroking your arm, or putting your hand on your heart while giving yourself
words of comfort.”

3. Deep breathing

A step further than mindful breathing, try closing
your eyes and slowing down your breath, says Jamie Clements, host of the Unwind
for Total Relaxation series on the MindLabs app.

“Reducing your breaths per minute with a strong
focus on using the diaphragm is one of the simplest ways to stimulate the vagus
nerve – this nerve holds all the keys when it comes to feeling relaxed,” he

Nick Mitchell, CEO and founder of Ultimate Performance, suggests the box breathing technique: “It’s as simple as breathing
in for four seconds, holding your breath for four seconds, and then exhaling
for four seconds. Repeat those three steps for four minutes or so and you will
start to feel everything go – the tension and the stress you’re carrying.”

4. Focus on the present

If you find your mind wanders during breathing
exercises, another way to practice mindfulness is by focusing on your five
senses. “Sit down quietly and take some slow deep breaths,” says Dr. Deborah Lee
from Dr. Fox Online Pharmacy. “Now pay attention to each of your senses – sight,
hearing, smell, touch, and taste.”

Create a mental list of all the things you can
sense around you: “This will sharpen your awareness and bring you into the
present moment. Keep breathing slowly in through your nose and out through your
mouth,” Lee adds. “You will feel calmer and more tranquil.”

5. Have a hug

We often want to vent to our partner or a friend
about a stressful situation, but a reassuring hug could be more beneficial.

“Social support can help us to feel safer and therefore
calm us down when we’re stressed,” says Dr. Lynne Green, a chief clinical officer
at Kooth. “Even just a reassuring touch on the shoulder from someone we care
about causes our brains to release oxytocin, also known as ‘the love hormone’,
which helps to soothe the stress response, particularly helping to relax the

6. Go for a walk

Even a quick loop around the block or to your local
park is a good idea when you’re feeling overwhelmed.

“A regular 10-minute walk is hugely beneficial for
your mental well-being, as being outside can increase your mood, and sleep quality,
and reduce anxiety,” says Yves Benchimol, co-founder of WeWard. “It is
something that can also be a social activity if you go with friends, or it can
be a way to have quality alone time and switch off.”

7. Energy visualisation

Popular with younger
generations, crystal healing is an alternative technique
believed by fans to have healing qualities. When you’re feeling
overwhelmed, try this visualisation technique to ‘charge’
a crystal or token with energy.

“Sit or lie comfortably in a quiet place where you
won’t be interrupted, and visualise a brightly coloured ball of light in your
hands,” says Flavia Kate Peters, leading elemental and ancient magic expert and
author of Reclaim Your Dark Goddess: The Alchemy Of Transformation.

“Place or push the light into a talisman such as a
token, piece of jewellery, or clear crystal while focusing on your
intentions. Imagine the light absorbing into the charm until you see in your
mind’s eye the charm radiating and pulsating with its newly charged magickal

8. Have an adult tantrum

“Ever notice how much better you feel after a
really good cry?” asks Zoe Clews, hypnotherapist, mental health specialist, and
founder of Zoe Clews & Associates. “It’s because it releases a stress

She suggests taking inspiration from toddlers – who
aren’t shy about expressing their anger: “One of my favourite techniques is
having an ‘adult tantrum’, lying on the floor and pounding your fists or just
shaking your body – save it for the privacy of your own home and not the

“It really does help discharge all the built-up
toxic stress,” says Clews. “We feel stressed when we feel ‘full’, so by
releasing it from the body in a safe and private way, you will experience
pretty instant relief.”

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Respiratory feedback is another type of biofeedback therapy. A randomized controlled trial from the Journal of Medical Internet Research suggests respiratory feedback is especially useful for the purposes of treating stress and anxiety. This study induced stress and compared the effects of two different treatments, splitting participants into three groups: one group used a breathing app that provided respiratory feedback, one group did a mindfulness body scan, and one group served as a control and didn't do anything. 

The authors found the breathing app to be significantly more effective for the purposes of stress recovery than the mindfulness body scan. This makes sense, as there is a well-established association between breathing patterns, stress, and relaxation. Harvard Health explains that shallow breathing or "chest breathing" can trigger anxiousness, while deep breathing or "diaphragmatic breathing" can lower your heart rate and blood pressure, creating feelings of relaxation.

Another study from Cognition and Emotion describes the intimate connection between breathing patterns and emotions. This was actually two studies: The first study measured participants' breathing patterns in response to various emotional stimuli, and in the second study, participants were then instructed to practice those breathing patterns without any stimuli. Unsurprisingly, the participants' emotional states changed based on the type of breathing pattern they were instructed to practice.

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In some situations, it can be tricky to maintain your calm and keep stress at bay. At such times, according to experts, concentrating on your breathing can help. Wondering how you can do that? Worry not, we’ve got your back. Adding to the list of effective techniques to help the body and mind feel calm in challenging situations, much like the ‘54321’ technique to cope with anxiety, or the deep breathing technique to relieve stress, and even box breathing, is ‘bunny breathing’ or ‘rabbit breathing’. Find out more about it here.

Dr Caroline Leaf, a mental health and mind expert,  took to Instagram to share why bunny breathing is worth your time. “A great breathing technique for reducing anxiety and stress!” she wrote.

How to do it?

*Sit up tall with your back straight and your head tilted up towards the sky.
*Take three short inhale breaths like a bunny sniffing a flower.
*Hold your breath for a moment, then exhale sharply.
*Repeat until calm and grounded.

How does this help?

According to Dr Manish Mannan, HOD pediatrics and neonatology, Paras Hospital, Gurugram, this technique is especially essential for children. “It may be used to aid children who are really distressed and unable to breathe, since it will enable them to connect to their breath (when exhaling) and allow them to breathe rather than spinning out,” said Dr Mannan while noting that it helps process strong emotions.

“Slow breathing techniques enhance autonomic, cerebral, and psychological flexibility that helps deal with challenges,” Dr Mannan told indianexpress.com.

Agreed Dr Santosh Pandey, naturopath and acupuncturist, Rejua Energy Centre and said that the action imitates the sobbing motion and helps children breathe through crying or while dealing with other big emotions like fear, anxiety, and sadness.

How does it work?

The inherent rapid intake of oxygen when practicing the bunny breath awakens the brain, said Dr Pandey, adding that it makes one more alert.

Chronic stress can put your physical and mental wellbeing at risk. (Photo: Getty/Thinkstock)

How long should one practice it for?

Rabbit breathing should be ideally practiced for 3-4 minutes. “If you feel any discomfort while practicing, take a break for few seconds,” said Dr Pandey.

Who shouldn’t practice?

According to Dr Pandey, people suffering from epilepsy, and people with high blood pressure should avoid the practice.

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