Breathing Lesson

As humans, we can live more than two weeks without food, three or four days without water, but only a minute or two without breathing.  We are born with the drive to breathe, and we will continue to do so automatically until we take our last breath.  Every breath isn’t exactly the same, though, is it?  Pause for a moment and just observe your breathing. If you’re calm and relaxed, your breath is likely long and full, filling your entire torso.  If you’re feeling pressured or anxious, you may notice a shallow, rapid breath. The breath is affected by our emotional state, and our emotional state affects the breath.

In a normal resting state, we only use a small portion of our breath capacity and respiratory muscles.  We tend to take short breaths, moving only the upper chest, all on automatic pilot.  But we can alter our breath, at least to a certain extent.  The breath can be sped up or slowed down, made fuller or more shallow.  We can change the length of the inhale or exhale, and use our muscles to move the air more forcefully.  All of these patterns can be helpful at times, and the yogic techniques called Pranayama make full use of them.  But breath work doesn’t have to be complex or difficult to be effective.

One of the first techniques I teach many patients is the Yogic Three-Part Breath.  It is an excellent way to get acquainted with your breath pattern, and with all the muscles that can be involved in breathing.  It’s called the Three-Part Breath because we will think of the torso in three sections: below the navel, from the navel to the mid-chest, and from mid-chest to the collar bones.  The lungs clearly don’t expand into our low belly when we breathe, but we can and should be using our abdominal muscles to make the most of our breath.  It can be helpful to practice this technique lying flat, with one hand on your low belly, and another on your chest.  Try to breathe through your nose.

Start by inhaling slowly while inflating your low belly.  You want to feel your hand moving up as you inhale.  You may have to push the muscles to create this movement.  If it’s difficult to feel, try placing a book on this area, and practice pushing it up with each inhale.  This is the first part of the breath, and usually the most challenging.  But, this is diaphragmatic breathing, or a deep belly breath.  Simply breathing into your abdomen in this way will calm your nervous system.

Part two expands the inhale into the mid-chest.  After inhaling and filling the belly, extend the inhale and picture the air rising into your chest, lifting and expanding your ribs before you exhale.  The rib cage goes all the way around the torso, so feel the ribs moving in the back as well as the front, the entire circumference growing outward.

Part three brings the inhale to its fullest capacity.  Again, start by inhaling into the belly, then lifting and expanding into the mid-chest.  Now continue your inhale, extending the sternum and broadening the collar bones, filling your lungs completely before exhaling.  This is a huge inhale, but try to remain relaxed and at ease throughout, never forcing or packing the air in, just allowing all parts of the torso to fill with the breath.  With an inhale so full, the exhale will naturally lengthen as well, calming the body even more.  Try to do several minutes of the full three-part breath.  If you feel anxious or short of breath at any time, return to normal breathing immediately.

I recommend practicing this breath every night before bed, it will trigger the relaxation response, allowing the body and mind to settle and prepare for rest.  Practicing when you are calm will help you learn the technique well, so it will be easy to use when needed.  Then use it anytime you are feeling stressed: before a meeting at work or a tense conversation, or even when stuck in traffic.  The best part is that the breath is completely portable, always available, and has no side effects.  The relaxation response, right at your fingertips.  Try it for yourself.

Seasonal Affective Disorder

It feels like fall outside today.  It’s breezy and much cooler, and I am starting to notice the shrinking daylight.  Maybe you are, too?  It may be a little harder to get out of bed in the morning, or you’re starting to crave more comforting foods.  The change may come up over night, and that heavy feeling starts settling in.  It’s natural for those of us who don’t live near the Equator to slow down as winter approaches.  We are mammals, after all, and the instinct to hibernate hasn’t completely left us.  Most people notice only minor changes in energy, mood or appetite as the cooler months set in, but for some, the effects are much stronger.

Seasonal Affective Disorder (also know as SAD, or winter depression) affects up to 5% of adults, and as many as 20% suffer from multiple symptoms of the disorder.  It typically starts in late September or early October, and improves in the spring.  The cause is uncertain, but may be due to lower levels of sunlight, which affects melatonin release and serotonin levels.  Common symptoms include fatigue, low mood or irritability, trouble concentrating, and low libido.  People with SAD tend to feel tired, unmotivated, and may start to avoid activities they usually enjoy.  The appetite may also increase, with a particular craving for carbs, and sufferers commonly gain weight.  If you notice many of these symptoms, and they are a significant change from your usual lifestyle, it’s important to discuss this with your doctor to see if you need treatment.

If your symptoms aren’t severe, there are many things you can do to help improve seasonal mood changes on your own:

1. Start your morning by turning on the lights as brightly as possible.  This will regulate the sleep/wake cycle, so your body knows it’s time to wake up.

2. Exercise regularly.  You may feel like slowing down, but continuing your usual exercise routine will improve energy and prevent weight gain.  A regular yoga practice is particularly effective at combating seasonal depression.  Find a class or try one of the many on-line videos.

3. Get outside.  Even in the winter, natural sunshine will help.

4. Consider taking a vitamin D3 supplement.  While there isn’t enough evidence to link vitamin D to SAD, we do know that many people living away from the Equator have a deficiency.  Low vitamin D can cause fatigue and low mood, and supplements are available at your regular drug store.  Your doctor may recommend checking your level with a simple blood test to ensure you are taking the right amount.

5. Try bright light therapy.  This requires the purchase of a special treatment lamp.  These lamps typically cost about $200, but you can find a range of styles and prices on the internet.  Insurance may cover the cost, but in my experience, don’t count on it.  In order to be effective, the lamp must have a brightness of at least 10,000 lux, and you will need to sit close to the lamp (but not looking at the light) for about 30 minutes each morning.  People with bipolar disorder should discuss bright light therapy with their doctor first, as it can trigger manic episodes.

6. If all else fails, or your symptoms aren’t improving, talk to your doctor.  Several anti-depressants have been found to be effective treatments for SAD.

The colder months are a time for slowing down, so listen to your body and take care of yourself.  Remember: no matter how dark and cold the winter, it’s always followed by the spring.


It’s just how it is

I read a great quote yesterday, from psychotherapist Virginia Satir: “Life isn’t how it’s supposed to be, it’s how it is.  The way you cope with it is what makes the difference.”  Some days are harder than others.  Let’s face it, sometimes whole periods of life are tough, or at least not how we feel they should be.  There are times we may think life is unfair, or that other people don’t have to work so hard.  It’s easy to fall into the trap of fighting against our experience and listing all the ways things ought to be different.  The last time I checked, though, those thoughts won’t change reality.  Sometimes it just is what it is.

The mind often doesn’t want to accept that, however.  So chances are that judgmental thoughts will continue, no matter how enlightened we are.  I don’t think there is one right way to manage an anxious mind, but no matter how we proceed, we must first be aware of what our thoughts are doing.  The only way I know how to do this is to sit quietly and watch them.

Seated meditation puts me in touch with my mental forecast.  I can see the negative paranoid stuff as well as the worry and projection.  It can be a little scary at first, but as I sit, I see that the thoughts arise, come into focus, then fade away.  The feelings they evoke do the same thing.  Everything is always changing, and I am not stuck with the circumstances or emotions of this moment.

Sometimes, just remembering that everything that comes up will eventually move on again is enough.  Other times, the distractions settle and I can see a clearer path through a difficult time or emotion.  Sometimes the thoughts keep coming, but I stay seated and quiet and I return to this moment again and again until my mind and body relax a little.  No matter what the outcome, meditation hasn’t removed my challenges, but it has allowed me to cope with them.  I stop lamenting what I think my life should be, and start living it as it is, in the best way that I can.

Choose a Different Response

I was checking voicemail yesterday and found myself in a familiar state: upset and agitated by one of the messages.  I interpreted a comment as a personal attack, and immediately went into defense mode.  I felt myself tighten up, my breath became shorter and I created a list of several people I wanted to call to complain about this person.  Now I have been down this road before.  Haven’t we all?  Sometimes we are correct, and the person is attacking us, other times we’ve misread the situation entirely. Regardless of their intention, we still get to choose how we’re going to respond.

I’ve been reading a lot of books about mindfulness lately.  Luckily, I had just started reading “Taking the Leap: Freeing ourselves from Old Habits and Fears” by Pema Chodron.  She says right in the beginning that if we stay present, we can use our “natural intelligence.”  It will always guide us to the right reaction in any situation.  But first we need to remove all the emotional baggage that is clouding our thoughts. I had to resist an impulsive reaction, and allow myself to be with everything that was present.  Even the uncomfortable thoughts and emotions.  So, I took a deep breath and sat with my feelings.  I recognized that I was triggered because of my own doubts and fears, and I remembered that in the past, gossiping and complaining did not help me feel better.  It just created drama.  I don’t like drama.

In the end, I decided to let the comment go.  This person might not have meant anything by it, and even if they did, what someone else thinks of me is not my business.  In other words, I saw that the right reaction was to not take it personally.  I have felt good about this choice, because I am not obsessing over the comment, I’m not plotting revenge, and I’m not endlessly stirring it up again by discussing it with anyone who will listen.  I honestly haven’t given it another thought.  Right now I’m almost grateful that it happened, because I learned that I can choose to respond in a different way, even when I’m upset.  This doesn’t come naturally, so I’m sure I’ll have to learn this lesson many more times.  But the ease of knowing I made the right decision seems worth the effort.