The Breath - Bipolar's Number One Killer App

Patient Expert

Let's talk about the breath. Of all the tools in our overall wellness toolkit, this is by far the most important. As a killer app for managing bipolar, I also rank it number one. Nothing else comes close.

So why haven't I written about it after all these years? It turns out that breathing is our most easily overlooked activity. We simply don't think about it. The trick is to start thinking about it, in essence to mindfully observe each breath.

What finally got me motivated to write about the breath was a short piece I came across in the 2009 book, "What Have You Changed Your Mind About?" The book is part of an annual series put out by Edge, where about 150 leading thinkers respond to the same thought-provoking question.

The particular response was by writer and technology guru Linda Stone. Ms Stone happened to notice that people tended to hold their breaths when responding to email and to hyperventilate when talking on their cell phones.

Both these tendencies, she reports, disturb oxygen and CO2 balance. She cites research that shows that disrupted breathing contributes mightily to stress-related diseases. Our body's biochemistry gets thrown off.

(For a detailed description of all the things that can go wrong when we are stressed, including in the brain, check out Robert Sapolsky's "Why Zebras Don't Get Ulcers.")

Our autonomic nervous system, which regulates our body functions at a mostly unconscious level, is divided into the parasympathetic and sympathetic nervous systems. The former is about rest-and-digest, the latter about fight-or-flight.

When everything is working right, there is a healthy tension between the two systems. Amazingly, our breath can shut down or kickstart either one. Breathe wrong and suddenly our body is converting glucose into raw energy, which is the very last thing we want to happen when our boss calls us into her office.

Breathe right and we may be able to call up that same energy on demand, when we need it, say to drag ourselves out of the house. We can also breathe right to activate the relaxation response.

According to Ms Stone:

I've discovered that the more consistently I tune in to healthy breathing patterns, the clearer it is to me whether I'm hungry or not, the more easily I fall asleep and rest peacefully at night, and the more my outlook is consistently positive. I've come to believe that within the next five to seven years, breathing exercises will be a significant part of our fitness regime.

Breathing figures mightily in yoga's many paths, so much so that the yogis assign the air about us a spiritual quality one they call Prana (with a capital P). Amy Weintraub in her 2003 "Yoga for Depression" points out that most of us tend to breathe inefficiently using the chest rather than the diaphragm.

According to Amy, mindful breathing "can create a calm, healing state in body and mind." Taking longer out-breaths than in-breaths, she notes, activates the relaxation response and can be employed as an instant and very powerful anxiety-buster.

Likewise, there are breathing "energizers" that feature rapid diaphragm movements.

Personal take

I have personally benefitted from mindful breathing. Unfortunately, I am a creature of bad habit. I seriously need to work a lot harder at this. With that in mind, here are some of my tricks:

**Just breathing, small dose  **

Stop whatever you're doing at regular intervals during the day and take a minute or two to focus on your breath. Sit up straight, close your eyes and follow your breath in and out. "When you breathe, just breathe."   I feel the effect instantly. Mentally and physically, I am in much better shape to get on with my tasks.

Just breathing, larger dose

If you can get away from your desk for five minutes or more, find a quiet place, sit comfortably with erect posture, close your eyes, and follow your breaths in and out to the count of 20. The calming effect is instant, palpable, and long-lasting. The exercise also helps clear the mind for meditation, if you are so inclined.

Quiet time

We all need our quiet time. A few deep breaths can work wonders.

Stepping outside

It's amazing what fresh air can do.

One nostril at a time

You can do this on the go or in a quiet place. With one finger, close your left nostril. Breathe through your right nostril and hold for a few seconds. While holding the breath, release your finger from your left nostril and close your right nostril. Breathe out slowly through the left nostril. Breathe back in through the same nostril and hold. Switch your finger back to the left nostril and breathe out through the right nostril.

Repeat the process. Exhaling should be twice as long as inhaling.

I find there is no better technique to slow down my runaway brain, or when I anticipate my brain going into runaway mode. The catch is I need to remember to use it.

Remembering to breathe

This is critical if the conversation or the situation is starting to heat up. Before you respond, either to a provocation or positive feedback, take a deep breath or two. You will thank yourself later.

Energizing breath

In yoga, the term is skull-shining breath. Please learn this under a trained practitioner. Sit comfortably and erect, With your diaphragm, force air out of your nostrils. The inhale is automatic. Repeat several times, but do not overdo it.

The effect is instant and energizing, and works to fend off those depressive states. Again, learn this under expert guidance.

Related activities

The breath is central to yoga, tai chi, martial arts, and similar practices. If you regularly engage in these, you are probably already a master breather. The same is true if you are a regular jogger or cyclist or swimmer. Going out for walks can also help you become aware of your breathing.

Bonus segment

I practice the didgeridoo for about an hour a day. I have mastered a technique called "circular breathing" that is very conducive to entering a calming meditative state. There is also "bounce breathing" that employs pushes from the diaphragm, very similar to the yogic shining skull breathing exercise. Thus, my didgeridoo acts as both a stress-buster and an energizer.

Final word

If we paid the same attention to our breathing as we did to our hair or our teeth, we would be far healthier, physically and mentally.   We would sleep better, have less stress, and function better day-to-day. We would also have a better handle on our moods and anxieties.

Seriously, I'm not kidding when I say that breathing is bipolar's number one killer app. We need to put some serious work into this.