Mindfulness Prescriptions; Take a Breath (Volume I)
The connections between physical and mental health are copious, and extend far beyond our current understandings within the field of exercise physiology. However, it should be noted that there is legitimacy behind the evidence which supports this intriguing connection. A meta-analysis published in the British Journal of Medicine found no difference in effectiveness between exercise, antidepressants, or a combination of them both for participants struggling with non-severe depression. It is also worth noting that the combination of antidepressants with a normalized exercise routine decreased the negative side effects that participants experienced from taking pharmaceuticals. This decrease exhibited itself as a difference from 22% experiencing negative side effects in the non-exercise group to 9% experiencing negative side effects in the exercise group. The physiological benefits of exercise are well known and understood, but their relationship to mental health is still an expanding field worth exploring. From an introspective understanding of how the mind and body respond to their environment, to the psychological benefits of positive self talk, and practicing mindfulness on a daily basis, there is much to be learned.
As I begin to dive deeper into this connection, I intend to help my clients bridge the gap between physical and mental health in as many ways as possible. This idea presents itself in the form of a “mindfulness prescription.” In other words, a mindfulness prescription is a method of daily practice that relates a common mental health maintenance activity to an exercise regimen. I am a firm believer that it is easier to adopt a new habit if one is able to understand the “why” behind the practice. This leads me to present you with an example which can serve as an introduction to the mindfulness prescription philosophy.
Growing up, I always remember people telling me to take a deep breath when I felt stressed out or irritated, but I never truly understood why. This lack of understanding led me to abandon the practice, writing it off as juvenile and an old wives’ tale. I’m sure I’m not the only one. In retrospect, I’m not even sure if those advising me to “take a deep breath” in my youth fully understood its purpose, but that was the problem. I found myself struggling to put something into practice because I did not believe in its effectiveness and I did not attempt to introspectively analyze its usage. But as I began to dive deeper into the concept of breathing techniques, I realized its legitimacy and brought it full circle.
Our nervous system can be broken down into two distinct parts including the central and peripheral nervous systems. The central nervous system (CNS) consists of the brain and spinal cord while our peripheral nervous system (PNS) consists of everything else including nerves that branch out from the spinal cord. When we consider deep breathing, we want to pay specific attention to the peripheral nervous system and its further categorizations (somatic, and autonomic). Our somatic nervous system takes in sensory information, processes it at the level of the CNS, and responds accordingly with our movements. It is calculated, and it is informed. On the other hand, the autonomic nervous acts independent of our awareness. This shunt of our PNS controls our blood pressure, heart rate, and many other functions including our ability to breath without conscious control. Furthermore, the autonomic nervous system breaks down into two distinct branches referred to as the sympathetic and parasympathetic nervous systems. (Visualize below)
Now that we have broken down the nervous system into its respective branches (specifically the sympathetic and parasympathetic nervous system), we can take a closer look at why. The sympathetic nervous system, responsible for our fight or flight response, mobilizes blood away from parts of the body that are not required for an immediate reaction to a stimulus. Blood transitions away from our stomach and towards our muscles to enable movement. Our pupils dilate in order to encourage focused vision and our heart rate increases to assure that our bodies are ready for action. But none of this would be possible without our endocrine glands pumping out hormones such as adrenaline and cortisol to enable all of these physiological processes. If our bodies maintain high latent levels of these hormones, side effects occur such as inflammation, chronic pain, and mood swings, all of which can have detrimental long term effects if not tended to. More so, these hormones are not solely released when a fight or flight moment occurs, but when we experience stress on a daily basis. But don’t panic just yet. The last thing I want to do is trigger a fight or flight response while you’re reading this article. But even if we’ve come to that point, the parasympathetic nervous system can be taken advantage of to save the day.
Now you might be asking, “how can I take advantage of the parasympathetic nervous system? Isn’t it part of the autonomic nervous system which I have no control over whatsoever?” Not necessarily. The parasympathetic nervous system, responsible for our rest and digest response, does the exact opposite of our sympathetic nervous system. In fact, the parasympathetic nervous system helps regulate the sympathetic nervous system so our bodies are not in a consistent state of non relievable stress. Hence, by activating the parasympathetic nervous system, we can alleviate our bodies from the hormones that we would like to sparingly use.
Conveniently, one of the key players innervating the parasympathetic nervous system is the vagus nerve. Stimulation of the vagus nerve results in physiological processes such as a decreased heart rate, decrease in blood pressure, and increase in digestion; the exact opposite of a sympathetic (fight or flight) response. Luckily for us, we can stimulate the vagus nerve by taking advantage of exercises such as deep breathing. In fact, breathing at a rate of six breaths per minute (five second inhale, five second exhale) has been shown to apply enough pressure to the vagus nerve, resulting in stimulation. Just like lifting weights or preparing for a speech, practice makes perfect. The more we challenge our vagus nerve through stimulation, the better our body becomes at regulating our heart rate during stressful situations. This concept is related to vagal tone which can be described as an analytical measure used to define vagal nerve stimulation. An indirect way of measuring vagal tone in a non clinical setting is by analyzing heart rate variability (HRV). HRV tells us how efficient our body is at returning our heart rate to baseline levels after being elevated. To bring this concept full circle, the more vagal tone we have, the higher our HRV, and in effect, the more efficient our body is at regulating our response to stress.
Now, you may be thinking that this has nothing to do with physical exercise which was the entire point of reading this article. Well hold on, we’re just getting to the best part. By stimulating the vagus nerve through deep breathing immediately after exercise, our bodies benefit heavily. First, by toggling the body into a parasympathetic state, the process of inflammatory reduction commences. As mentioned previously, inflammation has negative effects in the long term, so preparing our bodies for recovery can help reduce and prevent these symptoms. Additionally, by kicking the parasympathetic nervous system into action, the body initiates thermogenesis and the synthesis of muscle tissue. Digestion and anabolism going hand in hand is always a good thing. Lastly, when we exercise, we stimulate our sympathetic nervous system to a very strong degree, and as we know, practice makes perfect. The post exercise state is the prime opportunity for us to challenge our vagus nerve to the highest degree of difficulty. Just like pushing our limits when we lift weights, we should do the same when training our bodies to respond to stress.
So take a deep breath, everything will be alright. This time, I mean it!
Recchia, Francesco, et al. “Comparative Effectiveness of Exercise, Antidepressants and Their Combination in Treating Non-Severe Depression: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials.” British Journal of Sports Medicine, BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine, 1 Dec. 2022, bjsm.bmj.com/content/56/23/1375.
Gerritsen, Roderik J S, and Guido P H Band. “Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity.” Frontiers in Human Neuroscience, U.S. National Library of Medicine, 9 Oct. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/.
Williams, Caroline. Move: How the New Science of Body Movement Can Set Your Mind Free. Hanover Square Press, 2022.