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The Fullness of Midlife

"Can we regulate heart rate, anxiety, mood, depression, and circulation with breathwork?"

"Can we regulate heart rate, anxiety, mood, depression, and circulation with breathwork?"

by Dr. Barb DePree MD

Michelle Shaw

Michelle Shaw is a former coach and high school English teacher who came to yoga instruction at midlife. She holds Yoga Alliance Certification through Kia Miller and Tommy Rosen in Radiant Body Yoga. Radiant Body Yoga is a holistic approach that combines physical posture, breath work, kriyas, meditation, and chanting to increase strength, build vitality, and create mental clarity. She is also a certified Kripalu Yoga in the Schools instructor, for a curriculum developed in partnership with Harvard Medical School, and is interested in bringing the benefits of yoga into the educational system and more.

Barb: I’ve talked to Michelle Shaw before here on "The Fullness of Midlife." She is, in full disclosure, my own yoga instructor. Our earlier conversation was about how a yoga practice can support finding a place of calm in our lives. I invited Michelle back because of a book she dropped off on my porch recently. And I’ll be honest and say that, when I first picked it up I thought I’d maybe quickly skim it, and be able to go back and say, “Oh, yeah yeah, I’ve read it.” But I ended up literally reading it word for word, beginning to end, over just a few days. I was completely just enraptured by it. 

The book [named by NPR as among the best of 2020] is by the journalist James Nestor, and it is called Breath: The New Science of a Lost Art. And Michelle, I’m really grateful that you agreed to join me today to talk about this book. Welcome!

Michelle: Thanks so much for having me. It’s a pleasure to be back and talk with everyone about this wonderful book and about the power of breath. 

Barb: And over the last few years practicing yoga with you, I think I’ve had some sense of the importance of breath, and you have, you know, encouraged some breathing practices and talked about breath. But it was really this deep dive that made me so much more now appreciate what you are trying to convey in your work and in your instruction. And in just thinking about it differently, it is interesting, from a clinical perspective, that we just take breath for granted. 

I think it states that every day we breathe 25,000 times a day. But breath has a really critical impact on anxiety, blood pressure, heart rate, all these really kind of basic, critical functions. I’m curious how you came across the book, how you decided to dive into this deeper, and kind of what led you there. 

Michelle: Yeah, great. First of all, thank you for your candor that maybe, you know, you were going to flip through the book that I dropped off on your front porch, but I was thrilled when I found out that you were really captivated with it and taken with it. I’m honored that you read it.

I came to the book—just background there—one of my fellow yogi instructors works for a company called Breathwork, and we can talk more about that later. But she was interviewed by a magazine about the work that she’s doing at that company. She references the book in the article. When I read her reference to the book, I thought, “Oh, I completely trust her. This sounds really interesting. I’m going to read it.”

So I ordered it for myself, and read it quite quickly. Then I thought, “Wow, I am super-captivated by this, but is this just me as a yoga instructor?” 

As a yoga instructor, many of us just think of the postures that we do. You know, we do a Warrior II, or we try to do a Down Dog, or we have a posture in mind that we want to learn. If you think of a tree, when we think of eight different limbs of yoga—so that big tree having eight different parts—and one of those parts is the physical postures. That’s just one small part of yoga. Another part is what we call Pranayama, or this breath practice, this working with our breath.

As I did more advanced training beyond my original, one of my trainings was 60 hours of breathwork training. That doesn’t mean we’re just sitting and reading about breath, but we were having those experiences in our body and figuring out what works and why. Yogis have been doing this—I don’t know if it’s intuitively—but, there’s been this wisdom, this knowing in ones body; I’ve been fortunate enough to have it be passed down so that I can learn and share it with others. 

But what I found super exciting about this book and why I wanted to share it with you, I thought maybe—because I know you practice yoga—but you also have, obviously, all this medical and scientific knowledge and background, and maybe you would find it compelling because this book does this deep dive into the impacts of our breath, how we are not necessarily breathing correctly, and all the layers of consequences that that has. 

Can we regulate heart rate, anxiety, mood, depression, and circulation with breathwork?

He writes about it in a very data-driven point; he goes into it with his own body. The author, James Nestor, goes into it with his own body with deep experiences. He does some pretty nutty things, and I’ll leave that to your audience to hopefully read in this book. But he goes to kind of extremes to learn and understand what’s happening in the body with breathwork, and can we really do things to regulate heart rate, anxiety, mood, depression, circulation? All these things: can we really have an impact in our own bodies with our own breath? In this book, his answer is definitely, a resounding yes. Would you agree with that assessment?

Barb: Yes, and I think that’s what I found so interesting, that this basic function of which we all have accessibility to at any time we want—just having a deeper understanding of the impact and how to utilize it—we could ourselves have such an important benefit to, like you mentioned, mood and energy and anxiety. So, especially in the times in which we find ourselves now, needing to find solutions for navigating challenges, why wouldn’t we want to have a better understanding of how to use this resource that’s available to us? 

He starts the book by spending quite a bit of time talking about the difference between mouth breathing and nose breathing. This was all new to me, but it made so much sense, and I think about the people who have challenges around that. Can you just expand on that a little bit? About why nose breathing is really critical versus mouth breathing. 

Michelle: Sure. So, one of the quotes that is interesting in the book, it says “The three most important words might be ‘shut your mouth.’” [laughs] So it’s just a quick, easy way to remember that we want to be breathing through our noses. Unless you are doing something intentional otherwise, or you have some congestion or whatever else. But typically throughout the day we want to be breathing in and out, through the nose. 

The statistics in the book, nearly half of all people are chronic mouth breathers. Nearly half. And they are chronically stressed and exhausted as a result. Breathing through your nose triggers different body hormones, and if you breathe using your mouth, breathing through your nose can lower your blood pressure, help maintain a steady heart rate, it can help with memory consolidation. There’s a whole scientific explanation offered in this book as to why it has to do with oxygen levels, our carbon dioxide levels, what happens when air comes through our nose, how it’s filtered, how it’s purified, how it’s regulated in temperature versus what happens when we are breathing through an open mouth. 

He also goes into quite a bit of people with sleeping disorders—whether that’s sleep apnea, snoring, and then we’re not feeling rested. So that is absolutely one of his most paramount points. The other thing, I think—one of the interesting quotes was from Dr. Andrew Weil, and you might recognize the name: “If I had to limit my advice on healthier living to just one tip, it would be simply to learn how to breathe better.” How to breathe better. 

Barb: I know. Fascinating. And as you mentioned, the author, James Nestor, and a colleague, he did some kind of crazy things in better understanding how to see the impact of breath, but he literally plugged his nose for two weeks I think it was, and was a mouth breather. And the findings of quality of life and so many factors was just so dramatic. I think of all the conditions we—individuals—have that prevent them from being nose breathers, and I was just grateful that I’m able to be a nose breather [laughs]. I think that’s how I sleep at night, and hopefully that’s helping with memory and mental clarity and a lower blood pressure. But it was pretty astounding, and I think more people should just have awareness of that, and if there are tools we could implement to improve that, we should be doing it.

Michelle: Yeah, and it seems like such a simple thing. Like you said in the beginning, we breathe 25,000 times a day, it’s not something we typically have to think about. It’s interesting to talk about it during this time of a pandemic when we’ve been hearing a lot about respiratory challenges and dramatic problems, and obviously, that’s caused by something that we don’t necessarily have control over. 

How do I feel in my body right now?

But in our day-to-day lives, the fact that we can have this influence! I always think of it as a toolkit. I want to know how, if I’m feeling a little bit anxious—and this is something that maybe your audience can start to think about—but when you are anxious or upset, if you can take just a little meta moment, step outside your own body and say, “How do I feel in my body right now? When I’m anxious or upset or nervous or fearful, what does my body feel like?” Not what my head is thinking about, but what is my body experiencing? 

Oftentimes you’ll find our breath has come way up into the chest, and we’re super tight, and we might be breathing really shallow. So one of the biggest pieces of advice, along with breathing through the nose, is that we actually breathe more slowly. We try to extend this inhale and we extend this exhale, and that we use more of our diaphragm and more of our lung capacity. And that is something that typically we don’t do, but we can!

What I found exciting that stood out to me that maybe I hadn’t really thought of necessarily from a yoga training standpoint, but now from a scientific—and I love when those can marry together and just build upon one another—is that our lungs, they are just like another muscle. We can strengthen them. So if you’re a person that’s thinking, “I can’t nose-breathe” or “of course I breathe shallow” or “I struggle with asthma” or “I have allergies” or “I have other challenges.” Lungs are a muscle that we can work with, and we can make improvements, and he gives data points and percentages of growth that we can have and all this interesting information. 

Lungs are a muscle we can work with and improve

Barb: And he points out how athletes intentionally do breath work to increase their lung capacity. So, I guess I think about athleticism—it's really more about muscle and function and flexibility, and we just haven’t really heard much about the focus on breath, but I think I would appreciate your efforts in yoga in continuing to incorporate breathwork. And again—for selfish purposes, when I’m on the mat doing yoga, it’s more about being the Type A person, so why am I not doing more stretching and balancing, and you know, the active parts? So I sort of shamefully will say that the breathwork seemed a little bit of wasted minutes to me. I will never feel that way again, and I will have more appreciation because, honestly, we just don’t do that in our day to day. 

He had a whole chapter on exhalation. On the importance of exhaling, and how that ties in to carbon dioxide. I think the body is so fascinatingly complicated that something as simple as breath just has this really deep and integral impact on wellness. I’m just wondering if you would talk a little bit more about, you know, what you know about yoga, and things like slow inhale/exhale, and how it might impact how we feel at that time, as well as other times. 

Michelle: Sure. I love that this book has helped convert you and your own practice to appreciating breath. I know many times people are looking at yoga classes as fitness and as an exercise, and they want to be more flexible, and get into certain postures. My instructor, my teacher has taught me you give them a spoonful of sugar [laughs]. You know, to have the medicine. You give them what they want, but you also do these things that we know are so important.

When it comes to talking about this axiom rhythm to our breath, this is where we want to tune into. We want to have that awareness of where am I breathing? How am I breathing? If you measure your heart rate when you are inhaling, that heart is going to speed up. If you are measuring the heart rate as you exhale, that heart rate is going to slow down. Exhale starts to tap into our parasympathetic—this rest-and-digest response in the body. And it allows the body to conserve energy.

The analogy that I like that he offers for that is that—if any of your listeners have maybe been in a canoe or a kayak or you’ve been on any sort where you have to propel yourself like that—so if you took these short-step, choppy strokes with your canoe paddle, and were just kind of like flailing, and going faster and faster, and just trying to do this, thinking you’re giving more energy that you are going to be going faster in your canoe, it’s actually the opposite. You need these long, slow, efficient strokes with that paddle or that oar. And that’s where you have efficiency. That is very much like our breath. 

One of the best things we can do is to learn how to slow our breathing down.

One of the really interesting data points he brings up is the longevity of mammals, different mammals. Mammals that breathe really slowly—elephants, tortoises—their lifespan is super-extended. And that the animals who breathe really quick, you know, our four-legged friends, our dogs and other animals, their lifespans are shorter. Now of course that’s not only about breath rate, but they are starting to see these connections between, for example, anxiety, we talked a little bit about. If you come up in your chest and you’re breathing really shallowly, well, that is an anxious way of breathing. Well, then the mind starts to feel anxious. And then we start to breathe that way even more, and it triggers this hormonal response in the body and everything else. So pretty soon you’re on this not great spiral between how we’re breathing and how we’re feeling, and what our mind might be spinning in. So, one of the best things we can do is just be aware of how we are breathing and learn how to slow it down. And learn how to use more of the lungs and diaphragm.

So this is like the baseline of breathwork. When you come into it from a yogic standpoint, there’s so much more that we can do between balancing left and right hemispheres of the brain, elevating moods, relaxing the body. We can do this with different types of breathing! And I love having that as just something that helps me, especially in these challenging, unprecedented times to have this and be able to say “What does my body need right now?” And yeah, I might grab for that cup of coffee to lift me up, or I might grab for that glass of wine to help me calm down or unwind, but we have this whole pharmaceutical kit within our own body, and the easiest way to get to it through the breath.  

I find that really exciting that we can have this much resiliency and regulation from our own breath. And sure, the physical postures in the yoga class are fantastic. I like to feel strong. I like to take care of my physical muscles. I want to move my body as well as I can for as many decades as I can. But wow! Am I glad that I also know these other layers of what can impact my day-to-day life. I don’t have to be in my leggings. I don’t have to get on a yoga mat. I don’t have to take a class with an instructor. I can do this work within my own body as can every one of your listeners. 

Barb: I found it interesting too, that he sort of outlined the ideal breathing pattern. This five-and-a-half-second inhale, this five-and-a-half-second exhale amounts to five-and-a-half breaths per minute. And he also correlated it to many of the prayers or chants that have been around for centuries. Thinking that there’s probably some innate knowledge about what’s best because our practices, our religions have incorporated that. And as I try to do that, while I’m reading the book, and be aware of that pattern of breathing, I think my lungs need more muscle work [laughs]. It's not that I couldn’t, but it certainly wouldn’t be my natural breathing, and I wondered, do you think that with practice you can find a pattern of breathing like that, that becomes your baseline breathing?

Michelle: That’s a great question! I’m not sure I have the answer. I know in my own body, for example, if I’m working at my computer and I’m really focussed on writing something or getting something out, I will not have even noticed my breath. But when I finish that session, I will stand up from the computer, I might notice my jaw is super tight and locked, my shoulders are rounded, I have a headache. I’ve clearly not been breathing in that really beautiful pattern. Maybe I’ve been holding my breath in between, you know, spurts of mental energy that I’m putting out.

So one of my things—especially after reading this book—that has really shifted is just not just thinking about my breath in my yoga practice, but just in my everyday action. Right? So while I’m washing the dishes, or changing the laundry, or going out on a walk. It’s one of the glorious things that’s really helping during the pandemic is the everyday connect with nature. And as I’m walking, can I breath through my nose, and can it be a little slower?

It’s a challenge. I didn’t notice that about myself until I read this book, but when I take walks I tend to start mouth breathing. Because I have my heartrate up a little bit, and I don’t know why. You know in many other athletic activities we’ve never been encouraged to think about our breath. I’ve never heard like a basketball coach say, “As you are taking your lay-up, you should be exhaling at this point in your bodily motion.” So we just haven’t thought about it very much. 

It’s coming into just how important it is having that remain at the foreground of your own thinking, and checking in a little more regularly, and even being creative about ways to do that. 

I started in the interview talking about how I came to this book through a fellow yoga instructor with me. She actually works for a company called Breathwork, and they have a free app that you can get—and there are others; this is just one particular one. But what I love about these apps that anyone can download if you have that technology available for yourself, you can get the breath that he’s talking about, that rhythm. Because if you’re like, “How do I breathe five-and-a-half seconds on inhale and five-and-a-half seconds on an exhale? That seems crazy.” 

These apps will give you a little sound or a vibration or a visual queue, so you can start to kind of train yourself. And like, “Oh, at least I know in my body what that feels like as a baseline,” so we can try and develop that as more natural, and return to it more readily. So it might be something like that that we utilize as tools. Also, setting a timer for yourself, reminding yourself to breathe. Reminding yourself to just check on your breathing. And those are things that those apps can do, or many of our phones or computers can do. You know, take a breath break. Have that come up after you’ve been on your computer for 30 minutes so that you actually check back in and see how you’re doing. 

We know that anxiety and shallow breathing are interlinked. So again, especially in these stressful times, wouldn’t it be wonderful if we could recalibrate ourselves by taking just a few long, deep, even breaths. 

Barb: Yes, and I think a message that came through fairly consistently was this idea to breathe less, which is a little counterintuitive, but I think it’s back to the slower, more intentional, even breathing. So, yeah. 

Michelle: Well, my favorite final quote. This is mine in a nutshell, the book in a nutshell: “Breathing as it happens…” and this is on page 143 and 44, “Breathing as it happens is more than just a biochemical or physical act. It’s moving the diaphragm downward and sucking in air to feed hungry cells and remove waste. The tens of billions of molecules we bring into our bodies with every breath also serve a more subtle but equally important role. They influence nearly every internal organ, telling them when to turn on and off. They affect heart rate, digestion, moods, attitudes. When we feel aroused, and when we feel nauseated, breathing is a power switch to a vast network called the autonomic nervous system.”

Barb: Yeah, thank you. It was a great read, so I would recommend it to others who want to understand, again, how to access their own bodies to improve quality of life and wellness, I think. And health, overall health is improved. 

So as part of this, Michelle, I know you have prepared a guided breathing exercise for us. Shall we begin?

Michelle: Let’s do it. Fantastic. 

For this breath today, welcome and just take a moment. You could be lying on your back. You could be sitting on a yoga mat. You could be sitting in a chair. You could be in any bodily position. You could be standing up. That’s the beauty of this, you don’t need any special equipment or anything else. 

So just take a moment, and just try to give yourself a little bit of stillness. Settle in right where you are. And wherever you are and whatever position, go ahead and rest one hand, or both—doesn’t matter—onto your belly. As you rest the hand(s) on the belly—and many of us maybe have a love/hate relationship with this area—go ahead and give it some love and see if you can start your inhale all the way in from the bottom of that belly. 

So as you inhale, you are going to expand the belly into your hand. Lift that bottom hand. And as you exhale, you’re going to relax that belly back down. Let’s try that again. So inhale. Expand your belly. Go ahead, let it live. And exhale; let it back out. Let’s try one more round like that. Big inhale. We’re trying to breath through the nose. Inhale through nose, expanding belly. Exhale releasing that all back out. 


Now let's just keep one hand on the belly and float the other hand onto the heart. So we’re going to start that inhale way at the base of the belly. Lift that bottom hand, and now keep inhale going up into that top hand. See if you can take the breath up into that heart. And as you exhale, relax that all back down. 

Good. Big beautiful inhale lift the belly up and up into the heart, and a nice, slow, relaxing, complete exhale. Let’s do a few more rounds like that. That big, smooth inhale, and a long, relaxed exhale. Two more rounds. Wonderfully expansive inhale, keep taking in air, maybe lifting this time all the way up toward your collar bone, and exhale releasing all that all back out. One more time, please. Inhale lifting belly, lifting up the heart, keep lifting those lungs. Keep going. And exhale. Relax it all back down. Good. You can just release your hands and continue with this beautiful big belly, lift chest, lift heart, and relax on your exhale. 

Continuing here, now as you breathe, see if you can add a count to your inhalation, and a count to your exhalation. Maybe your inhale is a four. And then let’s try to get our exhale to be that same four. Expansive; if you like hand on belly and heart, great, stay there. Or, if you prefer, resting down. Wait. Continuing to find this rhythm where we soften any edges, we smooth out any glitches. We’re coming into this ease of inhale and exhale. 

Most of us will find one or the other much easier to extend; completely natural and normal, but try to find this balance exchange. The seamless effort of inhale and exhale. Good. So we’re going to try to come all together into this now. So hopefully you’ve established a rhythm that’s working. And we’re going to try together now to have that inhale for four and exhale for four. 

So here we go; joining in, inhale from nose, lifting for one… two… three… four. Exhale one… two… three… four. Inhale for one… two… three… four. Exhale one… two… three… four. Inhale for one… two… three… four. Exhale one… two… three… four. Inhale for one… two… three… four. Exhale five: one… two… three… four… and five. Inhale four. Exhale five. Inhale four. Exhale six. Inhale four. Exhale six. Inhale four. Exhale six. Continuing there, having that exhalation, like slowly letting the air out of a balloon. Pacing yourself. Relaxing, never letting yourself come into a place of strain. 

And as you continue your lung capacity will increase. You will find more flexibility through the diaphragm and extension through the lungs. It will come more naturally. And if you have the ability to draw out that exhalation, continuing it to a count of seven, maybe even extending it eventually to a count of eight, so that our exhalation is double the length of the inhalation. Yeah. 

This all comes back to this important, this beautiful, even rhythm of breath, and the importance of the exhalation to the body’s response to rest and digest. So as you continue to breathe just know that this is a breath that can serve you at any time of day. Whenever you want to come back to feeling more like yourself, when you want to reconnect, bring things down a notch, come back into a greater place of calm, shift energy away from fear or anxiety. Simply a few moments. You have great impact even after ten to twelve rounds of breath. Even as few as six rounds of breath, it will help your nervous system. 

And again, breath is the only way that we have access to our own nervous system. So it’s a beautiful gift you are walking around with at all times.

Whenever you are ready finishing your breath, just coming back in, offer yourself a moment of gratitude for turning down the level of stress, tuning up your own awareness, and coming back into a more neutral place of calm and clarity. 

Thank you for practicing with me today!

We've also made this breathing practice available as a stand-alone recording that you can use every day.


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