The power of breathing
If we can control the mechanical way we respond to stress, we could reduce anxiety.
Nobody wants to be stressed, anxious or depressed. And yet with all the science we have at our fingertips, all the experts coming at the problem from their different angles, it seems we are no better at preventing it.
That’s what author and life coach Sarah Laurie realised after a decade of working with corporates, training staff and speaking about wellness at conferences.
“Two years ago, I spoke to 350 corporate lawyers and afterwards a guy came up and told me that they needed this information so much because every person in the room knew someone who had ended their life because of stress. I pictured those 350 faces and thought, what the hell are we missing?” she recalls.
In a bid to find out, Laurie went on a research journey that took her to the lab of University of California neuroscientist Daniela Kaufer, whose work is focused on stress and the brain. She even watched an awake brain surgery, a procedure performed with the patient awake but sedated. Finally, she concluded what was needed was a way to switch off the stress response – the fight-or-flight mechanism once so crucial to our survival but mostly unhelpful in modern times – and that rather than focusing purely on our emotions, we should consider what is physically going on in our brains.
Laurie is now convinced a key to controlling anxiety and preventing a lot of depression is to change the way we are breathing. When we’re under pressure, we freeze and hold our breath. Under prolonged pressure, we start to chestbreathe at a faster rate. That’s what readies us for action, says Laurie, but it also switches off the executive-functioning part of the brain linked to coping, problemsolving and memory.
A healthy, calm breath comes from the stomach and through the nose. The trouble is most of us aren’t doing that habitually. And by constantly chestbreathing, we’re telling our brain we’re stressed, putting it in flight-or-fight mode, and not giving it the chance to process things properly.
Laurie has seen the effect addressing her own disordered breathing has had on her state of mind. “If I look at what happened last year – my marriage nearly ended and my husband had a heart attack,” she says. “They were really hard things, but I coped. I was surprised at myself.”
She has had to retrain herself to breathe properly, and at first she struggled. Now, she doesn’t get out of bed in the morning until she has done 10 really good stomach breaths. And she sets an alarm to check in with herself every 90 minutes to make sure she is still breathing properly.
“If we look at babies or animals, they breathe into their stomachs,” she says. “Meanwhile, adult humans are running round this world breathing into our chests and panicking everywhere we go, and we shouldn’t be. You can’t think well when you’re thoracic breathing over time.”
Life is unlikely to get less stressful, Laurie says, but if we can control the mechanical way we respond to that stress, we may be able to reduce anxiety and thus prevent depression.
Tania Clifton-Smith, of Auckland’s Breathing Works clinic, has trained 200 physiotherapists in the Bradcliff Method she co-developed. This helps people use their breath to find a baseline calm state that can form a foundation for resilience in the face of everyday stress.
However, breathing properly – through the nose and from the stomach – is not as simple as it might sound, cautions CliftonSmith. Some people have been doing it wrongly for so long, their physiology is set to that and they have to be weaned off.
“We need to reteach the body what it’s like to be at rest,” she says.
Whether you’re under stress on the farm or at your desk, Clifton-Smith’s advice is to regularly take a few moments to check in with yourself. “In the Western world, we don’t check in with our bodies, we check in with our minds,” she says. “What I’m trying to teach people is to pause and think about the physical body first – the feet; the legs, which are often tense; the pelvis and mid-chest. Then breathe out. The exhale is letting go physically and sends a message to the whole body.”
Once you’re breathing calmly, you can check in with your mind, and if you’re feeling under pressure, you are more likely to have the clarity to prioritise tasks, to catch those feelings of anxiety and decide what to do before problem-solving seems insurmountable.
responsible for more of those presenteeism losses.
Increasingly, big companies are coming to the understanding there can be a return on investment when they introduce screening and treatment programmes for employees. Big corporates, such as Unilever, are leading the charge in trying to find effective ways to reduce depression in the workplace. The foodto-cosmetics company was involved with a 2014 report that found 55% of employees diagnosed with depression needed to take time off work because of the illness.
Unilever’s former global vice-president of human resources, Geoff McDonald, has spoken about his experiences, telling the UK’s Telegraph, “I woke with a panic attack that was so severe I thought I was having a heart attack and was going to die. I went to the doctor the next day, who diagnosed me with anxiety-fuelled depression.”
McDonald stepped down from his Unilever job in 2014 to focus on Minds@ Work, a UK-based organisation dedicated to making workplaces mentally healthier. In New Zealand, the Mental Health Foundation has been putting energy into the same sort of thing. Among resources offered is a booklet, Working Well: A Workplace Guide to Mental Health, downloadable free from mentalhealth.org.nz.
“We’re now seeing businesses coming back with programmes they’re implementing that draw very heavily on the material,” says Robinson. “It’s starting to really gather some pace – from big organisations like The Warehouse, ACC and Coca-Cola, to smaller businesses. People are recognising that positive well-being creates engaged, productive staff, reduces presenteeism, increases turnover and contributes considerably to the bottom line.”
Investing in employees as an asset involves more than subsidising gym memberships and putting out a free fruit bowl. If staff are constantly overworked and under pressure, the warm fuzzies don’t cut it.
WORK/LIFE BALANCE FALLING
We are working hard as a nation. According to 2013 Census data from Statistics New Zealand, more than 40% of full-time managers put in over 50 hours a week. The OECD Better Life Index has us falling at 28th out of 38 countries for work-life balance (the Netherlands comes out best and the US and Australia are trailing behind us at 30th and 31st respectively).
“Working people harder and harder can be counterproductive,” argues Paul Dalziel, a professor of economics at Lincoln University. “Particularly when a certain amount of observation and creativity is required in staff.”
In a book he coauthored, Well-being Economics (Bridget Williams Books), Dalziel offers the case study of a Southland dairy farm that invested in extra workers and moved to a more socially friendly five days on/two days off working model so staff could do things such as play football on a Saturday or go to church on a Sunday. As a result, workers were less tired and burnt out, and that affected the bottom line. “While there was a rise in salaries, the staff were picking up on things like animal health, so that was paid for by reduced loss of stock,” Dalziel says.
He is aware that small-business owners, most likely stressed themselves, may look at caring for staff as yet another demand they have to meet. “But sometimes, a very small change can make a big impact on both the wellbeing and the productivity of the workforce. It can be a win-win for the employer and the employee.”
SUCCESS STORIES
Much the same conclusion was reached by a Like Minds, Like Mine research project, called
“Working people harder and harder can be counterproductive, particularly when observation and creativity is required in staff.”
What Works, done on behalf of the Mental Health Foundation. Dr Sarah Gordon, of the University of Otago’s department of psychological medicine, looked at success stories, interviewing a number of people with experience of mental illness and their employers to get some idea of what was needed to create a healthy workplace.
“One of the most interesting things was when we asked the employees if there were accommodations being made to support them, they would say yes,” says Gordon. “But when we asked the employers if they provided special accommodations for these people, they would say no. The main ones were increased flexibility of working hours, sick leave arrangements and location – and employers didn’t see them as out of the ordinary.”
All workers, not just the depressed ones, need some flexibility and support, says Gordon. They all have things in their lives that need to be accommodated, from sick kids to aged parents. The What Works research also examined difficulties around disclosure. When do you tell an employer you’ve had a mental-health issue – at the outset when you’re being interviewed for
the position or down the track when you’ve proved you can handle the role?
There are no straightforward answers, although Gordon spoke to some employers who admitted they were glad they hadn’t been aware of a mental-health problem at the interview stage because they might have excluded a person who then turned out to be a valuable member of the team.
WAKE-UP CALL FOR LAWYERS
The legal profession has been among those hardest hit by depression and anxiety – lawyers are 3.6 times more likely to suffer. The suicide of top barrister Greg King in 2012 was a wake-up call for the sector, and mental health is now a huge focus. For Jo Copeland, head of HR at Simpson Grierson, that means intervening early. As part
of their induction, new graduates joining the company are told it’s okay to admit if they’re struggling.
“Afterwards, without fail, I’ll always have one or two come up and say they suffer from depression and anxiety,” Copeland says.
For her, a tipping point was discovering a young lawyer employed by the firm was crying himself to sleep every night and feeling suicidal because he believed he had to hide the fact he was gay in order to survive his profession. “It’s hard enough to manage in this perfectionist, high-achieving environment without feeling that,” she says.
Simpson Grierson now has the Rainbow Tick to show they embrace diversity and a comprehensive mental health plan. Its approach is compassion first, and partners have had training to help them spot signs of a colleague in trouble. If necessary, the company will hold jobs open for 18 months. It also allows staff to buy extra annual leave and is involved in an Outward Bound scholarship, Take 21, for young lawyers who might be at risk.
Other initiatives to build resilience include an internal website – called OK? – focused
“Without fail, I’ll always have one or two come up and say they suffer from depression and anxiety.”
on mental wellness and they are developing staff workshops. “This is the most rewarding work you can do,” says Copeland. “We know we’ve prevented suicides.”
The World Health Organisation says depression is the leading cause of disability worldwide and a major contributor to the global burden of disease. There is a link between psychological health and heart health, for example, and a recent study from the University of Munich suggested
“I often see sensible workers burn out to meet management goals.”
depression should be considered alongside cholesterol levels and obesity as a risk factor for stroke and heart attack.
A US study suggested elevated stress hormones, such as cortisol, could lead to problems with blood-sugar metabolism, increasing the risk of diabetes. And stress and depressive episodes have also been linked to a rise of inflammation in the body.
AFRAID OF DERISION
As part of her treatments, Auckland clinical psychologist Natalie Flynn brainstorms and role-plays with clients. “Some have very reasonable requests/information to give to their employers, but are simply afraid of being met with derision or being looked over,” she says.
“I’m talking about issues such as approaching employers about physical pain or a mental-health diagnosis. Even in mental-health services, a place that promotes empathy and kindness, I often see sensible, resilient workers being driven to distress because of lack of support as they burn out to meet management goals.”
I was one of the lucky percentage that responds to medication (there is evidence that they are ineffective for 30-40% of people who use them as a sole treatment). A year on fluoxetine levelled my mood and cleared my mind enough for me to understand what had triggered the problem in the first place. I had become overwhelmed trying to do a demanding job and write a novel to a deadline.
That was more than a decade ago, and since then, I’ve been careful not to make the same mistake again. I work hard, yes, but never too hard, because I remember how it felt when all the joy drained from my life. And I don’t want to go back there.