Simple Breathing Practices to Manage Anxiety After Stroke

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I never knew what anxiety was or how it felt before I had a stroke.

It wasn’t until I discussed some of my post-stroke experiences with a therapist years later that I realized some of my early issues were anxiety-related.

Anxiety can manifest itself in many different ways and in my case, I often feel stress on my stroke-affected left side.

There have been many times when my left hand has started to fold into a fist as I prepared to go into meetings unsure of what would be discussed. Other times, my entire left side has tensed up as I waited for someone or waited in a long line at the store with many other things to do.

Although this was concerning at the time, I’ve found some simple breathing exercises in the years after stroke to help me manage my emotions in these stressful situations.

In particular, two exercises – the physiological sigh and box breathing – have been a huge help to me and I continue to use them when needed to this day.

Anxiety After Stroke

Anxiety is a common side effect of stroke, especially considering people can worry about having another stroke. Research indicates that roughly 20% of stroke survivors may have anxiety-related issues.

Shortly after my stroke, being in large crowds or busy places was quite overwhelming. The noises and commotion, combined with trying to process everything I was seeing or being asked, often led to sensory overload.

For example, a little over two months after my stroke, my girlfriend’s sister and brother-in-law offered to take us out to dinner. I hadn’t gone out much that soon after the stroke, and I was still learning all the different ways my body felt and responded in certain situations.

This dinner also came on the heels of an unexpected trip to the emergency room when I experienced stroke-like symptoms again so I was a little hesitant about going.

At the restaurant, my girlfriend’s sister asked me how it felt to climb back to the top of the mountain after the stroke had knocked me down – as if I had completely recovered. I probably gave a generic answer that it was nice to be back to doing normal things, like going out to dinner, but I was still working through some significant challenges.

Unbeknownst to her, I was heading to the bathroom often in between conversations since my left cheek felt numb, like it was injected with novocaine, and I was worried that my face may be drooping again like it had been just weeks before when we went back to the ER.

Trying to relax, I practiced a simple 3 to 4-count box breathing pattern when not involved in the conversation and made the best of these frustrating feelings on my left side.

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Simple Breathing Exercises to Manage Anxiety After Stroke

Breathing practices have long been used to manage stress and anxiety since certain breathing patterns are connected to particular emotions.

For example, breathing slower can help minimize stress and anxiety since these feelings cause you to breathe faster, which only makes matters worse. Instead, taking longer and slower breaths, like I tried to do at the dinner, can help you feel more calm.

Breathing practices are also valuable because you can do them anywhere and anytime without anyone realizing what you’re doing unless you make it obvious.

The two exercises that have helped me the most after stroke are the physiological sigh – also known as cyclic sighing – and box breathing.

Physiological Sigh

The physiological sigh is the practice I use most often, such as before work meetings, between sets at the gym, and before I start driving.

The physiological sigh can be summed up in four parts:

1. Take a long inhale through your nose
2. Follow that long inhale with by a sniff to fill your lungs
3. Hold your breath for a second
4. Exhale with a long sigh out of your mouth.
   

You can do it just once or repeat a couple of times and then return to breathing normally.

Box Breathing

Box Breathing was popularized by Navy SEAL Commander Mark Divine and is one of the most common breathing practices out there. It’s where most people who profess to practice “breathwork” probably started.

Box breathing follows four steps of even duration, hence why it’s called box breathing. Here’s an example:

1. Inhale for 3 seconds
2. Hold your breath for 3 seconds
3. Exhale for 3 seconds
4. Hold your breath for 3 seconds before repeating the steps

Each segment of the box can be as long as you’d like as long as they are all the same length.

Mental Health After Stroke

These simple breathing practices have been a huge help for me in the years after stroke, but there are many other options for treating anxiety.

If you’re struggling with post-stroke anxiety issues, your doctor or therapist may be able to suggest some additional remedies that you can help you work through this frustrating anxiety caused by a stroke.