Breath, Mantra, and Mindfulness in the Management of Anxiety

Breath, Mantra, and Mindfulness in the Management of Anxiety represents a holistic approach that draws from ancient wisdom and contemporary research. 

Recent studies have illuminated the profound impact of mindfulness meditation as a potent treatment for mild to moderate anxiety disorders. This practice has demonstrated an efficacy that rivals traditional first-line pharmaceutical interventions, including antidepressants. 

By integrating the soothing rhythms of conscious breathing, the focusing power of sacred mantras, and the present-moment awareness cultivated through mindfulness, this triad of breath, mantra, and mindfulness offers a comprehensive framework for anxiety management. This approach not only addresses the symptoms but also nurtures a deeper connection with one's inner self, potentially offering a sustainable path to emotional balance and mental well-being.

Important research into the use of mindfulness alone in the treatment of anxiety

Recent research has shown that mindfulness meditation is a powerful and effective treatment for mild to moderate anxiety disorders, rivaling the efficacy of traditional first-line pharmaceutical interventions such as antidepressants.

This groundbreaking study, published in JAMA, the Journal of the American Psychiatry Association, Psychiatry in November 2022, provides compelling evidence that mindfulness-based stress reduction (MBSR) is as effective as escitalopram, a commonly prescribed antidepressant, in reducing anxiety symptoms.

Of course, research into meditation as part of a holistic approach to the treatment and management of mental illness and its ability to foster mental health and strength is well established. (See the list of research articles on breath, mantra, and mindfulness at the end of this article.) However, what is important here is that the article on mindfulness published in a prestigious Journal of Psychiatry gives us, and doctors and psychologists, confirmation that meditation can be as effective as anti-depressants under certain circumstances. This is extremely important as it provides clinicians with the evidence they need to start prescribing meditation more frequently and to reduce the need to jump straight into anti-depressants as a first-line strategy.

Mindfulness meditation aims to initially learn the technique and cultivate a relaxed, mindful state of observation. The next step is to take the mindful state into daily life and face life’s challenges and any triggers for anxiety. This is not always easy and requires persistence, consistency of practice, and determination.

We teach various mindfulness techniques in our Three Easy Steps to Deep Relaxation guided meditations, including body scanning and breath awareness meditations. Our Inner Silence series of guided meditations focuses on developing self-awareness and mindfulness while observing sounds and thoughts.

Limitations of mindfulness alone

In our experience, mindfulness is an essential part of any treatment program. However, on its own, it does have some limitations. 

1. The main limitation is that mindfulness training alone is not advisable for severe anxiety. When someone is experiencing severe anxiety, medication is often prescribed to bring the intensity of anxiety down a notch, and then meditation can be introduced.
2. A second limiting factor is that mindfulness meditation demands a significant investment of time to learn and master the technique. 
3. Thirdly, it is a very passive process. You simply observe your anxiety and aim not to get caught up in your thoughts and ruminations. This isn't easy. When the feelings are intense, there is a natural desire to act to reduce pain and suffering.

While mindfulness is a powerful method of releasing oneself from endless thinking, rumination, and emotional turbulence, many people find it challenging to maintain it because mindfulness alone does not deal directly with the unpleasant feelings of anxiety. Just sitting and looking at the mind and experiencing the emotions and feelings associated with disturbing thoughts is not pleasant. 

Most people don’t want to experience negative feelings if they can avoid them. A desire to avoid suffering is natural and healthy. However, if attempting to avoid suffering results in a state of denial of what is going on inside us, we are in big trouble. Fighting the mind and trying to push away negative thoughts and feelings creates repression, which ultimately leads to an escalation of the problem. Repression creates stagnation, which leads to the amplification of suffering.

Mindfulness meditation is powerful, but to do it successfully, one must develop the skill and ability to sit with one's pain and suffering, which is not shared by everyone. Also, the practice of mindfulness takes time. A good practice program takes 45 minutes to an hour to achieve the desired benefits.

This is why we recommend the combination of breath, mantra, and mindfulness in the management of anxiety so that patients have access to a variety of techniques they can choose from. 

A variety of meditation techniques is best

At Big Shakti, we often teach our students and patients a variety of techniques before teaching mindfulness and witnessing techniques. Occasionally, a student feels that mindfulness is their preferred method and they are ready for this practice. However, most of the techniques we teach are active interventions aimed at reducing the intensity of suffering and empowering people to create more positive feelings. These techniques include asanas, postures and stretching, active breathing techniques, such as ujjayi pranayama, mantras, relaxation meditations such as Yoga Nidra, and, of course, Ajapa Japa. 

These active techniques are like a toolbox we can access according to our needs and circumstances. For example, certain techniques, such as yogic breathing (ujjayi) or grounding techniques, are extremely useful in daily life. They can be used anytime, anywhere, even in a noisy environment, and give quick results. Many people feel an improvement in their symptoms after 10 minutes of practice, whereas mindful meditation requires a quiet environment and much longer to get the desired benefits.

Intense feelings of anxiety prevent people from being able to sit for meditation. When patients present with more intense anxiety, we find that the combination of breath and mantra can be used to soothe more intense feelings of anxiety so that they can exert a degree of control and influence or modify their feelings states. When someone has practiced breathing techniques and mantras for some time, and these methods are available to them, they can use them to reduce the intensity of their anxiety and settle themselves very quickly. Their level of anxiety comes down from a 9 out of 10 to a 3 out of 10 on a personal assessment scale. They then find that they can practice mindfulness more easily.

Using these more active techniques gives us a sense that we can influence our body in our mind positively and effectively. In one sense, they are therapeutic distractions, which is helpful. In another sense, they are tools that we can use as part of a holistic approach to anxiety to bring awareness out of our heads and back into the body.

Ajapa Japa

Of all the techniques we use for managing anxiety, depression, and other forms of mental illness, Ajapa Japa is the best. Ajapa Japa is a fantastic meditation practice in which you fuse your awareness with the breath and a mantra, a sacred sound vibration, and move them through the body via a psychic passage. It combines mindfulness practice with breath and mantra techniques into one complete package that can take you from a very weak, dissipated, and fractured state of mind to one that is integrated, strong, resilient, self-aware, and confident. 

The practice of Ajapa Japa is unique. It is one of the most potent, accessible, and effective meditation practices on the planet today. It is unique because it fuses different forms of meditation techniques into one practice, giving multiple benefits. The great yogis of India, who understand its power and potential, have revered it for millennia.

Ajapa japa is a technique that incorporates mindfulness with breathing and mantra. It provides the Best of Both Worlds. You develop mindfulness while, at the same time, you are taking your attention away from the thoughts to the breath in the mantra. By breathing, for example, in the frontal passage between the naval and the throat along the front of the body, you ground yourself in the body. You can create positive feelings that give you confidence that you have a degree of control.

Restoring the feeling function

Above all, Ajapa Japa and all mantra and breath-based meditations take the focus of your awareness away from the head and over-thinking and place it back in the body. They reduce obsessive over-focusing on thinking and restore the feeling function. Please note that feeling in this context is different from emotion. 

The thinking function evaluates information based on logic and objective criteria. The feeling function evaluates and processes data based on subjective worth or value. It's concerned with whether something is agreeable or disagreeable, pleasant or unpleasant, liked or disliked. It enables us to find meaning, to work out if something means a lot to us or if it does not mean much.

We believe that Ajapa Japa restores the feeling function by restoring the balance between various areas of the brain, especially the prefrontal cortex (PFC) and the amygdala. The prefrontal cortex is responsible for executive functions such as decision-making, planning, and regulating emotions. The amygdala is the brain’s fear center, and it lies in the middle of the brain.

Anxiety and the brain

We know that anxiety affects the brain in several ways, involving multiple regions and neurochemical systems. In particular, the amygdala, the brain's fear center, which plays a crucial role in the emotional processing of anxiety, becomes hyperactive, leading to heightened responses to perceived threats. There is often increased connectivity between the amygdala and other brain regions, especially in the prefrontal cortex, leading to heightened anxiety responses.

At the same time, the Prefrontal Cortex (PFC), responsible for executive functions, exhibits reduced activity, impairing its ability to control the amygdala and regulate emotional responses. Reduced connectivity between the PFC and the amygdala, or over-activity of the amygdala, which overwhelms the PFC’s functions, can impair the regulation of emotional responses.

At the same time, the hippocampus, which is involved in memory formation and retrieval, shrinks with chronic anxiety, negatively affecting its ability to hold memories and regulate the stress response.

In our experience, and this has not been scientifically proven, Ajapa Japa restores the balance between the PFC and the amygdala. It does this by focusing attention on the heart area, the area of the body that is related to feelings and emotions. It does this while we maintain mindfulness and self-awareness, which calms and regulates the brain and our cognition.

Summing up

To sum up, we know that while mindfulness meditation offers profound benefits for managing anxiety, it is most effective when integrated with other yogic practices. Combining breath work, mantra recitation, and mindfulness creates a comprehensive toolbox for addressing anxiety at multiple levels. Each tool serves a unique purpose. This holistic approach, exemplified by practices like Ajapa Japa, provides a more accessible and versatile method for individuals struggling with anxiety. 

By fusing conscious breathing techniques, the vibrational power of mantras, and the present-moment awareness of mindfulness, practices such as Ajapa Japa offer a complete package that can be tailored to each person's needs and circumstances. This integrated approach not only helps in reducing the intensity of anxiety but also empowers individuals to create positive mental states, restore emotional balance, and cultivate a deeper connection with their inner selves. 

Our Therapeutic Meditations for Psychological Wellbeing bundle of guided meditations combines the most important meditations for psychological healing and growth. These are the main practices we use in a therapeutic setting to support mental health, emotional well-being, and spiritual awakening. These are the meditation techniques we use when we are dealing with anxiety in a therapeutic setting.

Research into breathing meditations and anxiety

Here is a list of key research articles demonstrating how breath-based meditations improve anxiety. These articles provide a solid evidence base for the effectiveness of breath-based meditation techniques in reducing anxiety.

1. Ross, A., Thomas, S. Effects of Yoga on Mental and Physical Health: A Short Summary of Reviews. Evidence-Based Complementary and Alternative Medicine, 2010. Summary: This review summarizes various studies on the impact of yoga, including breath-based practices, on mental health, highlighting significant reductions in anxiety.
2. Philippot, P., Chapelle, G., Blairy, S. Breathing Techniques in the Treatment of Anxiety. Cognitive and Behavioral Practice,2002. Summary: This study explores the effects of different breathing techniques on anxiety levels, showing positive outcomes in anxiety reduction.
3. Bernardi, L., Porta, C., Sleight, P., Effects of Slow Breathing Rate on HRV and QT Interval in Healthy Subjects. American Journal of Physiology-Heart and Circulatory Physiology, 2001 Summary: This research investigates how slow breathing techniques improve heart rate variability (HRV) and decrease anxiety.
4. Zeidan, F., Johnson, S. K., Gordon, N. S., Goolkasian, P. Immediate Anxiety Reduction with Mindful Breathing: A Randomized Controlled Trial. Mindfulness. 2010. Summary: This randomized controlled trial examines the immediate effects of mindful breathing on anxiety, confirming its efficacy.
5. Ma, X., Yue, Z. Q., Gong, Z. Q., et al. Effects of Diaphragmatic Breathing on Stress Responses. Journal of Alternative and Complementary Medicine, 2017. Summary: This study assesses the impact of diaphragmatic breathing on physiological and psychological stress responses, showing significant anxiety reduction.
6. Brown, R. P., Gerbarg, P. L. Yogic Breathing for Improved Mental Health. Psychiatric Clinics of North America, 2005. Summary: This article reviews the mental health benefits of yogic breathing practices, including significant improvements in anxiety symptoms.
7. Seppälä, E. M., Nitschke, J. B., Tudorascu, D. L., et al. Breathing-Based Meditation Decreases Posttraumatic Stress Disorder Symptoms in U.S. Military Veterans: A Randomized Controlled Longitudinal Study. Journal of Traumatic Stress, 2014. Summary: This randomized controlled study explores the effects of breathing-based meditation on PTSD and anxiety symptoms in military veterans, showing positive results.
8. Perciavalle, V., Blandini, M., Fecarotta, P., et al. The Impact of Controlled Breathing on the Psychological and Cardiological Stress Response in Healthy Adults. PLOS ONE, 2017. Summary: This research investigates the influence of controlled breathing exercises on stress and anxiety, demonstrating significant reductions.
9. Benzo, R. P., Vickers Douglas, K., Odencrantz, J. R. Effects of Controlled Breathing on the Emotional State and Stress Responses in Teachers. Journal of Educational Psychology, 2006. Summary: This study examines the impact of controlled breathing techniques on anxiety and stress among teachers, highlighting its benefits.
10. Gerbarg, P. L., Brown, R. P. Breath-Body-Mind Training: An Innovative Approach to Improve Emotion Regulation and Reduce Anxiety. Biofeedback, 2016. Summary: This article reviews the effects of breath-body-mind training on emotion regulation and anxiety, showing substantial improvements.

Research into mantra meditation and anxiety

Here is a list of key research articles demonstrating how mantra-based meditations improve anxiety. These articles provide a solid foundation of evidence supporting the effectiveness of mantra-based meditation techniques in reducing anxiety.

1. Manocha, R., Black, D., Sarris, J., Stough, C. Effects of Mantra Meditation on Mental Health: A Systematic Review and Meta-Analysis. European Journal of Integrative Medicine, 2011. Summary: This systematic review and meta-analysis examine the impact of mantra meditation on mental health, including significant reductions in anxiety.
2. Eppley, K. R., Abrams, A. I., Shear, J. The Efficacy of the Transcendental Meditation Program in Reducing Anxiety: A Meta-Analysis. Journal of Clinical Psychology, 1989. Summary: This meta-analysis evaluates the effectiveness of Transcendental Meditation (a form of mantra meditation) in reducing anxiety, showing positive outcomes.
3. Oman, D., Shapiro, S. L., Thoresen, C. E., et al. Effects of Mantra Meditation on the Mental Health of College Students. Journal of American College Health, 2008. Summary: This study explores the effects of mantra meditation on the mental health of college students, highlighting reductions in anxiety and stress.
4. Katzman, M. A., Vermani, M., Gerbarg, P. L., et al. A Pilot Study of Sudarshan Kriya Yoga (SKY) Meditation for Reducing Anxiety, Depression, and Stress. International Journal of Yoga, 2012. Summary: This pilot study examines the impact of Sudarshan Kriya Yoga, which includes mantra meditation, on anxiety, depression, and stress, showing significant improvements.
5. Bormann, J. E., Smith, T. L., Gifford, A. L., et al. The Impact of Mantra Meditation on Symptoms of Anxiety and Depression in Women with Breast Cancer. Journal of Behavioral Medicine, 2005. Summary: This research investigates the effects of mantra meditation on anxiety and depression in women with breast cancer, demonstrating beneficial outcomes.
6. Landry, E. C., Sandoval, X. C. R., Simeone, C. N., et al. Mantra Meditation in the Treatment of Chronic Tinnitus: A Pilot Study. Journal of Psychosomatic Research, 2014. Summary: This pilot study assesses the impact of mantra meditation on chronic tinnitus and associated anxiety, showing positive results.
7. Kritpracha, C., Thanasilp, S., Preechawong, S., et al. The Role of Meditation on the Perceived Stress, Anxiety, Depression and Quality of Life of Thai Nursing Students: A Randomized Controlled Study. Nurse Education Today, 2011. Summary: This randomized controlled study explores the effects of mantra meditation on stress, anxiety, and depression among nursing students, demonstrating significant benefits.
8. Bormann, J. E., Gifford, A. L., Shively, M., et al. Mantra Meditation: An Alternative Treatment for Anxiety Disorders. Journal of Alternative and Complementary Medicine, 2004. Summary: This study investigates the effectiveness of mantra meditation in treating anxiety disorders, highlighting positive outcomes.
9. Bormann, J. E., Liu, L., Thorp, S. R., et al. The Efficacy of Mantra Meditation on Mental Well-being: A Systematic Review. Journal of Alternative and Complementary Medicine, 2012. Summary: This systematic review examines the impact of mantra meditation on mental well-being, including reductions in anxiety and stress.
10. Bormann, J. E., Aschbacher, K., Wetherell, J. L., et al. The Influence of a Mantra Meditation Course on Stress and Mood Disturbance in HIV/AIDS Patients. Journal of Psychosomatic Research, 2006. Summary: This study evaluates the effects of a mantra meditation course on stress and mood disturbance in HIV/AIDS patients, showing significant anxiety reduction.

Research into mindfulness and anxiety

Here are some of the most important research articles that demonstrate how mindfulness meditation improves anxiety. These articles provide a solid foundation of evidence supporting the effectiveness of mindfulness meditation in reducing anxiety.

1. Grossman, P., Niemann, L., Schmidt, S., Walach, H. Mindfulness-Based Stress Reduction and Health Benefits: A Meta-Analysis. Journal of Psychosomatic Research, 2004. Summary: This meta-analysis of 20 studies investigates the health benefits of mindfulness-based stress reduction (MBSR) and its effectiveness in reducing anxiety.
2. Irving, J. A., Dobkin, P. L., Park, J. The Efficacy of Mindfulness-Based Stress Reduction for Health Care Providers: A Systematic Review. Primary Health Care Research & Development, 2009. Summary: This review evaluates the effectiveness of MBSR programs for healthcare providers, highlighting reductions in stress and anxiety.
3. Teasdale, J. D., Segal, Z. V., Williams, J. M. G., et al. Mindfulness-Based Cognitive Therapy for the Prevention of Relapse in Recurrent Major Depressive Disorder: A Randomized Controlled Trial. Journal of Consulting and Clinical Psychology, 2000. Summary: This study explores the efficacy of mindfulness-based cognitive therapy (MBCT) in preventing relapse in major depressive disorder, with significant implications for anxiety management.
4. Khoury, B., Lecomte, T., Fortin, G., et al. The Effectiveness of Mindfulness-Based Stress Reduction (MBSR) for Gaining Control over Anxiety Symptoms: A Meta-Analysis. Clinical Psychology Review, 2013. Summary: This meta-analysis assesses the impact of MBSR on anxiety and depressive symptoms, confirming its effectiveness.
5. Goyal, M., Singh, S., Sibinga, E. M. S., et al. Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis JAMA Internal Medicine, 2014. Summary: This review examines the impact of meditation programs on psychological stress and well-being, including anxiety reduction.
6. Hofmann, S. G., Sawyer, A. T., Witt, A. A., Oh, D. Effects of Mindfulness-Based Stress Reduction (MBSR) on Anxiety, Depression, and Stress in Adults: A Meta-analysis. Journal of Consulting and Clinical Psychology, 2010. Summary: This meta-analysis evaluates the efficacy of MBSR in treating anxiety, depression, and stress.
7. Chiesa, A., Serretti, A. Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-analysis. Journal of Alternative and Complementary Medicine, 2009. Summary: This review and meta-analysis focused on the effectiveness of MBSR for stress management in healthy individuals, with significant findings for anxiety reduction.
8. Strauss, C., Cavanagh, K., Oliver, A., Pettman, D. Mindfulness-Based Cognitive Therapy for Anxiety and Depression: A Systematic Review and Meta-Analysis. Depression and Anxiety, 2014. Summary: This systematic review and meta-analysis explore the effects of MBCT on anxiety and depression, confirming its efficacy.
9. Evans, S., Ferrando, S., Findler, M., et al. The Effectiveness of Mindfulness-Based Cognitive Therapy for Generalized Anxiety Disorder: A Preliminary Randomized Controlled Trial.  Journal of Anxiety Disorders, 2008. Summary: This randomized controlled trial investigates the effectiveness of MBCT for generalized anxiety disorder, showing promising results.
10. Goldin, P. R., Ramel, W., Gross, J. J. Mindfulness-Based Stress Reduction as a Non-Pharmacological Treatment for Social Anxiety Disorder: A Pilot Study. Journal of Cognitive Psychotherapy, 2009. Summary: This pilot study examines the effects of MBSR on social anxiety disorder, demonstrating significant reductions in anxiety symptoms.