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  • Brian Sass

Tools For Managing Stress and Anxiety

Updated: Mar 19, 2023


This blog will focus on managing stress and anxiety, and more importantly will go into detail on practical, at-home applications for controlling and reducing stress and anxiety. The stress response is a generic (non-specific) physiological mechanism for the brain and body to deal with many different experiences in the world. If you are playing a sport, dealing with the loss of a loved one, or worried about an upcoming meeting, the stress response that is activated in all of these situations is the same in terms of what happens inside your body. This stress response is generic; it was not made to occur for any one particular event, but instead is designed to change the state of the brain and body in a time of need. This gives the stress response certain advantages and disadvantages. The advantage of having a generic stress response is that there are hard-wired biological mechanisms to control this response; for example, using certain breathing techniques can either drastically increase or decrease the stress response in the body. However, the disadvantage of having a generic stress response is that it may become chronically activated or dysregulated if non-stressful experiences are processed as stressful, which is what occurs in dysautonomia.

stress anxiety treatment dysautonomia
There are tools to reduce your stress!

The stress response is created by a network of neurons that originate in the brain and travel in a chain-like pattern down the spine. When activated, these neurons release chemicals (equivalent to adrenaline) that act on different muscles, organs, and tissues throughout the body. This release of neurochemicals effectively activates, or deactivates, different areas of the body. For example, when the stress response is activated, the heart rate will increase but digestion and gut motility will decrease (based on the receptors of the tissues that react to the chemicals released by the neurons of the stress response). In other words, the stress response effectively is an on/off switch or a yes/no activation pattern to certain areas of the brain and body. The physical responses to stress, because of this global effect on the body, are numerous (i.e., your mouth gets dry, you become more light sensitive (pupils dilate), heart rate can start to race, your breathing rate increases, you may start to shake or have muscle tremors, etc.).

The best tools to reduce stress quickly (even in real-time when you are experiencing stress) are going to be tools that have direct lines into the autonomic nervous system. The autonomic nervous system is a reflexive system (for the most part, we don’t have volitional control over it). This is why if you are experiencing stress, telling yourself to “calm down” never works. In fact, telling yourself or someone else to “step being stressed out” or to just “calm down” will usually just make the stress even worse. If you want to reduce stress, the best method is to activate the part of the autonomic nervous system designed for calmness and relaxation, called to the parasympathetic system. The parasympathetic system is part of the autonomic nervous system that directly decreases the effect of the sympathetic, or stress, system. In other works, when the stress system is activated, instead of trying to cognitively calm yourself down (which is usually ineffective), it is better to activate the parasympathetic system that will reflexively and directly cause the stress response to reduce and stop. But how do you activate the parasympathetic system?

The quickest way to activate the parasympathetic nervous system in a self-directed way (on your own without equipment) that will result in decreasing the stress response in real-time through hard-wired mechanisms of the autonomic nervous system is called the “physiological sigh”. The physiological sigh is performed by altering your respiration pattern, but is different from other breathwork techniques. Most other breathwork techniques involve lying down or sitting down and deliberately breathing in a particular way for a certain number of minutes in order to change your mental state (think of meditation type activities). There are benefits to this type of breathwork, but the physiological sigh takes it to another level. The physiological sigh interacts with the brain, body, lungs, and heart to affect the stress response directly by observation of the heart rate. When the stress response is active, the heart rate increases to pump blood out to the big muscles of the body to allow for movement. Through mechanisms and neurological links to the autonomic nervous system, the physiological sigh allows you to voluntarily use your breathing to decrease your heart rate, thereby lowering the stress response.

This is how it works; when you inhale, blood starts to move more slowly in the heart as a result of the physical properties of the heart and diaphragm. The slowed blood flow is recognized by special neurons in the heart, that send signals up to the brain to speed up the heart rate to increase blood blow. The brain, receiving this signal, then sends a signal back to the heart that increases the heart rate. So, if you want to increase your heart rate voluntarily, you would inhale for a longer period of time and/or inhale more vigorously (exaggerated, forced inhale) compared to your exhale. Remember, breathing this way would effectively cause an overall increase in your heart rate, that would ultimately lead to an increased stress response (there are certain situations where this is beneficial). However, you want to reduce the stress response, you would do the opposite; you would make your exhale (breathing out) longer than your inhale (breathing in), and/or by making your exhales more vigorous (forced) than your inhales. The best way to make your exhales more vigorous and prolonged the exhale is through “pursed lips” like you are blowing out candles; this allows only a small amount of air to be released (allowing you to breath out for a longer period of time) while you can voluntarily breath out harder than normal to make it more vigorous.

The 2nd part of the physiological sigh involves adding a 2nd inhale before the prolonged exhale. This may seem counterintuitive; however, the double inhale takes advantage of the physical properties of the lungs to promote increased oxygenation exchange by decreasing carbon dioxide. So, if you take a deep inhale, followed by a brief 2nd inhale, then finish with a prolonged exhale that is overall longer in duration than the two inhales, you are voluntarily decreasing the heart rate by autonomic nervous system controls resulting in a lower stress response globally in real time. This is the physiological sigh; a double inhale followed by a forced, prolonged exhale. Usually, if you are breathing in the pattern, you can perform a 4 second inhale followed by an 8 second exhale, or a 5 second inhale followed by a 10 second exhale. Once you practice and learn the technique of the physiological sigh, you can easily breathe in for 3 seconds, take a brief 1 second 2nd inhale, and breathe out for 8 seconds with repetition. You can perform this activity for a certain number of breaths, or breath in this pattern for a number of minutes. If you have a watch or other tracker of your heart rate, you can also monitor the heart rate to watch it decrease as you perform this activity. It is an amazing hard-wired autonomic response that you can perform to reduce the stress response and trigger relaxation quickly at any time! Remember, the best part of the physiological sigh is you can perform it in real-time; you don’t have to go to a clinic or specific place to perform it. If you are at home, at the store, or driving your car, you can perform the physiological sigh anywhere. Also, since the stress response is a generic response, the physiological sigh will work to reduce emotion, psychological, financial, or any other kind of stress that you may be experiencing!

Our mission at Great Lakes Functional Neurology is to help you understand your injury and get you back to normal, healthy living. We strive to equip you with the tools needed for a full neurological recovery. If you would like to know more, we would be happy to discuss our services in more detail with you. You can reach us at (616)-581-1558 or visit our website at and schedule a complimentary phone consult with one of our doctors.

Some of the content in this blog was put together using information from Dr. Andrew Huberman’s podcast entitled “Tools for Managing Stress and Anxiety”. Dr. Huberman is a Professor of Neurobiology and Ophthalmology at Stanford School of Medicine. He has made numerous free videos focused on practical, low-cost options and methods to improve your health and life using principles of neurology and science-based tools. Visit to learn more from Dr. Huberman!


MEDICAL DISCLAIMER The content above is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. Great Lakes Functional Neurology does not take responsibility for possible health consequences of any person or persons reading or following the information in this educational content. We recommend readers that are taking prescription or over-the-counter medications consult their physicians before starting any nutrition, supplement or lifestyle program.

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