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Breathing Exercises and Grounding Techniques to Calm Down

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Breathing Exercises and Grounding Techniques to Calm Down

Three exercises you can follow on screen instead of counting in your head: box breathing, paced inhale and exhale, and 5-4-3-2-1 grounding. Use them for stress, anxiety, anger, panic, overthinking, or a night when your mind will not switch off. Press start on any card and follow the video. Nothing is recorded and nothing is sent anywhere.

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What are these exercises, and what do they help with?

Box breathing, paced inhale and exhale, and 5-4-3-2-1 grounding are three short exercises that help you calm down. Use them for stress, anxiety, anger, panic, overthinking or trouble sleeping. Each one runs on screen, so you follow the pace rather than counting alone. They take two to five minutes.

Clinically reviewed by Dr. Qurrat Ulain, Consultant Psychiatrist. Last updated .

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People use these for

  • Stress
  • Anxiety
  • Panic attacks
  • Anger
  • Overthinking
  • Exam pressure
  • Work pressure
  • Feeling overwhelmed
  • Winding down at night
  • Before a difficult conversation

Ready when you are

BREATHE IN HOLD BREATHE OUT HOLD
  • Breathe in
  • Hold
  • Breathe out

4 seconds each side

Rounds completed: 0

Soft sound plays while it runs. Use the speaker to mute.

4 in, 4 hold, 4 out, 4 holdAbout 2 minutesSitting or standing

Box breathing

Four equal phases of four seconds. The equal counts are the point: when you are too anxious to concentrate, a shape that repeats the same way every time is easier to follow than a rhythm you have to remember. Each side of the square is a different phase and a different colour, so you always know whether you are breathing or holding. Follow the marker with your eyes and let your breath match it.

  1. Breathe in for four. Sit with your back supported and your feet on the floor. Breathe in gently through your nose as the marker travels along the top side.
  2. Hold for four. Hold gently as the marker comes down the right side. Do not clamp down or strain.
  3. Breathe out for four. Let the breath flow out through your mouth as the marker travels back along the bottom.
  4. Hold for four, then repeat. Hold up the left side with the lungs empty, then begin again. Eight rounds is about two minutes.

Ready when you are

Breaths completed: 0

Soft sound plays while it runs. Use the speaker to mute.

5 in, 5 outAt least 5 minutesNo breath holding

Paced inhale and exhale

This is the calming breathing technique the NHS describes, with no hold in it at all. Breathe in gently and regularly, counting steadily from one to five, then let it flow out gently for a count of five. The circle grows as you breathe in and shrinks as you breathe out, so you never have to count for yourself [1].

  1. Get comfortable. Sit in a chair that supports your back, or lie down. Let your shoulders drop. You can also do this standing.
  2. Breathe in for five. Gently and regularly through your nose while the circle expands. Do not gulp the air.
  3. Let it flow out for five. Let the breath leave on its own while the circle shrinks. Do not force it and do not pause between.
  4. Keep going for five minutes. Doing this daily when you are calm works better than only reaching for it in a crisis.

Ready when you are

5-4-3-2-1

Five senses, counting down. Name each thing in your head or out loud.

Step 0 of 5

Soft sound plays while it runs. Use the speaker to mute.

5 sensesAbout 3 minutesAnywhere, eyes open

5-4-3-2-1 grounding

Grounding moves your attention out of your thoughts and back into the room you are actually in [2]. It is the one to reach for when the problem is spiralling thoughts, or a feeling of being unreal or detached, rather than a racing heart. Clinical guidance describes grounding as a way to help someone who is overwhelmed by memories or strong emotions become aware of the here and now [3].

  1. Five things you can see. Ordinary things count: a door handle, a fan, a crack in the paint.
  2. Four things you can feel. The chair against your back, your feet inside your shoes, the temperature of the air.
  3. Three things you can hear. Listen for the quietest sound you can find, not the loudest.
  4. Two things you can smell. If you cannot smell anything, name two smells you like.
  5. One thing you can taste. Or take a sip of water and notice it. Then check how you feel, and repeat if you need to.

When these are not the right tool

These are coping tools that bring distress down in the moment. They can steady you during stress, anger, panic, overthinking or a restless night, but they do not treat an anxiety disorder, depression, panic disorder or trauma, and they are not a substitute for an assessment. Skip the breath holding in box breathing if you are pregnant, have a heart or lung condition, or find that holding makes you more anxious, and use the paced inhale and exhale exercise instead. If you or someone close to you is in immediate danger or at risk of self harm, contact emergency services now: Rescue and Ambulance 1122, Police 15, Edhi 115, Chhipa 1020, or your nearest government hospital emergency department. SehatYab is an online clinic and is not an emergency service.

Questions

Breathing and grounding, frequently asked questions

Short answers to what people ask us most about these exercises.

Box breathing is a paced breathing exercise with four equal phases: breathe in for four, hold for four, breathe out for four, hold for four. The equal counts are what make it easy to follow when you are too anxious to concentrate.
The NHS suggests repeating a calming breathing technique for at least five minutes. Two minutes still helps in a difficult moment. Doing it daily when you are calm works better than only reaching for it during a crisis.
Slow paced breathing can bring the physical intensity down and gives you something to do while the peak passes. It does not treat the underlying panic disorder. If panic attacks keep happening, a course of therapy is the treatment that changes the pattern.
You name five things you can see, four you can feel, three you can hear, two you can smell and one you can taste. It moves attention out of your thoughts and back into the room you are actually in.
Stress, anxiety, anger, panic, overthinking, exam or work pressure, and winding down at night. Breathing suits a racing heart or tight chest. Grounding suits spiralling thoughts or feeling detached. Many people ground first, then breathe.
Breath holding is not right for everyone. If you are pregnant, have a heart or lung condition, or find that holding makes you more anxious, skip box breathing and use the paced inhale and exhale exercise instead, which has no hold.
No. They are coping tools that lower distress in the moment. They do not treat anxiety, depression, panic disorder or trauma. If stress or low mood is affecting your sleep, work, studies or relationships, book an assessment with a clinical psychologist.
Yes. Count in whatever language you think in, because the counting is the whole mechanism and it works better in your first language. SehatYab clinicians teach these exercises in Urdu and English, and in Punjabi with some clinicians.

References

  1. Breathing exercises for stress. NHS.
  2. Ground yourself. Oxford Health NHS Foundation Trust, CAMHS.
  3. Grounding techniques. Trauma Informed Care in Behavioral Health Services, SAMHSA, via NCBI Bookshelf.

If you are reaching for these every day, that is worth a conversation

Coping tools hold the moment. Therapy changes the pattern, whether that is anxiety, low mood, anger, burnout or sleep that never settles. Book a private online session with a clinical psychologist, in Urdu or English, from anywhere in Pakistan.

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