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ANXIETY, DEPRESSION, Stress Reduction

How to De-Stress Your Way Out of Anxiety and Depression

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April 25, 2024

BY Joie Meissner ND, BCB-L

Biofeedback and Relaxation Therapy (RT) aim to alleviate stress, anxiety and depression by promoting a state of relaxation.

Biofeedback-Assisted Relaxation Therapy (BART) helps break that vicious cycle of anxiety by taking the body out of fight-or-flight into a more relaxed state. This can help shift the amygdala—the brain’s threat center sentinel—out of hyperactivation so that when stressors present themselves, it is not on hair-trigger resulting in heightened anxiety. Thus, it heads off anxiety before it can gain a foothold.

BART uses biofeedback technology to help people learn to shift out of the physiology of stress and anxiety into a calm state. It helps people slow speedy hearts, quiet anxious breathing patterns and relax tense muscles. These new skills build a sense of empowerment and safety. BART techniques include autogenic training (a form of self-hypnosis), guided imagery and progressive muscle relaxation.

Chronic stress does damage through the repeated activation of the fight-or-flight mechanisms of the body called the HPA axis, or hypothalamic-pituitary-adrenal axis. This causes a cascade of biochemical events leading to hyperactivation of inflammatory proteins that are linked to depression, anxiety, insomnia and a host of other conditions. 1, 2, 3, 4

Relaxation therapy is commonly used for stress management, which cuts inflammation. 5

Inflammation has been implicated as an important part of the mechanism driving anxiety and depression. 6, 7, 8, 9

Inflammation—which can be caused by stress—and its cascade of biochemical consequences including decreases in the brain’s self-healing ability, might be the reason that antidepressants don’t work that well in patients with high levels of inflammation. 10   And it might also explain why patients that have elevated inflammation may not respond as well to talk-therapy. 11

There’s a smoking gun in the brain that’s at the center of a vicious cycle of stress leading to anxiety. It’s a sentinel in the brain whose job it is to keep us safe from threats: the amygdala.

The vicious cycle is set off by stress, which triggers activation of the amygdala, which in turn causes the release of fight-or-flight response chemicals. These chemicals trigger more inflammation, which sets off even more activation of the amygdala. The process feeds on itself leading to a hyperactive amygdala that reacts to the tiniest of stimuli and creates anxiety and depressive mood.

Biofeedback-Assisted Relaxation Therapy is a powerful tool to help people learn how to break out of the vicious cycle and calm and stressed body and mind.

Numerous studies show “relaxation therapy improves anxiety in patients with anxiety disorders and patients experiencing situational anxiety,” according to a panel of experts at NatMedPro. 12, 13, 14, 15, 16, 17

Relaxation therapy was found to have medium-high efficacy on the symptoms of anxiety by a meta-analysis of 16 randomized control trials. “The effect of relaxation therapy on symptoms of depression, phobia, and worry was significant” as well, the researchers wrote. “Relaxation therapy can be selected as a useful intervention for reducing negative emotions in people with anxiety disorders.” 18

Relaxation Therapy (RT) is efficacious for the treatment of both generalized anxiety and panic disorders, according to a meta-analysis of 5 clinical studies. RT was shown to be as effective as cognitive behavioral therapy, the gold-standard treatment for improving symptoms of anxiety in patients with generalized anxiety disorder. 19

Relaxation therapies as well as other counseling techniques are often combined with biofeedback to enhance efficacy and further defeat stress.

When our minds become stressed, our bodies also become stressed whether we notice that stress or not. Our breathing and heart rate increase and our muscles tighten, among other wide-spread effects. Biofeedback is a bridge between our conscious awareness and our stressed physiology allowing us to learn how to shift into a relaxed state. Biofeedback uses instruments to measure a variety of signals associated physiological functions like finger temperature and muscle tension in real time so you can learn to relax from the flight-or-fight stress response.

“Adding HRV biofeedback to psychotherapy can increase heart rate variability and augment treatment effects in various mental disorders,” according to a 2022 review of studies on HRV and its therapeutic modulation in the context of psychopharmacology as well as psychiatric and neurological disorders. 20 Abundant HRV is a sign of health and is thought to also reflect resilience and behavioral flexibility.

Heart rate variability (HRV) biofeedback is a specific form of biofeedback that measures heart rate and helps people learn how to vary heart rate in a particular way that shifts them out of the fight-or-flight state. Heart rate varies based on breathing and patients learn to change their breathing pattern to increase HRV using feedback from an audiovisual display. Learning to change breathing helps people shift into a calmer state, a skill that once learned can be applied when needed.

When our bodies shift from a stressed state, we can measure a drop in the stress hormone cortisol. Cortisol is your body’s stress manager, orchestrating responses to social, psychological and physical challenges.

A 2023 study posed the question whether HRV biofeedback could lower levels of cortisol in female athletes.  The athletes were given short sessions of heart rate variability biofeedback lasting six minutes, three times a day for seven weeks. Cortisol levels decreased significantly after biofeedback, the study found. HRV biofeedback is an effective method to control stress in female athletes, the researchers concluded. 21

“HRV [heart rate variability] biofeedback training is associated with a large reduction in self-reported stress and anxiety,” a 2017 analysis of 24 controlled studies totaling 484 participants concluded. 22

Fifty-two middle-aged patients with panic disorder receiving four weeks of HRV biofeedback showed reduced anxiety and increased HRV as compared to controls who were unchanged in a 2022 randomized controlled study. 23

Shifting the body into a physiologically relaxed state can change the way a person thinks and feels.

Depressive thinking resulted in changes in heart rate and perspiration that occur during times of elevated stress, a 2022 study found. After biofeedback training, levels of stress, anxiety, and depressive thinking fell and heart rate patterns consistent with relaxation rose. People in the control group showed no such improvements. 24

Heart rate variability biofeedback improves depressive symptoms, a 2021 analysis of 14 randomized controlled studies including 794 participants concluded. The researchers found it to be “a valid technique to increase psychological well-being.” 25

Hypnosis is another powerful tool used to de-stress and to enhance the efficacy of talk therapy.

To learn more about how hypnotherapy and hypnosis cut stress, reduces anxiety and depression click link below:

Harness Hidden Strengths with Hypnotherapy

Care informed by the understanding that emotional and physical wellbeing are deeply connected

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Citations

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