The autonomic nervous system can be deliberately influenced through the breath. Slow paced breathing at roughly 5–6 breaths per minute increases heart rate variability (HRV), a biomarker of vagal tone and stress resilience, and reliably reduces cortisol. This is the mechanism behind techniques like box breathing (used by US Navy SEALs) and 4-7-8 breathing (popularized by Dr. Andrew Weil at the University of Arizona).
Mindfulness-Based Stress Reduction (MBSR), developed by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical School in 1979, is one of the most-studied behavioral interventions in medicine. A 2014 JAMA Internal Medicine meta-analysis of 47 trials found moderate-quality evidence that mindfulness programs improve anxiety, depression, and pain - with effect sizes comparable to antidepressant medication for mild-to-moderate depression.
Self-compassion - treating yourself with the same kindness you would offer a friend - was operationalized by Dr. Kristin Neff at the University of Texas at Austin. A 2012 meta-analysis in Clinical Psychology Review found self-compassion to be a stronger predictor of mental health outcomes than self-esteem, and protective against burnout, depression, and anxiety.
Cognitive reappraisal - reframing the meaning of a situation - is a core technique of Cognitive Behavioral Therapy (CBT), the most empirically supported psychotherapy for anxiety and depression. The American Psychological Association and the UK's NICE guidelines both list CBT as a first-line treatment.
