Breathing is Medicine

Sean Gallagher, MD

Rates of depression and anxiety are on the rise. I know I'm seeing more of it. My name is Sean Gallagher and I'm a primary care Pediatrician in Licking County. I work at, what many of you stationed inside the I-270 loop might refer to as, "Outside Hospital." I have a strong interest in Psychology. I use my knowledge of Psychology every day in my practice. From potty training to habit reversal, to behavior impacting nutrition, to responding to tantrums, it is critical to good Pediatric care.

I was, thus, thrilled to hear the news about a study published in JAMA Psychiatry last fall. It detailed a randomized clinical trial comparing mindfulness-based stress reduction vs SSRI treatment. The interventions were found to be equivalent: both reduced anxiety. Mindful breathing is becoming more popular outside of medicine. However, it's been around for hundreds of years. 4-7-8 breathing has its origins in pranayama, the yogic practice of intentional breathing. During my time with the 2022-2023 class of the Physician Leadership Academy, I've received invaluable instruction on mindfulness techniques including breathing. These tools have been crucial in combatting my own anxiety and burnout.

I've incorporated counseling on mindful breathing into my clinical practice. I coach all of my patients with depression and anxiety on it. I encourage teens to do 4-7-8 breathing twice daily and to utilize box breathing when acutely stressed. I recommend "knuckle breathing" or finger tracing for my younger patients. Mindful breathing is working its way into education; school districts in my county are teaching box breathing to their students. At my clinic, I encourage parents to do the twice-daily breathing with their kids; it benefits them too. Perhaps most exciting, is that mindful breathing is something we Pediatricians can give to our parents suffering from post-partum depression. Standards of care call for Pediatricians to screen moms for this condition. Previously, most of us would provide counseling resources, knowing wait lists are long. We're no longer constrained to hoping for the best. Now, we can offer treatment.

In a hard scientific sense, we physicians aren't able to replicate the detailed daily eight-week program from the study above on a patient-by-patient basis. However, mindful breathing has no downsides I can think of. One might argue that, during lengthy clinic appointments, counseling on this will take time; good patient care often does.

Sean Gallagher, MD, FAAP is a primary care Pediatrician in Licking County. He tweets @TheKidKidDoc