Box breathing for anxiety and hot flushes

Sometimes it comes out of nowhere. You are standing in the supermarket queue, and your heart starts to race, your face goes hot, and a little voice says: something is wrong.

In perimenopause, many women feel this. Changing hormones can make the body jumpy, like a smoke alarm that goes off when you make toast. The alarm is real. But very often, there is no fire.

When the body is loud, the breath is the quickest way I know to speak back to it.

Box breathing

Picture a square. You will travel around it with your breath, four slow counts on each side.

1. Breathe in through your nose for four counts. One, two, three, four.
2. Hold gently for four counts.
3. Breathe out slowly through your mouth for four counts.
4. Hold again for four counts, with empty lungs.

That is one square. Do four or five. Let your shoulders drop a little more each time.

If holding your breath feels uncomfortable, make the counts shorter, three or even two. Or simply skip the holds and just make the out-breath long. Ach, it is breathing, not an exam.

When to use it

• When you feel a hot flush beginning. Many women find that slow breathing helps them ride the wave instead of fighting it.
• Before a difficult phone call or a meeting.
• When you wake at night with a racing mind.
• In the supermarket queue. Nobody can tell you are drawing squares.

Make it an anchor

When you finish your last square and feel calmer, press your thumb and index finger together. Do this every time you practise. After a while, that little touch alone starts to bring the calm back.

A racing heart can have many causes. If it happens often, or comes with chest pain, dizziness or breathlessness, please see your doctor.