More than half of college students self-report some kind of anxiety and depression. This study reports how a university course that incorporated structured self-experience practices may reduce symptoms of self-reported anxiety associated with college stress and strain. Ninety-eight college Junior and Senior students were enrolled in a Holistic Health class that focused on “whole-person” Holistic Health curriculum and included the exploration of psychobiology of stress, the role of posture, and the psychophysiology of respiration. The class included daily self-practices of awareness of stress, muscle relaxation, diaphragmatic breathing, and posture awareness. The students were instructed to apply these techniques whenever they become aware of, or experienced, sensations of stress or dysfunctional breathing during the day. After 5 weeks of practice, the students self-reported a 73% reduction in anxiety, 68% reduction in stress, 27% reduction in neck and shoulder discomfort, 26% reduction in abdominal discomfort; 18% of abdominal discomfort and 16% reduction in menstrual cramps. We recommend that schools incorporated a “whole-persons” self-care approach within their curriculum to teach students skills to prevent and reduce anxiety and stress and that therapists teach these skill before beginning bio/neurofeedback.
Adams, K. L., Saunders, K. E., Keown-Stoneman, C. D. G., & Duffy, A. C. (2021). Mental health trajectories in undergraduate students over the first year of university: A longitudinal cohort study. BMJ Open, 11(12), e047393. https://doi.org/10.1136/bmjopen-2020-047393
Bandelow, B., Reitt, M., Röver, C., Michaelis, S., Görlich, Y., & Wedekind, D. (2015). Efficacy of treatments for anxiety disorders: A meta-analysis. International Clinical Psychopharmacology, 30(4), 183–192. https://doi.org/10.1097/YIC.0000000000000078
Barr, E. A., Peper, E., & Swatzyna, R. J. (2019). Slouched posture, sleep deprivation, and mood disorders: Interconnection and modulation by theta brain waves. NeuroRegulation, 6(4), 181–189. https://doi.org/10.15540/nr.6.4.181
Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173, 90–96. https://doi.org/10.1016/j.jad.2014.10.054
Bhattacharya, R., Shen, C., & Sambamoorthi, U. (2014). Excess risk of chronic physical conditions associated with depression and anxiety. BMC Psychiatry, 14, 10. https://doi.org/10.1186/1471-244X-14-10
Bier, M., Peper, E., & Burke, A. (2005). Integrated stress management with Make Health Happen: Measuring the impact through a 5-month follow-up. Poster presentation at the 36th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback. Abstract published in Applied Psychophysiology and Biofeedback, 30(4), 400. https://biofeedbackhealth.files.wordpress.com/2013/12/2005-aapb-make-health-happen-bier-peper-burke-gibney3-12-05-rev.pdf
Bierman, E. J. M., Comijs, H. C., Jonker, C. & Beekman, A. T. F. (2005). Effects of anxiety versus depression on cognition in later life. The American Journal of Geriatric Psychiatry, 13(8), 686–693. https://doi.org/10.1097/00019442-200508000-00007.
Bushman, B. J., DeWall, C. N., Pond, R. S., & Hanus, M. D. (2014). Low glucose relates to greater aggression in married couples. Proceedings of the National Academy of Sciences, 111(17), 6254–6257. https://doi.org/10.1073/pnas.1400619111
Bushnell, G. A., Stürmer, T., Gaynes, B. N., Pate, V., & Miller, M. (2017). Simultaneous antidepressant and benzodiazepine new use and subsequent long-term benzodiazepine use in adults with depression, United States, 2001–2014. JAMA Psychiatry, 74(7), 747–755. https://doi.org/10.1001/jamapsychiatry.2017.1273
Chirikov, I., Soria, K. M, Horgos, B., & Jones-White, D. (2020). Undergraduate and graduate students’ mental health during the COVID-19 pandemic. UC Berkeley: Center for Studies in Higher Education. https://escholarship.org/uc/item/80k5d5hw
Coakley, K. E., Le, H., Silva, S. R., & Wilks, A. (2021). Anxiety is associated with appetitive traits in university students during the COVID-19 pandemic. Nutrition Journal, 20, 45. https://doi.org/10.1186/s12937-021-00701-9
Crane, E. H. (2013). Highlights of the 2011 Drug Abuse Warning Network (DAWN) findings on drug-related emergency department visits. In The CBHSQ Report. Rockville, MD: Substance Abuse and Mental Health Services Administration. https://www.ncbi.nlm.nih.gov/books/NBK384680/
Du Pasquier, D., Fellrath, J. M., & Sauty, A. (2020). Hyperventilation syndrome and dysfunctional breathing: Update. Revue Medicale Suisse, 16(698), 1243–1249. https://europepmc.org/article/med/32558453
Gilbert, C. (2003). Clinical applications of breathing regulation: Beyond anxiety management. Behavior Modification, 27(5), 692–709. https://doi.org/10.1177/0145445503256322
Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence. Dialogues in Clinical Neuroscience, 17(3), 337–346. https://doi.org/10.31887/DCNS.2015.17.3/akaczkurkin
Kang, H.-J., Bae, K.-Y., Kim, S.-W., Shin, H.-Y., Shin, I.-S., Yoon, J.-S., & Kim, J.-M. (2017). Impact of anxiety and depression on physical health condition and disability in an elderly Korean population. Psychiatry Investigation, 14(3), 240–248. https://doi.org/10.4306/pi.2017.14.3.240
Körner, R., & Schütz, A. (2020). Dominance or prestige: A review of the effects of power poses and other body postures. Social and Personality Psychology Compass, 14(8), e12559. https://doi.org/10.1111/spc3.12559
Lowery-Gionta, E. G., DiBerto, J., Mazzone, C. M., & Kash, T. L. (2018). GABA neurons of the ventral periaqueductal gray area modulate behaviors associated with anxiety and conditioned fear. Brain Structure and Function, 223(8), 3787–3799. https://doi.org/10.1007/s00429-018-1724-z
Lum, L. C. (1981). Hyperventilation and anxiety state. Journal of the Royal Society of Medicine, 74(1), 1–4. https://doi.org/10.1177%2F014107688107400101
MacCormack, J. K., & Lindquist, K. A. (2019). Feeling hangry? When hunger is conceptualized as emotion. Emotion, 19(2), 301–319. https://doi.org/10.1037/emo0000422
Marker, I., & Norton, P. J. (2018). The efficacy of incorporating motivational interviewing to cognitive behavior therapy for anxiety disorders: A review and meta-analysis. Clinical Psychology Review, 62, 1–10. https://doi.org/10.1016/j.cpr.2018.04.004
McGrady, A., & Moss, D. (2013). Pathways to illness, pathways to health. New York, NY: Springer.
Metzler, H., & Grèzes, J. (2019). Repeatedly adopting power postures does not affect hormonal correlates of dominance and affiliative behavior. PeerJ, 7, e6726. https://doi.org/10.7717/peerj.6726
Peper, E., Gibney, K. H., & Holt. C. (2002). Make health happen: Training yourself to create wellness. Dubuque, IA: Kendall-Hunt.
Peper, E., Harvey, R., & Hamiel, D. (2019). Transforming thoughts with postural awareness to increase therapeutic and teaching efficacy. NeuroRegulation, 6(3), 153–169. https://doi.org/10.15540/nr.6.3.153
Peper, E., Harvey, R., & Lin, I.-M. (2019). Mindfulness training has elements common to other techniques. Biofeedback, 47(3), 50–57. https://doi.org/10.5298/1081-5937-47.3.02
Peper, E., Lin, I.-M., Harvey, R., Gilbert, M., Gubbala, P., Ratkovich, A., & Fletcher, L. (2014). Transforming chained behaviors: Case studies of overcoming smoking, eczema, and hair pulling (trichotillomania). Biofeedback, 42(4), 154–160. https://doi.org/10.5298/1081-5937-42.4.06
Peper, E., Lin, I.-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood. Biofeedback, 45(2), 36–41. https://doi.org/10.5298/1081-5937-45.2.01
Peper, E., & MacHose, M. (1993). Symptom prescription: Inducing anxiety by 70% exhalation. Biofeedback and Self-Regulation, 18, 133–139. https://doi.org/10.1007/BF00999790
Peper, E., Miceli, B., & Harvey, R. (2016). Educational model for self-healing: Eliminating a chronic migraine with electromyography, autogenic training, posture, and mindfulness. Biofeedback, 44(3), 130–137. https://doi.org/10.5298/1081-5937-44.3.03
Peper, E., Sato-Perry, K., & Gibney, K. H. (2003). Achieving health: A 14-session structured stress management program—Eczema as a case illustration. Presented at the 34rd Annual Meeting of the Association for Applied Psychophysiology and Biofeedback. Abstract in Applied Psychophysiology and Biofeedback, 28(4), 308. https://biofeedbackhealth.files.wordpress.com/2013/12/2003-aapb-poster-peper-keiko-long1.pdf
Peppin, J., Pergolizzi, J. V., Raffa, R. B., & Wright, S. L. (2020). The benzodiazepines crisis. New York, NY: Oxford University Press.
Richmond-Rakerd, L. S., D’Souza, S., Milne, B. J., Caspi, A., & Moffitt, T. E. (2022). Longitudinal associations of mental disorders with dementia: 30-year analysis of 1.7 million New Zealand citizens. JAMA Psychiatry, 79(4), 333–340. https://doi.org/10.1001/jamapsychiatry.2021.4377
Sapolsky, R. (2004). Why zebras don’t get ulcers (3rd ed.). New York, NY: Owl Books.
Shader, R. I., & Greenblatt, D. J. (1993). Use of benzodiazepines in anxiety disorders. The New England Journal of Medicine, 328(19), 1398–1405. https://doi.org/10.1056/NEJM199305133281907
Shri, R. (2012). Anxiety: Causes and management. The Journal of Behavioral Science, 5(1), 100–118. https://so06.tci-thaijo.org/index.php/IJBS/article/view/2205
Smith, R., Thayer, J. F., Khalsa, S. S., & Lane, R. D. (2017). The hierarchical basis of neurovisceral integration. Neuroscience & Biobehavioral Reviews, 75, 274–296. https://doi.org/10.1016/j.neubiorev.2017.02.003
Smits, J. A. J., Berry, A. C., Tart, C. D., & Powers, M. B. (2008). The efficacy of cognitive-behavioral interventions for reducing anxiety sensitivity: A meta-analytic review. Behaviour Research and Therapy, 46(9), 1047–1054. https://doi.org/10.1016/j.brat.2008.06.010
Streeter, C. C., Gerbarg, P. L., Brown, R. P., Scott, T. M., Nielsen, G. H., Owen, L., Sakai, O., Sneider, J. T., Nyer, M. B., & Silveri, M. M. (2020). Thalamic gamma aminobutyric acid level changes in major depressive disorder after a 12-week Iyengar yoga and coherent breathing intervention. The Journal of Alternative and Complementary Medicine, 26(3), 190–197. https://doi.org/10.1089/acm.2019.0234
Streeter, C. C., Gerbarg, P. L., Nielsen, G. H., Brown, R. P., Jensen, J. E., & Silveri, M. M. (2018). Effects of yoga on thalamic gamma-aminobutyric acid, mood and depression: Analysis of two randomized controlled trials. Neuropsychiatry (London), 8(6), 1923–1939. https://www.jneuropsychiatry.org/peer-review/effects-of-yoga-on-thalamic-gammaaminobutyric -acid-mood-and-depression-analysis-of-two-randomized-controlled-trials-12856.html - :~:text=Results%3A,anxiety improved in both groups
Thayer, J. F. (2006). On the importance of inhibition: Central and peripheral manifestations of nonlinear inhibitory processes in neural systems. Dose-Response, 4(1), 2–21. https://doi.org/10.2203/dose-response.004.01.002.Thayer
Tsai, H.-Y., Peper, E., & Lin, I.-M. (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23–27. https://doi.org/10.15540/nr.3.1.23
Toossi, H., Del Cid-Pellitero, E., & Jones, B. E. (2017). Homeostatic regulation through GABA and acetylcholine muscarinic receptors of motor trigeminal neurons following sleep deprivation. Brain Structure and Function, 222(7), 3163–3178. https://doi.org/10.1007/s00429-017-1392-4
Wilhelm, F. H., Gevirtz, R., & Roth, W. T. (2001). Respiratory dysregulation in anxiety, functional cardiac, and pain disorders: Assessment, phenomenology, and treatment. Behavior Modification, 25(4), 513–545. https://doi.org/10.1177/0145445501254003
Copyright (c) 2022 Erik Peper, Richard Harvey, Yaneth Cuellar, Catalina Membrila
This work is licensed under a Creative Commons Attribution 4.0 International License.Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).