The Physiological Sigh: Fast Relief for Stress with DBT

Introduction

Ever had a moment when stress hits you like a wave—making your heart race, your thoughts scatter, and you just want everything to STOP? You’re not alone. Intense emotions can take over quickly, and it’s tough to regain control in the moment.

Imagine if there was a simple, science-backed way to send a "calm down" signal to your body—no equipment, no prep, just your breath. That’s where the physiological sigh comes in: a powerful tool from neuroscience that lines up perfectly with DBT's approach to distress tolerance.

Ready to discover how two deep breaths and a slow exhale can dial down overwhelm—fast?

What Is the Physiological Sigh—and Why Does It Work?

The physiological sigh is more than just a deep breath. It’s a specific breathing pattern discovered in the 1930s and recently popularized by neuroscientist Andrew Huberman:

“Billions of people suffer from stress…The best way that I am aware to do that is called the physiological sigh.” — Andrew Huberman

Instead of taking any old inhale and exhale, the physiological sigh uses two quick inhales (the second is small) followed by a long, extended exhale. This helps clear out excess carbon dioxide—which spikes in your blood during stress—and sends a message to your brain and body: “Hey, it’s okay to relax.”

How It Fits in DBT

DBT (Dialectical Behavior Therapy) teaches us that changing how our bodies respond to distress can shift how we feel—and act—when life gets tough. The physiological sigh is an excellent example of combining mindfulness and distress tolerance: noticing when you're overloaded, and giving yourself a rapid tool to lower the tension before emotions spiral out of control.

Learn more about DBT and its four skill modules.

How To Do the Physiological Sigh—Step-by-Step

Let’s break it down. You can use this skill almost anywhere: before a difficult meeting, after an argument, or even in bed when racing thoughts won’t let you sleep.

Double Inhale (through your nose):
- First, take a deep inhale, filling your lungs.
- Before you exhale, add a second, shorter inhale—almost like a “top-up.”
Slow Extended Exhale (through your mouth):
- Exhale gently, slowly, and completely. Take your time—as you breathe out, try to make it longer than your inhales.
Repeat One to Three Times:
- If you still feel tense, do it a couple more times. Most people notice a shift after one to three cycles.

Example scenario: You’re at work, and your inbox is overflowing. Stress spikes, shoulders tense. You pause, take a double inhale, slow exhale—repeat twice. Suddenly, you’re a bit more grounded, ready to tackle the next task.

Common mistake:
Trying to force the breath or rush the exhale. This can actually increase anxiety. Instead, stay gentle and let the air flow out naturally.

Why Does This Technique Work So Quickly?

When we’re stressed, our breathing gets fast and shallow, and carbon dioxide builds up, increasing anxiety signals in the brain. The physiological sigh “re-inflates” collapsed air sacs in the lungs and clears CO₂, giving near-instant feedback to your nervous system: “You’re safe.”

Real-World Applications

Public speaking: Before stepping up, use a physiological sigh to settle nerves and boost focus.
Relationship conflict: Feeling triggered? One or two sighs can reduce the urge to say something you'll regret.
Daily frustrations: Missed the bus? Tough customer call? Use this skill to recover your composure in real time.

Want more DBT skills for on-the-go relief? Check out our Skills Library.

Using the Physiological Sigh With WithMarsha

Practicing new skills alone can be tough—and honestly, it’s normal to forget what to do in the heat of the moment. WithMarsha makes it easier:

Get real-time guidance: WithMarsha can walk you through each step, complete with reminders and encouragement.
Track your practice: Log your physiological sighs and notice patterns—see if certain times or situations trigger you more.
Personalized suggestions: Not sure which DBT skill fits your stressful moment? Ask WithMarsha for a tailored recommendation.

Learn how DBT skills support emotion regulation.

What If “It’s Not Working”?

Let’s be honest: the physiological sigh is simple, but that doesn’t mean you’ll feel like a new person every time. And that’s okay.

You might need to repeat it: Most people find 1–3 cycles help. Give yourself permission to take what you need.
Practice helps: Like any DBT skill, it gets easier and more automatic over time.
Combine with other skills: Pair the physiological sigh with a DBT TIP skill (temperature, intense exercise, paced breathing) for extra impact. Explore TIP here.

Important: Techniques like the physiological sigh are supportive tools—not quick fixes for deep or persistent distress. If anxiety or stress feels unmanageable, reaching out for professional support is always encouraged.

Learn about the evidence for DBT and emotion regulation.

Conclusion

Stress is part of life—there’s no getting around that. But you can choose how you respond, and small actions (like the physiological sigh) make big differences over time. DBT teaches us that agency starts with awareness and one step forward—and you’re already doing it just by reading this.