What Your Breathing Says About Your Mental Health
Welcome to Impact Factor , your weekly dose of commentary on a new medical study. I'm Dr F. Perry Wilson from the Yale School of Medicine.
You don't need to think about it until you think about it: breathing. The most fundamental physical function. The most basic act that our bodies undertake to keep our brains alive, exchanging cardon dioxide for oxygen, nourishing every cell inside us.
The reason you don't need to think about breathing is because of an area of the brainstem called the pre-Bötzinger complex. It's a group of cells that acts as a pacemaker clicking off about 12 times a minute, triggering your body, without conscious thought at all, to breathe.
Of course, you know it's more complicated than that. You can hold your breath, after all — you are in control of the process. And it's more complicated than that . Higher levels of your brain feed into the pre-Bötzinger complex to increase your breathing rate when your body is moving, or when energy expenditure goes up.
And it's even more complicated than that. You may never have noticed, but when you are breathing through your nose, you're mostly breathing through one nostril at a time, oscillating back and forth, allowing one nasal passage to regain some moisture while the other does the work.
For something you don't think about at all, breathing is taking up a lot of brain space.
Could these complex respiratory patterns reveal something, then, about the state of our brains? Are all the yogis and gurus and influencers right about the importance of how we breathe? Is the breath the window to the soul?
If you want to really interrogate the way we breathe, you need to do some pretty precise measurements — which is why I was so intrigued by this paper, appearing this week in Current Biology.
The centerpiece of the article is a new technology: a nasal cannula, but not of the sort you've seen before.
Researchers led by Timna Soroka created this device, which precisely measures the airflow in and out of each nostril. They recruited 100 people to wear it for 24 full hours.
At a sampling rate of 6 Hz, this is a ton of data. In fact, compressing that stream of data into interpretable metrics is a feat in and of itself. The primary analysis derived 24 different measures from this airflow data. Some of these are intuitive: the volume of air inhaled and exhaled, the rate of airflow, the rate of oscillation between one nostril and the other.
This graph, which colors airflow from the right nostril in purple and the left in blue, shows that oscillation in a single participant.
Some metrics are less obvious: the coefficient of variation of the breathing duty cycle, for example, appears to quantify how much one breath changes compared to others.
Our brains are unique, and, it turns out, so are our breathing patterns. The researchers wanted to know whether the 24 metrics derived from someone's breathing pattern could be used to identify them. Can breathing act like a fingerprint?
The results were impressive.
This graph shows how a computer model did when predicting which of the 100 patients a given airflow pattern came from. The diagonal lines are correct predictions. If airflow patterns were random, the machine would only get this right 1% of the time. Instead, it was correct 91% of the time. This approaches biometric levels of accuracy, similar to voice recognition.
These unique respiratory fingerprints were stable over time. Forty-two of the participants came back for another round of 24-hour monitoring, somewhere between 5 days and 2 years later. The system could identify who was who with 95% accuracy even all that time later.
This is all pretty cool, but let's be honest: You're never going to unlock your laptop by strapping a nasal cannula to your face and breathing for a while.
Where this study gets really interesting is in the links between breathing parameters and other physical and psychological parameters.
For example, the breathing pattern was associated with body mass index. People with a higher BMI had a higher tidal volume — a larger volume of air during a typical respiration — than people with a lower BMI.
That makes some sense. People with more mass might need to exchange more air to keep oxygen and carbon dioxide levels normal.
But our psychology changes how we breathe as well. The researchers divided people into low and high scorers on the Beck Depression Inventory. Now, it's worth noting that none of these participants suffered from clinical depression, but of course some had higher scores and some had lower scores. You can see here that the peak inspiratory flow, the fastest rate at which we breathe in, was substantially higher in those with more depressive symptoms.
This is not a conscious process. This is the state of your brain controlling subtle features about how you breathe that can only be revealed with new technology.
It didn't stop with depression. The researchers could distinguish between people with high vs low anxiety scores by looking at the variation in their inspiratory pause.
And you could determine who was more likely to have autistic features — again, none of these individuals had clinical autism — by looking at the percentage of breaths with an inspiratory pause.
This is where this stuff starts to get interesting, because it suggests that there are physiologic links between brain states and breathing patterns and that those links can be mapped with careful measurement.
I actually think there is a practical application to this. No, I don't think we'll all be walking around with tubes in our noses like stillsuits from Dune . But plenty of people are wearing nasal cannulas at night — for CPAP treatment. Adding technology like this to those devices could give insights into how these metrics change over time, perhaps cluing us into changes in our mood or anxiety or other health conditions before we are even consciously aware of them.
Our breathing says a lot about us. So, to paraphrase Sylvia Plath, take a deep breath and listen to the old brag of your heart. I am, I am, I am.
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From left to right: DISTILLATE VAPE CARTRIDGE Oil; THC potency as high as 95 percent. THCA SAND Concentrated tetrahydrocannabinolic acid (THCA); converts to 75 to 90 percent THC when heated. INFUSED JOINTS Pre-rolled joints blended with or coated in a concentrate product; varied potency. CANNABIS TOPICALS Balms and creams applied to skin; nonintoxicating, typically low THC content. MARIJUANA FLOWER THC potency can reach nearly 35 percent; average closer to 15 percent. Back in the 1960s, the THC concentration in cannabis was around 4 percent, D'Souza notes. Currently, it's around 18 percent, with some products made from cannabis bud at 35 percent. But 'concentrates that are vaped could have THC concentrations that are 65 to 95 percent. With that comes greater risk,' says D'Souza. THC concentrations in dabs can also range from 60 to 90 percent. 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A study in a 2024 issue of the journal Psychological Medicine found that adolescents who used high-potency cannabis weekly had an 11 times greater risk of developing a psychotic disorder. Young adults over the age of 19 did not have an increased risk. Part of the vulnerability is because teen brains are still developing and undergoing changes related to pruning, a process in which the brain eliminates unnecessary neurons and neural connections, D'Souza says. 'This process leads to maturation of the brain,' he explains. Regular use of high-potency THC can disrupt these physiological processes in the brain. 'In younger people, being exposed to these potent psychoactive substances can affect cognitive skills such as memory, concentration, attention, analytical thinking, and impulsivity,' Anand says. 'It's bad for everybody, but it's devastating in younger people because these effects can be permanent.' Research has also found that people who experience cannabis-induced psychosis at any age have a 47 percent higher risk of developing schizophrenia or bipolar disorder. In addition to these mental health risks, there are potential consequences for physical health. Use of vaping concentrates can lead to 'popcorn lung' (aka bronchiolitis obliterans, a disease that affects small airways in the lungs), shortness of breath, a nagging or persistent cough, and wheezing, says Robert Welch, a pharmacist and director of the National Center for Cannabis Research and Education at the University of Mississippi. Over time, chronic irritation of lung tissue could increase the risk of long-term damage to the lungs. And dabbing can expose people to contaminants, including heavy metals, solvents, and pesticides. Among Gen Z consumers of legal cannabis—those born between 1997 and 2009—sales of vaping products exceed all other categories, including edibles and flower, according to the industry data firm Headset. Who's at risk for addiction? With these high-potency forms of cannabis consumption, there's a greater risk of developing cannabis use disorder—'which boils down to a loss of control of cannabis use even though it interferes with your personal life, academic life, or professional life,' D'Souza says. Generally, 'most people who are using these high levels of THC started at a lower level, with milder THC potency, and developed a high tolerance so they need more, more, more,' Anand says. 'People can develop an addiction where they need it or crave it.' This is a greater concern with today's high-potency cannabis. 'We used to think the risk of cannabis use disorder was less than one in 10—that's because the cannabis used to be much weaker,' D'Souza says. 'In the current cannabis landscape, the rates of cannabis use disorder are closer to one in three. And the younger brain is much more likely to develop addiction because the brain undergoes its greatest changes in early to mid adolescence.' In fact, research has found that teens are at significantly higher risk of developing cannabis use disorder within the first year after starting to use cannabis than adults are. 'There's this misconception that you can't get addicted to cannabis,' Welch says. 'That's just not true, especially with regular or high use' of today's high-potency cannabis. Perhaps counterintuitively, concerns about high-potency pot have prompted calls for the federal government to remove cannabis from its most restrictive class of illicit drugs. Legal limits on THC content vary at state levels, and moving cannabis from the Drug Enforcement Administration's Schedule I to Schedule III would allow for federal regulations on potency. This reclassification was initiated in 2024, during the previous presidential administration, but it's now in limbo. A version of this story appears in the September 2025 issue of National Geographic magazine. Set Design: Mat Cullen, Lalaland Artists
