When breath lifts your mood: Dynamic everyday links between breathing, affect, and emotion regulation in remitted depression.

BACKGROUND

Internalizing disorders are marked by emotional dysregulation and attenuated positive affect and emotion regulation deficits. Respiration increasingly has been recognized as a unique physiological marker that reflects and shapes emotional processes. Elucidating whether the link between respiration and positive affect is strengthened or weakened in those with remitted depression (rMDD) could have important treatment implications. Likewise, understanding the role of emotion regulation strategies in respiration-affect dynamics could inform targeted interventions.

METHODS

Seventy-three adults (36 rMDD, 37 healthy controls) completed a 7-day ambulatory protocol that included repeated ecological momentary assessments (EMAs) of affect, emotion regulation, and continuous respiratory monitoring via Hexoskin shirts. Respiratory metrics (mean tidal volume, breathing rate, and minute ventilation) were derived from the 30-min periods preceding each EMA. Multilevel models were used to examine within-person associations between respiration and subsequent affect, and to test moderation by diagnostic group and emotion regulation strategy.

RESULTS

Within-person increases in mean minute ventilation and breathing rate predicted subsequent increases in high-arousal positive affect (HAPA). The strength of the relationship between respiration and affect was moderated by history of depression as well as by average emotion regulation use. At the between-person level, individuals with more variable tidal volume demonstrated greater use of acceptance.

CONCLUSIONS

These findings suggest that respiratory patterns may influence dynamic affective functioning. Our results may offer important implications for developing treatment interventions, including just-in-time or novel breathing interventions to increase HAPA and potentially prevent relapse for individuals with rMDD.