Slow Breath Practice Sheet: A Free Slow Breathing and Resonance Breathing Worksheet
Depression · Practice-informed · Practice-informed
A practice sheet with two breathing techniques and one rule: comfort. Nose-low-slow breathing is a simple arousal-regulation skill within established breathing-pattern practice. Resonance breathing at about six breaths a minute is the pace most often used in heart rate variability biofeedback, where meta-analyses report small to medium benefits for depressive symptoms, but those studies used biofeedback and none targeted seasonal depression.
Underlying mechanism: Nose-Low-Slow Breathing and Optional Resonance Breathing Practice Log
What it helps with
- Giving the client one simple body-level skill that lowers tension and works as a reliable cue anchor in winter.
- Attaching practice to existing cues such as the kettle, the dark commute or bedtime, so it is not an extra task.
- Offering a more structured second technique to clients who are curious, without making it a requirement.
- Showing change in calm from before to after each practice in a simple log.
How clinicians use it
- Teach Part 1 in the room for three to five minutes and agree the cue.
- Hold Part 2 back until the first technique feels familiar, then offer it as optional.
- Use the Part 3 log as a conversation starter and never as a target for the client to hit.
Clinical Implementation Guide
- Check medical cautions (asthma, cardiac or respiratory conditions, panic) first.
- Teach nose-low-slow breathing and agree one cue before the client leaves.
- Offer resonance breathing later and only if the client is curious.
What the worksheet looks like
| Technique | Pace | Rating |
|---|---|---|
| Nose-low-slow breathing (first) | Gentle, quiet, no counting, soft natural pause | Practice-based |
| Resonance breathing (optional, later) | 5 seconds in and 5 out, about 6 breaths a minute | Emerging |
| Longer out-breath variation (optional) | For example 4 seconds in and 6 out | Practice-based |
Clinical cautions
Never use breath holds. Stop if dizzy, light-headed or anxious. Check with the GP first with asthma, a respiratory or cardiac condition or panic that is triggered by slow exhalation, and keep practice gentle. The resonance rating is Emerging because the heart rate variability research used biofeedback protocols with feedback and structured practice, not unguided breathing, and none was in seasonal depression. Nose-low-slow breathing is practice-based. Breathing does not remove low mood and is not a treatment on its own. This tool is not a substitute for individual face-to-face therapy or for emergency crisis support.
References
- Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Frontiers in Psychology, 5, 756. https://doi.org/10.3389/fpsyg.2014.00756
- Donnelly, D., Georgiadis, E., & Stavrou, N. (2023). A meta-analysis investigating the outcomes and correlation between heart rate variability biofeedback training on depressive symptoms and heart rate variability outcomes versus standard treatment in comorbid adult populations. Acta Biomedica, 94(4), e2023214. https://doi.org/10.23750/abm.v94i4.14305
- Vann-Adibe, S., Tsui, H. K. H., Zhou, H. Q., Ciren, Z., Li, C., & Cha, S. K. W. (2026). Efficacy and methodology of remote heart rate variability biofeedback interventions for mental health: A systematic review and meta-analysis. Applied Psychophysiology and Biofeedback, 51(3), 441-452. https://doi.org/10.1007/s10484-025-09750-w
- Galin, S., Nagy, L., Turan, C., Laczko, D., Szabo, B., Hegyi, P., Molnar, Z., & Keri, S. (2026). Heart rate variability as a predictor of future depressive symptoms: A systematic review and meta-analysis. Journal of Affective Disorders, 403, 121388. https://doi.org/10.1016/j.jad.2026.121388
Part of
Wintering Well
Related worksheets
Next steps
- Browse the full clinical resource library — every worksheet, free and printable.
- Hear about new free resources. Join the clinician email list for occasional notes when there is something useful to share. The sign-up form is at the foot of this page once it has finished loading. This worksheet is free without signing up; unsubscribe anytime.
- Professional and Studio workflows — saved Client Packs, secure delivery and programme publishing when you need more than individual free resources.
