What you've heard: Breathwork will fix your anxiety
Can breathwork fix anxiety?
Helps a little; not a substitute for therapy or medication. Evidence grade: Probable.
Published Updated
The "What you've heard" box in Chapter 13
Helps a little; not a substitute for therapy or medication
The evidence
Pooled across randomized trials, breathwork brought small-to-moderate reductions in stress, anxiety and depressive symptoms; most trials carried a moderate risk of bias, and the authors warned against "a miscalibration between hype and evidence."25 The fast-breathing and breath-hold styles popular online also carry a real hazard: they can cause fainting, and fainting in water can kill (see Safety below). An anxiety disorder is a treatable illness, and breathing belongs alongside its treatment.
Where the book tests it
What the book recommends instead
Practice slow breathing or mindfulness for five to ten minutes a day, or take an eight-week course
ProbableEvidence grade: Probable. Good observational evidence with a plausible mechanism, or small or few trials.How: breathe about six times a minute, roughly four seconds in and six out, sitting down, on most days; use a count, an app or a prayer to keep the pace. For anxiety that persists, consider an eight-week mindfulness-based stress reduction course. Why: small-to-moderate reductions in stress and anxiety in trials, and one course proved no worse than a standard drug for anxiety disorders.
Talk to a clinician if low mood or anxiety lasts more than two weeks or gets in the way of work, sleep or people
StrongEvidence grade: Strong. Multiple randomized controlled trials, or consistent large cohort studies with a well-understood mechanism.How: a family doctor is a fine first stop. Before the appointment, write down what you have noticed, for how long, and what it is costing you in sleep, work and time with people, because a low day in the waiting room can make a hard month sound like nothing. Ask about the options, including talking therapy; if cost or a waiting list is the barrier, say so and ask about lower-cost and online options. Why: every antidepressant tested beat placebo; the wrong chemical story never meant the treatment was wrong. If you already take a psychiatric medicine, keep taking it; any change belongs in a conversation with the person who prescribed it.
Related claims
- Does grounding work, or is it pseudoscience?Emerging and contested.Evidence grade: Emerging. Early, small, animal-only, or actively contested.
- Does forest bathing work through tree chemicals?Enjoy the forest as relaxation, plausible though the size is uncertain; the tree-chemical immune story is unproven.Evidence grade: Emerging. Early, small, animal-only, or actively contested.
- Is adrenal fatigue real?False.Evidence grade: Probable. Good observational evidence with a plausible mechanism, or small or few trials.
- The physiological sigh: what the evidence showsA reasonable quick reset with thin evidence; "fastest" and "proven" are overstated.Evidence grade: Emerging. Early, small, animal-only, or actively contested.
Sources
The "What you've heard" box in Chapter 13
- 25.Fincham, G.W., Strauss, C., Montero-Marin, J., and Cavanagh, K. (2023). "Effect of breathwork on stress and mental health: a meta-analysis of randomised-controlled trials." Scientific Reports, 13(1), 432. https://doi.org/10.1038/s41598-022-27247-y (12 trials and 785 adults for stress, effect -0.35; anxiety -0.32; depressive symptoms -0.40.)
Note numbers are those of Chapter 13, Stress and the Mind.
This verdict is one of the "What you've heard" boxes in Chapter 13, Stress and the Mind, where the book tests the claims people repeat against the studies behind them. The grade rates the evidence behind the verdict, by the book's stated method.
Educational content, not medical advice. Disclaimer.