Can Breathing Exercises Make Anxiety Worse?

Yes, breathing exercises can make anxiety worse for some people. The usual causes are long breath holds, fast or deep breathing, and trying too hard to control the breath. Most people do fine with gentle, slow breathing and a longer exhale, but you should know the warning signs and how to adjust.

This article explains who is most at risk, why it happens, what research says, and how to keep your practice gentle.

Can breathing exercises make anxiety worse?

They can, and it is more common than most guides admit. Some people feel dizzy, tingly, short of air or suddenly more anxious partway through an exercise.

This has been studied under the name "relaxation-induced anxiety." In a 1983 study, some tense adults reported more tension during relaxation exercises than before them (Heide and Borkovec, 1983). A 1988 study of 30 chronically anxious adults found 5 of them (17%) felt more anxious during a single relaxation session. Those people tended to fear losing control and fear becoming anxious (Braith et al., 1988).

In panic disorder the picture is mixed. A 2003 review judged the evidence for breathing training too weak for a clear verdict (Meuret et al., 2003), and a 77-person trial found that adding breathing retraining to cognitive behavioral therapy gave no extra benefit, with some signs of a slightly worse result (Schmidt et al., 2000). Breathing is not dangerous for most people, but it is not a sure help either.

Why it happens

Three common reasons.

Too much air. Fast or deep breathing can lower carbon dioxide in the blood, which may bring tingling, light-headedness and a feeling of unreality. Those sensations can feel like danger, and the fear speeds up breathing even more.

Breath holds feel like air hunger. For someone who fears suffocation sensations, a long hold can set off the exact fear they are trying to calm.

Watching the body too closely. Paying close attention to your breath can make you notice every small sensation. For some anxious people, that closer look raises alarm. The Braith study linked relaxation-induced anxiety to a fear of becoming anxious (Braith et al., 1988).

How to keep breathing exercises gentle

1. Make the inhale small and easy. Think of a quiet sip of air through the nose, about 3 or 4 seconds, not a big gulp.
2. Make the exhale a little longer. About 5 or 6 seconds, soft and unforced.
3. Skip breath holds. Go straight from inhale to exhale and back.
4. Start with 1 to 3 minutes. Add time only if it feels okay.
5. Keep your eyes open if closing them raises anxiety, and let your attention rest on a spot in the room.
6. Stop at the first sign of trouble. Return to normal breathing and wait a few minutes.

If breathing practice keeps feeling worse, try an alternative that does not focus on the breath, such as noticing five things you can see, or a slow walk. Not every calming tool suits every person.

What the research shows

• Relaxation-induced anxiety, 30 chronically anxious adults: 5 (17%) felt more anxious during one relaxation session, linked to fear of losing control. It was a small, older study (Braith et al., 1988).
• The first controlled study, 14 tense adults, 1983: some reported more tension during relaxation, and the effect was stronger in a focused-attention exercise than in progressive muscle relaxation (Heide and Borkovec, 1983).
• Breathing training for panic disorder, 9 studies: too few and too varied for a firm conclusion (Meuret et al., 2003).
• Breathing retraining added to CBT, 77 patients: no clear extra benefit, with some data hinting at poorer outcomes (Schmidt et al., 2000).
• Breathwork trials overall: only four of the trials in a 2023 review reported on adverse effects. One trial of fast-paced breathwork reported some hot flushes, shortness of breath or sweating in a small subgroup. The authors asked for better reporting (Fincham et al., 2023).

The takeaway: serious harm from gentle breathing is rare, but bad reactions are real and under-reported, so go slowly and listen to your body.

Common mistakes

• Pushing through dizziness. Tingling or light-headedness is a signal to stop.
• Copying a long-hold method from the internet. A 4-7-8 or other held pattern is a lot to start with when you are anxious.
• Breathing into a paper bag. It lowered oxygen sharply in a 1989 study, which reported three deaths when it was used on people who were short of oxygen or had heart problems (Callaham, 1989).
• Treating a bad session as a failure. It tells you what to change, such as shorter counts or no holds.
• Practicing only in a crisis. A bad moment is the hardest time to learn something new.

Who should be careful

• People with panic disorder: breath holds and fast, deep breathing can trigger or worsen symptoms. Favor gentle long-exhale breathing and keep sessions short at first.
• People with asthma or another lung condition: avoid forceful breathing, and check with your doctor first.
• People who fear physical sensations or fear losing control: this group may be more likely to feel worse during relaxation, so start slowly and consider guidance from a therapist.
• Anyone who feels dizzy, tingling, faint or short of breath: stop, breathe normally, and rest.
• Anyone with frequent or severe anxiety or panic: please see a doctor or therapist. Breathing alone is not enough.