Breathwork Risks in Psychiatric Conditions: Psychosis, Mania, Dissociation and Panic

If you need help now

If you are in distress, thinking of harming yourself, or seeing or hearing things that frighten you, contact the 988 Suicide & Crisis Lifeline in the United States by calling, texting or chatting 988. It is free, confidential and open all day, every day. [1] For immediate danger call 911. If you take medicines for a mental health condition, do not stop or change them because of anything on this page; talk to your prescriber.

Short answer

Gentle, slow breathing is widely used and is generally considered safe for healthy people. The concern on this page is intensive practice: long periods of fast, deep breathing that deliberately changes carbon dioxide in the blood, sometimes with music, touch and emotional release. This page does not teach any such practice. Sources we read advise that people with psychosis, bipolar disorder, dissociative disorders and panic disorder avoid it or seek specialist advice first.

What the sources say

Mental health professionals' view. In a 2026 study, mental health professionals (54 participants across six four-hour workshops) tried an intensive breathwork session and then rated its suitability. Psychotic, dissociative and bipolar disorders were identified as contraindications. [2] The authors say caution applies for panic disorder and that people new to breathwork with anxiety disorders may be susceptible to negative experiences. [2] This is expert opinion after a single exposure, not a record of harms. Evidence label: expert opinion.

Narrative review (2026). A review of breathing practices says people with epilepsy, panic disorder or psychotic disorders show increased vulnerability to respiratory manipulation. [3] It also reports that breathing practices have, rarely, triggered perceptual disturbances including visual and auditory hallucinations. [3] Evidence label: limited, mostly case-level.

Consumer health page. A Healthline article on holotropic breathwork lists severe mental illness and seizure disorders among conditions to discuss with a doctor first, and describes the practice as breathing fast for minutes to hours. [4] It also says the practice may bring intense emotions and painful memories that could worsen symptoms. [4]

Trial exclusions. One trial of intensive breathwork excluded people with a history of psychosis, [5] and another trial also excluded suicidal ideation and bipolar disorder. [6] That tells us researchers judged these groups unsafe to include. It does not tell us how often harm happens.

Panic and anxiety

Overbreathing causes tingling, dizziness and a racing heart, which can feel like panic. A review notes breathing interventions may worsen anxiety in some people, [3] and the NHS describes a panic attack as very frightening and distressing. [7] For gentle options, see breathing practices if you have anxiety or panic history and panic attacks.

Dissociation, trauma and altered states

A review reports that overbreathing can bring feelings of detachment or loss of self-boundaries in some people, [3] and that people with acute stress disorders may relive traumatic memories during hyperventilation. [3] The NHS lists feeling not connected to your body as a panic symptom. [7] If such feelings appear, stop and return to normal breathing. See trauma-informed breathwork and breathwork and altered states.

Psychosis and mania: what case reports exist

Proper evidence not found for systematic data on how often breathwork triggers psychosis or mania. We searched Europe PMC and a web search for breathwork, pranayama and yogic breathing with psychosis, mania and case report, and found no breathwork-specific case series.

What exists is limited. A 2022 case report from a psychiatric institute in New Delhi describes a 19-year-old woman who had been practising hatha yoga and kundalini asanas for three months, with pranayama and meditation unguided, and who was diagnosed with schizophrenia, catatonic subtype. [8] The authors note that limited literature exists as case reports. [8] One case cannot show that the practice caused the illness; these conditions can arise on their own. Separately, a 2024 case series reports seven people who developed psychiatric illness after meditation (not breathwork). [9] Pranayama is a living Indian tradition taught with experienced guidance; these reports are about unguided practice and should not be read as a verdict on the tradition.

The NHS describes mania as a severe high mood in bipolar disorder. [10] For background see psychosis vulnerability and mania and bipolar-related concerns.

What the research cannot tell us

Many studies are small, self-selected and unblinded. In the workshop study, effects were mostly mild and the authors called them predominantly benign, [2] but participants were screened and supervised, so that does not describe an unscreened group. A general NCCIH note says relaxation techniques are usually safe but some people report increased anxiety, intrusive thoughts or fear of losing control. [11]

Practical points

• Talk to a clinician before intensive breathwork if you have any condition above, or a close family history.
• Skip intensive breathwork during a period of poor sleep, high stress or unstable mood.
• Facilitation is generally unregulated; see breathwork in therapy and clinical settings.