Diaphragmatic Deep Breathing Exercise Effectiveness in Management of Generalized Anxiety Disorder: A Scoping Review

Written by Abraham B. Asto, Annabelle R. Borromeo, Phyllice A. Breboneria, Art Gregor A. Nerbes, & James Ryan M. Villaruel

doi: https://doi.org/10.13178/jnparr.2025.1501.1505

Abstract

Background: Generalized anxiety disorder was considered the most prevalent mental health disorder in 2023, affecting 301 million people or an estimated four percent (4%) of the world population. However, the standard treatments for anxiety do not include much discussion around the effects of diaphragmatic deep breathing exercises to alleviate symptoms.

Objective: This scoping review was aimed to recognize the effectiveness of diaphragmatic deep breathing exercise in alleviating anxiety in general, presenting a literature position about diaphragmatic deep breathing exercise intervention for adults assessed with anxiety disorder using tools with high validity and reliability.

Methods: CINAHL, ProQuest, Medline (National Library of Medicine), PsycINFO, PubMed (National Institutes of Health), Sigma Repository, Web of Science and Cochrane Central register of controlled trials databases were searched using the PRISMA 2020 flow diagram.

Results: Investigators identified only six articles that met full eligibility criteria for inclusion, demonstrating that diaphragmatic deep breathing exercises, regardless of the specific protocol used, reduced anxiety levels in clinical, real-world, and research settings. These articles were included in the final review and were appraised for quality and strength using the Johns Hop-
kins Evidence Based Practice model tools.

Conclusion: The effectiveness of diaphragmatic breathing for decreasing anxiety level has been positive and the technique is relatively quick, inexpensive, and can be implemented in both real-world and clinical settings, as demonstrated in studies included in this review. Further, future research should include the optimization, stabilization and standardization of diaphragmatic breathing practices and protocols for the reduction of anxiety levels.

Keywords: diaphragmatic deep breathing exercise, generalized anxiety disorder, breathwork intervention, anxiety management