Breathwork can produce powerful physical, emotional, and psychological experiences. But powerful does not mean therapeutic.
For some people, breathwork can feel calming, grounding or deeply meaningful. For others, the experience can become physically and psychologically overwhelming. And sometimes, the effects do not end when the session does.
Immediately, or even a few days after – you might be feeling anxious, emotional, disconnected from yourself, unable to sleep, frightened by what happened, or simply not quite like yourself. When the experience was presented to you as healing, to release trauma, or to regulate the nervous system, feeling worse afterwards can be especially confusing.
One of the difficulties is that distress following breathwork is often interpreted in one of two extremes. Either something has gone wrong, or the distress is explained away as part of a healing process that you simply need to surrender to.
Neither assumption is particularly helpful.
A difficult experience does not automatically mean you have been psychologically harmed. But persistent or worsening symptoms should not be dismissed as evidence that your body is “releasing trauma” either.
As a Clinical Psychologist working with trauma, altered states, and integration, we need to acknowledge there is an important middle ground.
An intense experience ≠ a therapeutic experience.
What matters is understanding what happened, how you are functioning now, whether symptoms are settling or worsening, and whether additional support may be appropriate.
What do we actually mean by breathwork?
“Breathwork” is an umbrella term covering a very broad range of breathing practices.
At one end of the continuum are gentle techniques involving slow, controlled, or paced breathing – these are often referred to as meditative breath practices. At the other end of the continuum are more intensive practices involving prolonged periods of rapid, deep or continuous breathing, often accompanied by music, movement, emotional processing, or encouragement to continue through uncomfortable sensations.
These practices are not the same and should be treated accordingly.
Some intensive forms of breathwork deliberately produce substantial changes in physiology and subjective experience. Research into high-ventilation breathwork has identified changes associated with carbon dioxide levels, autonomic nervous system activity, and altered states of consciousness.
The intensity and duration of the breathing technique matter. So do the environment, the facilitators, the person participating, their physical and psychological history, their expectations, and what support is available if the experience becomes difficult, or if they experience prolonged difficulties after.
Why can intensive breathwork feel so powerful?
Part of the answer is physiological.
When we substantially change the way we breathe, particularly through prolonged rapid or deep breathing, we can change the balance of oxygen and carbon dioxide in the body. Rapid breathing can reduce carbon dioxide levels, known as hypocapnia. This can contribute to physical experiences such as tingling, light-headedness, changes in bodily sensation, muscle tightening, dizziness and changes in perception.
Those sensations can become intense.
For someone who is already sensitive to bodily sensations, has a history of panic, trauma or dissociation, or has not been adequately prepared for what was going to happen, the experience may also become psychologically challenging and at times overwhelming.
The kicker..
Intensive breathwork can produce powerful temporary changes in consciousness. This is often accompanied by transient perceptual changes of yourself, your body, the world, and others, emotions, time, memories, and the environment around you.
That does not automatically make these experiences pathological. In fact, in the right container, with appropriately trained facilitators, and adequate preparation; these experiences can be powerful. But we should not assume that because an experience may feel profound or cathartic, that it is necessarily therapeutic.
Sometimes something powerful happens and a person understands it, processes it, and returns to ordinary functioning without difficulty. Sometimes something powerful happens and they do not.
Why might I feel worse after breathwork?
People respond differently to altered-state experiences, and symptoms that occur after breathwork are not necessarily caused by breathwork itself, but the process may have disrupted unprocessed emotional content.
However, if there has been a clear change in how you feel or function following an intensive breathwork experience, it is worth exploring further.
Anxiety or panic
Some people experience significant anxiety during intensive breathing.
The physical sensations produced by rapid breathing can overlap with sensations commonly experienced during panic, including dizziness, changes in heart rate, tingling, chest sensations and feeling unable to settle.
For some people these sensations stop when the session ends. Others may remain heightened or scared by what happened, become increasingly focused on bodily sensations, or experience ongoing anxiety afterwards.
Feeling disconnected, unreal, or unlike yourself
Some people describe feeling strange or disconnected after an intense breathwork experience.
You might feel detached from yourself, emotionally numb, dreamlike or as though the world around you does not quite feel real.
Clinically, experiences like these may sometimes be described as depersonalisation or derealisation.
If you are experiencing these symptoms, contact your GP, psychologist, or psychiatrist for support.
Difficult memories or emotions
Breathwork is sometimes promoted using language about “releasing trauma”.
We need to be more careful and considerate about the use of this language.
Strong emotional experiences can bring up memories, thoughts, bodily sensations, or uncomfortable emotions into our awareness. For people who have been through traumatic events, this can be destabilising or overwhelming. Some people may experience emotional flooding. These experiences do not necessarily mean that the body has “released stored trauma”, nor does emotional intensity prove that trauma has been successfully processed.
For someone with a trauma history, what emerges during an altered state can be confusing or confronting. This can lead to prolonged difficulty to ground afterwards.
Opening something psychologically is not the same as knowing what to do with it. This is one reason preparation, containment, and appropriate follow-up matter.
Difficulty sleeping or settling afterwards
Some people may feel highly activated following an intense breathwork experience. This might look like difficulty sleeping, emotional sensitivity, agitation, racing thoughts, feeling unusually alert, rumination, negative self-talk, or difficultly returning to normal routines.
There can be many possible causes for symptoms like these, if a significant or notable change began during or shortly after an intensive breathwork experience, tell your GP, psychologist or psychiatrist about it.
Does feeling distressed after breathwork mean that I have been harmed?
Not necessarily, a difficult experience does not automatically mean you have sustained a psychological injury.
Human beings can have challenging emotional experiences without those experiences causing lasting psychological harm.
At the same time, I don’t agree with the opposite assumption that “distress following an intensive altered state practice should automatically be interpreted as healing, release, transformation or evidence that somebody simply needs to “surrender” more deeply to the process.”
Sometimes people need reassurance and time, help making sense of what happened, and sometimes they need proper psychological or medical support.
Those are very different things.
What matters clinically is not whether somebody labels an experience a “release” or a “breakthrough”. What matters is what the person is actually experiencing now.
- Are you sleeping?
- Can you work?
- Can you connect with other people normally?
- Do you feel safe?
- Are you able to regulate your emotions?
- Do you feel grounded in yourself and your surroundings?
- Are symptoms settling, remaining the same, or becoming worse?
Those questions tell us considerably more than whether an experience felt profound at the time.
Preparation, Screening, and Integration Matter.
Breathwork can sometimes be treated casually because there is no substance involved. But “drug free” does not mean “psychologically insignificant”.
Some intensive breathwork practices are specifically designed to alter a person’s physiological and psychological state. If we are deliberately creating an altered state, we need to take that seriously.
That does not mean every person participating in breathwork needs a psychologist sitting beside them.
It does mean people should be able to make an informed decision about what they are participating in and what support exists if something becomes difficult. Before participating in intensive breathwork, here are some reasonable questions to ask the facilitator:
- What type of breathing will I actually be doing?
- How long will the intensive breathing continue?
- What physical and psychological effects might occur?
- Is there any screening beforehand?
- What training does the facilitator have?
- What happens if I become frightened, dissociated, or overwhelmed?
- What is the emergency plan if somebody becomes medically or psychologically unwell?
- What support is available afterwards?
- And importantly, where does the facilitator’s professional scope end?
A facilitator can be experienced in breathwork without being trained to assess or treat mental illness.
Those are different skill sets.
Knowing how to facilitate an altered state is not necessarily the same as knowing how to recognise or manage psychological deterioration during or afterwards.
What about Integration?
The word “integration” gets used a lot in altered-state spaces. But simply put, integration is about making sense of an experience and working out how it fits into your ordinary life.
It does not mean every unusual experience needs to be interpreted as profound. Nor does it mean a psychologist should tell you what your experience meant. And, it certainly does not mean reinforcing an explanation simply because it sounds spiritual, psychological, or compelling.
Good psychological integration should leave room for uncertainty.
Sometimes an experience makes sense immediately.
Sometimes its meaning changes with time.
Sometimes there is no grand meaning at all.
And sometimes the priority is not interpretation. It is helping somebody sleep, feel safe, regulate their nervous system, restore normal functioning and determine whether something more significant is occurring.
When should I seek professional help after breathwork?
Not everyone who has a difficult breathwork experience needs psychological treatment.
A short period of feeling emotional, tired, or reflective after an intense experience may settle without intervention. However, professional support may be appropriate if symptoms are persistent, worsening, frightening, difficult to understand or substantially interfering with your normal life.
These challenging experiences may include:
- persistent anxiety or panic
- feeling significantly disconnected from yourself or your surroundings
- intrusive or distressing memories
- increased rumination and negative self-talk
- difficulty sleeping that is not settling
- significant emotional instability or agitation
- difficulty working, studying or managing ordinary responsibilities
- feeling scared by changes in your thoughts, emotions, or perception
- symptoms that continue to worsen rather than settle
There is also an important difference between psychological support and emergency care.
If you are experiencing severe confusion, significant changes in behaviour or perception, an immediate mental health crisis, or you are at risk of harming yourself or somebody else, seek urgent medical assistance through 000 or your nearest emergency department.
What kind of professional should I speak to?
Your GP is often a reasonable starting point, particularly where there are significant physical symptoms, major sleep disturbance, medication considerations, or uncertainty about whether a medical issue may be contributing.
Tell them about the breathwork, while it sounds obvious – your GP may not ask.
If your symptoms began after participating in intensive breathwork, meditation, a retreat, a ceremony, or another altered-state practice, that information may be clinically relevant.
You do not need to convince your GP that breathwork caused what you are experiencing. Information that may help your GP includes:
- what type of practice you participated in
- approximately how long it lasted
- what happened during the experience
- when your symptoms began
- how you felt beforehand
- what has changed since
- whether you used any medications, supplements or substances around the same time.
The timeline matters.
Your GP can then consider that information alongside other possible medical or psychological explanations rather than trying to make sense of your symptoms without an important part of the history.
Depending on your symptoms, involvement from a psychologist or psychiatrist may also be appropriate. Working with a psychologist who understands trauma, dissociation, altered states and harm-reduction approaches.
That does not mean automatically pathologising your experience or validating every interpretation of it. There is an important middle ground.
My own work as a Clinical Psychologist often sits within that space. I work with people who have had experiences that may be meaningful, confusing, scary, destabilising, or several of those things at once. My role is to help understand what people are experiencing now, assess what may be contributing to it, support psychological safety and functioning, and determine what care may be appropriate.
Breathwork is a powerful tool. We should treat it like one.
This article is not an argument against breathwork.
Breathing practices have existed across cultures and traditions for a very long time, and emerging research into particular forms of breathwork is genuinely interesting.
But I think we lose something important when any powerful psychological practice becomes a trend.
The conversation can quickly become focused on breakthroughs, catharsis, release and transformation, while preparation, screening, adverse experiences, and appropriate aftercare receive far less attention.
We can respect the potential value of a practice while still talking openly about risk.
In fact, I would argue that taking a practice seriously means doing exactly that.
If somebody feels worse after an altered-state experience, the answer should not automatically be: “You’re healing.” or “Something has gone terribly wrong.”
There is a large clinical space between those two conclusions. That space requires curiosity, appropriate assessment, psychological safety and, sometimes, simply helping a person understand what happened.
Support following a difficult breathwork or altered-state experience
Conscious Mind Centre provides psychological care for adults experiencing distress, confusion, or difficulty making sense of altered-state experiences, including experiences occurring in association with intensive breathwork.
Our approach is grounded in trauma-informed psychological care, harm reduction, and integration.
Our role is not to promote or discourage breathwork. It is to help people understand what they are experiencing and determine appropriate psychological support where clinically indicated.
If you are unsure whether psychological support is appropriate, you can contact Conscious Mind Centre to discuss our services or speak with your GP.
References
- Havenith, M. N., Leidenberger, M., Brasanac, J., Corvacho, M., Carmo Figueiredo, I., Schwarz, L., … & Jungaberle, A. (2025). Decreased CO2 saturation during circular breathwork supports emergence of altered states of consciousness. Communications Psychology, 3(1), 59.
- Fincham, G. W., Kartar, A., Uthaug, M. V., Anderson, B., Hall, L., Nagai, Y., … & Colasanti, A. (2023). High ventilation breathwork practices: An overview of their effects, mechanisms, and considerations for clinical applications. Neuroscience & Biobehavioral Reviews, 155, 105453.
Shai Hipperson
Shai Hipperson is a Clinical Psychologist based on the Gold Coast with a focus on PTSD, Trauma, Adverse Childhood Experiences, Complex PTSD, and integration of altered states.
Frequently Asked Questions
Can breathwork cause anxiety?
Intensive breathwork can produce physical sensations that overlap with sensations experienced during anxiety and panic, including dizziness, tingling and changes in bodily awareness. Some people may also experience significant anxiety during or following an intense session.
Anxiety occurring after breathwork does not, by itself, establish that breathwork caused the symptoms. Persistent or worsening anxiety should be assessed in the context of the person’s broader health and circumstances.
Why do I feel strange after breathwork?
Intensive breathwork can involve substantial changes in physiology, emotional state, and subjective experience.
Feeling “strange” could mean many different things, including heightened anxiety, fatigue, emotional sensitivity, dizziness, detachment, or difficulty grounding after an intense experience.
If the feeling is persistent, worsening or interfering with your daily life, consider discussing it with your GP or psychologist.
Can breathwork cause dissociation or derealisation?
Yes, altered-state experiences can involve changes in a person’s sense of self, body, or surroundings. Some people may describe experiences resembling depersonalisation or derealisation during or following an intensive breathwork session.
Persistent symptoms require individual assessment rather than assuming either that they are dangerous or represent a normal part of a healing process.
How long should I feel different after breathwork?
There is no universal timeframe. Different practices vary considerably in intensity and all people respond differently.
If symptoms are significant, worsening, prolonged, or interfering with your ability to function normally, seek appropriate professional advice.
Should I do breathwork again after a difficult experience?
If a previous session resulted in substantial or ongoing distress, it may be sensible to understand what occurred and consider your individual circumstances before repeating the same intensive practice.
Your GP or psychologist can help assess persistent symptoms where required.
