I want to talk about the role of prāṇāyāma in recovery, and the potentially positive impact it can have for those experiencing or on the road to recovery. I start by exploring the term ‘recovery’, what it is and what it means. I look at some of the symptoms that can manifest during recovery and the impact these can have on an individual and their ability and potential to recover. I explore some existing coping strategies and then discuss prāṇāyāma, what it is, why it works, and how to practice the associated techniques. Finally, I outline a prāṇāyāma routine that can be used daily to promote health and wellbeing, and aid recovery.
What is recovery?
According to the Substance Abuse and Mental Health Services Administration (‘SAMHSA – Substance Abuse and Mental Health Service Administration’ 2025), recovery can be understood as a ‘process of change through which an individual improves their health and wellness, lives a self-directed life, and strives to reach their full potential. Mental Health Ireland state that recovery can be defined as ‘having somewhere to live, someone to love, somewhere to work, and something to hope for (‘Mental Health Ireland’ 2025).
Individuals can be in recovery from many things. This can include recovery from addictions (e.g., drugs, alcohol, gambling, eating, shopping etc), grief and loss, trauma, neglect, natural disasters and so on.
Symptoms associated with recovery
Some of the negative symptoms that those in recovery often experience include anxiety, stress, depression, low energy levels, and insomnia. With references to addiction recovery, Kumar (Kumar 2024) says that often anxiety and addiction go together (dual diagnosis). Similarly, Vezenkov and Manolova (2025, 10), suggest that adult recovery from addiction is often associated with symptoms such as; anxiety, depression, sleep-related issues, attention deficit, irritability, low-energy levels, autoimmune imbalance, chronic fatigue, panic attacks, shortness of breath, rapid exhaustion, sudden outbursts, avoidance of physical/emotional/cognitive effort, emotional detachment, and social withdrawal.
Moreover, it is not just that there are often symptoms associated with recovery. Symptoms and associated negative emotions like shame, guilt, stress, or poor coping strategies can have a detrimental impact on recovery success and frequency of relapse (Weaver, Turner, and O’Dell 2000, 161). Research (Weaver, Turner, and O’Dell 2000) that explored symptoms of psychosocial stresses and related coping strategies of women in continuous recovery (1-5 years) from addiction, found that stresses can be influenced by factors such as money, emotional health, physical wellbeing, close family members, marital/intimate relationships, and parenting.
Coping strategies
So, what are some of the existing coping strategies used by those in recovery? Weaver (Weaver, Turner, and O’Dell 2000) found that coping strategies include passive and negative approaches such as procrastination, keeping feelings to themselves, complaining or blaming others, being critical of themselves; as well as active or positive coping strategies including writing a plan to handle a problem, reading or writing for pleasure, expressing feelings, seeing humour in situations, and praying or meditating (Weaver, Turner, and O’Dell 2000, 164). Interestingly, they also found that although participants in recovery were more likely to use active or positive coping strategies, a high percentage continued to engage in negative coping strategies. This, according to the researchers, suggests that continued help and support is still needed even for those on the road to recovery – particularly in strengthening self-acceptance and coping skills (Weaver, Turner, and O’Dell 2000).
Another research paper (Villaggi et al. 2015) explored the coping strategies used by individuals recovering from depression, anxiety, and bipolar disorders. The study emphasises the importance of supporting self-management in a way that respects the individual and identifies several different self-management strategies used to promote recovery for those with anxiety, depression or bi-polar disorder. The authors suggest that recovery strategies can include a variety of strategies. These include medication, illness evaluation, cognition restructuring, and professional support, but also alternate medicines such as meditation and yoga.
Prāṇāyāma
Prāṇāyāma consists of different breathing exercises that are together designed to move the participant towards a state of relaxation and meditation. Prāṇāyāma (which can be translated as restricting or controlling life force or the breath) is a key part of a yoga regimen that also includes physical movement, postures (asana) and meditation. Prāṇāyāma and associated breathing exercises have many beneficial effects that can directly help alleviate the negative symptoms commonly associated with recovery.
Evidence that prāṇāyāma works
Muniyandi (2015) explored the impact of prāṇāyāma on anxiety levels among alcoholics. 60 individuals were asked to do 15 minutes of prāṇāyāma a day for 30 days. The authors conclude that the results of the study indicate that prāṇāyāma helps decrease levels of anxiety among alcoholics.
Another study (Udayakumar 2022) recorded the effectiveness of prāṇāyāma (Alternate Nostril Breathing) on those recovering from Internet addiction. Studying 100 male and female medical students between the ages of 18-25 over a 6-week period, they found that doing regular prāṇāyāma had an immediate and positivise impact on students’ wellbeing and the associated symptoms of recovery from Internet addiction.
Also, although not undertaken on those officially in recovery, another study explored the effectiveness of prāṇāyāma in reducing anxiety amongst caregivers. The participants were asked to perform 30 minutes of prāṇāyāma once a week for 4 consecutive weeks. The authors comment that the results indicate that prāṇāyāma is an effective strategy for reducing anxiety and integrating prāṇāyāma within a support programmes is a valuable approach for improving wellbeing.
Similarly, Kushwaha et al. (2024) asked university students to perform a 60-minute prāṇāyāma and meditation session 6 days a week for 10 weeks. The results showed that there were significant positive changes in all domains of well-being, and this emphasise the importance of prāṇāyāma and meditation as having a positive influence on wellbeing. Interestingly, the study also showed that there was a significant improvement in BMI and BP for those that took part in the study.
Another study (Kannan et al. 2015, 18–20) showed that prāṇāyāma has a significantly positive impact on depression. The authors of this research propose that prāṇāyāma has a 62-79% success rate in the treatment of depression and can normalise brain wave patterns, increase serum prolactin (well-being hormone) and is as effective as standard anti-depressant drug regimens.
Furthermore, prāṇāyāma is safe, free of unwanted side effects, self-empowering, and leads to relaxation and a better quality of life that can eventually eliminate symptoms of depression. Nagar and Betal (2023) also comment that prāṇāyāma is a potent means of alleviating anxiety, depression, and stress: prāṇāyāma brings about deep relaxation, stabilises emotions and reasoning, and eradicates irrational impulses and other mental disorders.
Why does prāṇāyāma work?
OK. So, prāṇāyāma can help alleviate negative symptoms associated with recovery. But how does this work? What is the science it? According to Nagar and Betal (2023), prāṇāyāma: 1/ calms down the excitation of the Hypothalamus, Pituitary, and Adrenal (HPA) axis and normalises and equalises the functions of the autonomic nervous system; 2/ stops the over production of the stress-producing hormones and facilitates optimum secretion of serotonin hormones; 3/ limits the arousal of the limbic system (seat of emotion) and enhances the arousal of the higher cortical region of the brain.
Muniyandi (2015) states that when an individual experiences anxiety and stress the sympathetic nervous system becomes activated and triggers a fight or flight response. This results in increased heart rate, rapid and shallow breathing, and heightened muscular tension. Prāṇāyāma works by slowing and deepening the breath and this activates the parasympathetic nervous system (rest and digest). This leads to decreased heart rate, lower blood pressure, reduced muscular tension, effectively reversing the physiological symptoms of anxiety.
A further point to note is that it is not just that prāṇāyāma helps alleviate many of the symptoms associated with recovery: prāṇāyāma provides a direct sense of autonomy and self-management which is of further benefit for the individual giving them a sense of agency, self-confidence, and independence. According to Muniyandi (2015):
“The practicality of prāṇāyāma as an anxiety-reduction tool lies in its accessibility and the sense of agency it provides to practitioners. Unlike some interventions that rely on external factors, prāṇāyāma empowers individuals to participate in their anxiety management actively. This sense of control can be particularly beneficial…”.
Why not use other publicly available breathing techniques?
You may ask, why not just use any one of the many breathing exercises publicly available online? Surely these are good enough. Why bother with prāṇāyāma? First, all the breathing exercises that you might find online originate from prāṇāyāma. Second, breathing exercises–although they can appear harmless–can have a significant negative (as well as positive) on the physical and psychological body. This means it is crucial the participant is shown how to practice the breathing exercises properly and safely by a qualified and experienced prāṇāyāma specialist. Third, with prāṇāyāma there is a clear method for each breathing technique as well as set sequences that have been designed and perfected over thousands of years specifically to provide maximum benefit for the individual. Fourth, prāṇāyāma breathing exercises can be practised by and adapted for anyone of any level from complete beginner to advanced students. This means that the student will not only learn safely how to improve their overall well-being and health within a clear and structured approach, but also that their prāṇāyāma practice can grow and develop as they improve their skill, knowledge, and ability.
In summary, prāṇāyāma is a sustainable method for improving physical and mental health and is particularly beneficial for helping to alleviate the negative symptoms associated with recovery.
A Simple 10-Step Prāṇāyāma Breathing Routine Suitable for Beginners and Above
Below is a simple 10-step prāṇāyāma sequence that can be used by anyone. The sequence should take about 30 minutes or so, but you can change the timing to fit your needs and available time. Always take your time and stay well within your limits.
Please read carefully before you start. Each of us is on a different journey to health and wellbeing. We are all different physically and mentally, have different objectives, different lifestyles, and live in different environments and places. The prāṇāyāma breathing techniques presented here will therefore have different outcomes for each person. Any material presented is for educational purposes only. Although all techniques are based on genuine personal experience and authentic trainings, results cannot be guaranteed. If you are in any doubt whatsoever about your own physical or mental wellbeing you should consult a medical professional. It is your responsibility to ensure that you are suitably healthy (mentally and physically) to do these exercises. Always practice prāṇāyāma carefully and with respect.
All breathing is through the nose.
1/ Preparation – If possible, avoid consuming solids for 2 hours and liquids for 45 minutes before you start. Try to find a location that is clean, uncluttered and quiet where you will not be disturbed. The space you practice in should not be too hot or cold. Clothes should be comfortable and non-restricting.
2/ Posture – Your back and neck should be straight throughout the practice. You can practice sitting on a chair or on the floor, but you must be comfortable. If you use a chair, make sure it’s a firm chair like a wooden kitchen chair or stool. Don’t use a soft sofa chair. When using a chair, your legs should be straight with ankles directly below knees. You can simply rest your hands palms down on the tops of your thighs or palms up with index fingers and thumbs touching on each hand. If you sit on the floor, you can cross your legs or – if you can manage – sit half or full lotus. The hips should be above the knees when sitting on the floor so you may need to sit on something like a bolster or folded towel to raise your hips.
3/ Body relaxation – Close your eyes. Scan and observe your body for tension. If you feel tension, just let gravity do the work and allow that part of the body to relax and be heavy. Start with the right hand/arm, move to the shoulder, then down to the right leg and foot. Do the same on the left side. Then take your awareness to the base of the spine and work your way up the back to the crown of the head. Continue over the top of the head to the forehead, eyebrows, eyes, cheeks, and mouth.
Duration: 2-3 minutes
4/ Breath Awareness – Observe air going into and out of nostrils. Carefully and mindfully notice the temperature, speed, and any sound. Also notice any movement in your abdomen or chest as you inhale and exhale.
Duration: 2-3 minutes
5/ Kapalbhati – This is a cleansing technique. The process involves inhaling passively by letting the abdomen drop out, then exhaling quickly and at the same time pulling in the abdominal muscles. Here, you are not breathing with the chest so try to only move the abdominal area. For beginners, breathe about one respiration every 1-2 seconds. As you progress, you can gradually increase this to once every second and then twice every second. Start with a round of 10 breaths. Take a break for about 30 seconds or so and then do a second round of 15-20 breaths. Take another break of about 30 seconds and do your final round of 20-30 breaths.
Duration: 2-3 minutes
5/ Deep slow breathing – First, inhale slowly to the abdomen by pushing down the diaphragm and inflating the belly. In the same breath, move your awareness to the chest region and inhale to fill the middle of the lungs. Finally, and also in the same breath, move your awareness to the shoulders and clavicle area filling the top part of your lungs. This is one in-breath. Your focus should be mainly on the abdominal and chest region with a 50:50 ratio. If you inhale for 4 seconds, spend 2 seconds filling the abdomen and 2 seconds filling the chest. When exhaling, exhale in the opposite order with the same ratio/emphasis on chest and abdominal areas.
When doing slow deep breathing, you should try to exhale longer than you inhale. A ratio of 2:1 is best. So, if you inhale for 4 seconds then exhale for 8 seconds. Start with something like 3 counts for inhalation and 3 counts for exhalation and build from there (3:4; 3:6; 4:6; 4:8).
Duration: 5 minutes
6/ Alternate nostril breathing (Anulom Vilom) – Here, we continue to use slow deep breathing but instead of breathing through both nostrils we close each nostril in turn. Start by closing the right nostril and exhale completely through the left. Then inhale slowly and fully through the left, close the left nostril and exhale fully through the right. Then inhale through the right nostril, close the right nostril and exhale through the left. This is one complete cycle (in left; out right; in right; and out left). Use the tip of the right-hand thumb to gently close the right nostril and the tip of the third finger on the same hand to close the left nostril. Index and middle fingers of the right hand can be extended to rest between the eyebrows or folded inwards to rest on the top lip.
Duration: 5 minutes
7/Humming Breath (Bhramari) – The final breathing technique is humming breath. Again, we use slow deep breathing. The only difference is that we hum on the exhale. When humming, try to make the sound even and consistent. You can increase the impact of this technique by pushing the pultruding parts of the ears inwards with the tips of the thumbs to block external sounds. When doing this, the palms should be facing towards the face, the index and middle fingers should be resting on closed eyelids, third fingers on either side of the nose, and small fingers just above the top lip.
Duration: 5 minutes
8/ Sit quietly with your eyes closed for a few minutes.
9/ Keeping your eyes closed, rub your palms together and place the palms over the eyes and very gently massage the eyes with the heals of the palms. Then massage the temples with the index fingers and at the same time use the thumbs to massage underneath the cheek bones. Finally, place the palms over the eyes again. Slowly open your eyes and remove your hands. If you wish, you can finish by bringing your hands together in a prayer position and gently bowing.
10/ Once you’ve finished, leave a gap of about 20 minutes or so before you eat or drink anything, and try to maintain slow deep abdominal breathing throughout the day.
Bibliography
Kannan, K., K. Lalitha, Ramachandra Ramachandra, Sailaxmi Gandhi, and C. Kumar. 2015. ‘Effectiveness of Pranayama on Depression in Elderly’. Journal of Krishna Institute of Medical Sciences University 4 (January):18–27.
Kumar, Vinod. 2024. ‘Addiction and Anxiety Counselling’. Studies in Psychological Science 2 (September):1–8. https://doi.org/10.56397/SPS.2024.09.01.
Kushwaha, Jairam, Vatsala Thapliyal, Lakshmikant Nagar, and Ghanshyam singh Thakur. 2024. ‘Effect of Pranayama and Meditation on Well-Being among University Students: A Randomized Controlled Trial’. Journal of Mountain Research 19 (January). https://doi.org/10.51220/jmr.v19-i1.31.
‘Mental Health Ireland’. 2025. MentalHealthIreland.Ie/. 11 April 2025.
Muniyandi, S. 2015. ‘Effectiveness of Pranayama on Anxiety among Alcoholics in a Selected De-Addiction Centre at Chennai’. International Journal of Nursing Education and Research 3 (January):299. https://doi.org/10.5958/2454-2660.2015.00012.5.
Nagar, Lakshmikant, and Chintaharan Betal. 2023. ‘Effect of Pranayama in the Management of Anxiety, Depression and Stress (Ads): A Review Study’ 37 (April):83–87.
‘SAMHSA – Substance Abuse and Mental Health Service Administration’. 2025. SAMHSA. 04 2025. https://www.samhsa.gov/.
Udayakumar, Karthika. 2022. ‘Effect of Alternate Nostril Breathing on Evoked Potentials among Internet Addicts’. Bioinformation 18 (November):1075–80. https://doi.org/10.6026/973206300181075.
Vezenkov, Stoyan, and Violeta Manolova. 2025. ‘SCREEN ADDICTION – BIOMARKERS, DEVELOPMENTAL DAMAGE AND RECOVERY’ 1 (March):6–18.
Villaggi, Benjamin, Hélène Provencher, Simon Coulombe, Sophie Meunier, Stephanie Radziszewski, Catherine Hudon, Pasquale Roberge, Martin D. Provencher, and Janie Houle. 2015. ‘Self-Management Strategies in Recovery From Mood and Anxiety Disorders.’ Global Qualitative Nursing Research 2 (December):2333393615606092. https://doi.org/10.1177/2333393615606092.
Weaver, Gayle D., Norma Haston Turner, and Kristi J. O’Dell. 2000. ‘Depressive Symptoms, Stress, and Coping among Women Recovering from Addiction’. Journal of Substance Abuse Treatment 18 (2): 161–67. https://doi.org/10.1016/S0740-5472(99)00031-8.