Effectiveness of Breathing Exercises on Stress, Anxiety, and Depression in Collegiate Adults: An Interventional Study

Abstract

Background: Stress, anxiety, and depression are highly prevalent among collegiate adults and adversely affect academic performance, physical health, and quality of life. Accessible, low-cost, non-pharmacological interventions are needed to address this burden. Objective: To evaluate the effectiveness of a structured breathing exercise programme on stress, anxiety, and depression in collegiate adults. Methods: A single-group pre-post interventional design was used with 60 collegiate adults (18-30 years; purposive sampling) attending the Department of Physiotherapy, Career Point University, Kota. Participants completed a four-week breathing programme (diaphragmatic breathing, alternate nostril breathing, Bhramari pranayama, and coherent slow breathing; three sessions/week, 20-30 minutes/session). The Depression Anxiety Stress Scale-21 (DASS-21) and Perceived Stress Scale (PSS-10) were administered before and after the intervention. Paired-samples t-tests and Cohen's d were used for analysis. Results: Mean DASS-21 scores fell from 15.83 (SD 2.74) to 12.40 (SD 2.66), a 21.7% reduction (t(59) = 38.11, p < 0.001, d = 4.92). Mean PSS scores fell from 14.37 (SD 2.24) to 10.30 (SD 2.41), a 28.3% reduction (t(59) = 45.95, p < 0.001, d = 5.93). No participants remained in the severe DASS-21 category after the intervention, and the proportion of participants in the low-PSS category more than doubled (38.3% to 86.7%). Conclusion: A four-week structured breathing exercise programme was associated with statistically significant and large within-group reductions in stress, anxiety, depression, and perceived stress among collegiate adults, supporting further evaluation of its use in university-based mental health promotion and physiotherapy practice.