Effectiveness of mindful breathing exercises on symptom reduction and quality of life in individuals with major depressive disorder : a systematic review

Abstract

BACKGROUND : Major depressive disorder (MDD) is a global cause of disability, with many patients experiencing suboptimal response to conventional treatments. Mindful breathing exercises, a simple and scalable technique, have emerged as a promising non-pharmacological intervention for alleviating depressive symptoms and improving quality of life. Objectives : To evaluate the effectiveness of mindful breathing exercises on symptom reduction and quality of life in individuals diagnosed with MDD. METHOD : A systematic search of Cochrane Library, MEDLINE (PubMed), PEDro, Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science and BioMed Central databases was conducted from inception to September 2025. Our review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible criteria were intervention studies examining the effects of mindful breathing on depressive symptoms and quality of life in individuals diagnosed with MDD. Two reviewers independently screened the studies, extracted the data and assessed the methodological quality using the Cochrane risk of bias tool. A narrative synthesis was conducted because of heterogeneity in outcome measures and intervention protocols. RESULTS : Two studies involving 179 participants met the inclusion criteria. One study combined cognitive behavioural therapy with breathing exercises, demonstrating improvements in sleep quality, psychiatric symptoms and heart rate variability. Another study demonstrated a significant reduction in anxiety. CONCLUSION : Mindful breathing exercises are beneficial in alleviating symptoms of depression and anxiety, as well as enhancing physiological indicators in people with MDD. CLINICAL IMPLICATIONS : Our review highlights breathing techniques as an affordable, non-pharmaceutical option to conventional treatment; however, more research with rigorous outcomes is needed.