Anxiety and depression are two of the most common disorders in mental health. Everyone has experienced either one to some degree. Like, I'm positive over 98% of the people in the room are incredibly anxious over the winding down of the semester. Lots of stuff to turn in and what not. I'm also willing to bet that you guys have experienced depressive symptoms at some point in your life. May not have been a full-blown diagnosis of depression, but you've felt the sadness, the lethargy, the irritability, whatever it looks like for you. Well you're obviously not alone. Anxiety affects 40 million people in the US and depression affects 14 million people over the age of 18 in the US. There is also a 50% chance of comorbidity, so if you suffer from one, there's a 50% chance you suffer from the other. Now, anxiety and depression happen. Anxiety and depression are natural responses to stress or other upsetting events in your life. If these symptoms don't subside and dominate your life, then there's a problem.Ideally, the treatment for both of these disorders is therapy + medication. However, we know that often times doesn't happen because MDs and family doctors prescribe them like candy. So typically we see just the medication being prescribed. This can be a a very long process because the same dose of the same medication does not work for everybody in the same way. It could potentially take weeks to find a suitable medication and dose. So then the question arises: what can those suffering from anxiety or depression do to help decrease their symptoms? Or if they're in therapy, what can they do to supplement the coping strategies that they're learning?
I wanted to see if yoga could help. We all have that image of a yoga guru meditating on a mountain top in absolute peace or doing a ridiculously insane posture and still looking like they're in absolute peace. There's also an image of yoga being a great way to get in shape. But more importantly, yoga may be a great way to cope with anxiety and depression. So yoga is an increasingly interesting topic to study among researchers. Studies have increased tremendously from 34 studies in the 90s to 221 studies in the 2000s. What's really great about yoga is that it's accessible to anyone to wants to practice. There's a huge variety of yoga styles, all of which are customizable to the individual practitioner. There's even a style called "chair yoga" that has been developed for senior citizens and physically disabled persons. Studies have also suggested that yoga can be effective in a variety of populations' mental health states, such as adolescents, schizophrenics, individuals with PTSD, and the people with moderate symptoms. So whats up?
I also want to note before I go on that yoga is an incredibly profound and multifaceted subject. It takes at least one life time to understand all of what yoga has to offer. So what I'm about to present is my best understanding of what I have learned during the past 14 weeks.
Mindfulness is defined as a state of awareness and attentiveness of every passing moment without judgment. Brisbon & Lowery (2009)Beginners in hatha yoga vs advanced in hatha yogaPretest = Mindful Attention Awareness Scale & Perceived Stress Scale before regularly scheduled hatha yoga classPosttest = after the classResults: advanced practitioners = higher levels of mindfulness & lower levels of stressPerspective changes: rather than evaluating an event as good or bad, they see the moment for what it is: they let it exist as a neutral event and move onAlso brain changes!
Anteriorinsula = area of the brain that is activated by feelings of anxietyPCC, TPP junction, cerebellum & hippocampus = involved in emotional processing or self-perceptionTP junction = related to spatial unity between mind/body
Descilo et al. studied how different yoga breathing styles affect PTSD symptoms in survivors of tsunami184 survivors to 1 of 3 groups:Breath interventionBreath intervention + exposure therapyWait listResults:Significant/rapid decreases in PTSD symptoms & depressionIncreased quality of lifeIncreased likelihood for sustaining results
Respiration system vagus nerve; regulates autonomic nervous system and accounts for 75% of parasympathetic fibers in the bodyResearch = stimulation of vagus nerve decreases blood flow to limbic system; decreases depressive and anxiety symptomsANDBreathing styles used in Descilo et al. mimick the sound of the ocean. “Breath Water Sound” imitated the sound of the waves Exposure therapy exposing them to sounds that trigger memories of the tsunami
Meditation is similar to mindfulness. To someone who is naive to yoga, there may not be much of a difference. In fact, sometimes I mix them up. But the difference is distinct. Meditation is the practice through which an individual comes to know all levels of the self. So mind, body, and spirit as they would say in the yoga tradition. Male participants 1 of 2 groups Experiment group: meditation session before stressful computer game Control group: waiting room before stressful computer gameComputer game is stressful because it was to designed to be easy to master through skill, but always resulted in defeat. THUS the game because stressful and frustrating because participants knew they had the skill to win, but never could ):RESULTS: Meditation group = lower levels of stressWhy? Increase in alpha, gamma, and theta brain waves. These brain waves are associated with wakeful relaxation with closed eyes, unity of conscious perception, and deep meditative states
You can see the comparison between alpha and theta frequencies during meditation and during baseline measurements which are in black. You can see in image “a” that the red meditation bar is represents a higher frequency in various areas of the brain. You can see the same in image “b” with theta waves. Though the frequency difference between meditation and baseline isn’t as drastic as alpha waves, you can still see an increase in frequency during meditation.
American’s view yoga more as a way of staying in shape rather than a mind/body/spiritual discipline. Mindfulness & meditation may not be practiced.What is the relationship between yoga and exercise?
Participants = signed up for 1 year physical education class and randomly assigned to one of the following groups:Yoga & Feldenkrais = mindfulness exercisesSwimming & Dancing = aerobicComputer class = controlPretest: measured mood, affect, & anxietyAttended their class 1x a week for a yearPosttest: measured mood, affect, & anxietyResults: yoga, Feldenkrais, & Swimming = lower anxiety and higher levels of subjective well-being
Streeter et al. also conducted a study comparing yoga to aerobic activity.Measured GABA levels in a yoga condition and a walking condition;Yoga participants = enhanced mood, increased GABA levels, & decreased anxietyWhy do we see a difference between swimming compared to walking and dancing when they are all considered aerobic exercises?
Swimming = mindfulness aspectMindfulness of breathPredictable/rhythmic movementsWalking/dancing condition = distractions by internal stimuli (worried about making the right steps, looking good) or external stimuli (we don’t know where the walking condition occurred [busy street? Indoors?]; were they listening to music?) not one single thing to focus on
It does appear that yoga makes a positive impact on the practitioner's life, especially in terms of mindfulness. It seems that mindfulness is yoga's greatest tool in coping with anxiety and depression. Being aware of the present moment, being aware of breathing (are you breathing), and being aware of who you are. These are things that are goals of therapy: who are you and are you managing? Most importantly: are you happy? The Descilo et al. study measuring anxiety in survivors of the south-east asia tsunami, I feel, speaks a lot for that. It's also important to note that aerobic exercise can have the same calming effect as long as there's a mindfulness aspect to it. Or a period of time to just "check out" of reality and focus on something other than the junk in your head.I think my favorite part of yoga is that accessibility it has. Anyone can do it.
Yoga as a Supplement to Psychotherapy
IntroductionAnxiety + Depression = Big Problem
Could yoga help…?• Increase in studies researching the linkbetween yoga and mental health– 1990-1999 = 34 studies on PSYCHinfo– 2000-2010 = 221articles on PSYCHinfo
Foundation Research• Mindfulness• Breathing• Meditation• Yoga vs. Exercise
Mindfulness• Mindfulness: a state of awareness andattentiveness of every passing moment withoutjudgment; aka non-reactivity• Brisbon & Lowery (2009)– Mindfulness & stress in advanced ( x > 5 yrsexperience) and beginning ( x < 5 yrs experience)hatha yoga practitioners• Advanced practitioners = higher levels of mindfulness andlower levels of stress– Perspective change– Brain changes
Mindfulness and the brain• Anterior insula– Mindfulness practice = lower activation of anteriorinsula• Increased gray matter in posterior cingulatecortex, temporoparietal junction, cerebellum,and hippocampus– TP junction: related to spatial unity between selfand body
BreathingDescilo et al. (2009)• 184 survivors of 2004tsunami with PTSD• Conditions:– Yoga breath intervention– Yoga breath intervention +exposure therapy– Wait list group• Results:– significant and rapiddecreases in PTSD symptomsand depression– increased quality of life– increased likelihood forresults to be sustained
Meditation• Similar to mindfulness• Mohan, Sharma, &Bijlani (2011)– Male participants =meditating novices– Stressful computer game– Meditation group =lower levels of stresscompared to control• Brain waves– Alpha, gamma, theta
MeditationHalsband, U., Mueller, S., Hinterberger, T., & Strickner, S. (2009). Plasticity changes in the brain in hypnosis andmeditation. Contemporary Hypnosis (John Wiley & Sons, Inc.), 26(4), 194-215. doi:10.1002/ch.386
Yoga vs. Exercise• Netz (2003) compared mindful exercises toaerobic exercise– Yoga– Feldenkrais (awareness through movement)– Swimming– Aerobic dancing– Computer class (control)• Yoga, Feldenkrais, and swimming = lower anxiety& higher levels of subjective well-being
Yoga vs. Exercise• Streeter et al. (2010)– Measured GABA levels between yoga practicingcondition and walking condition– Yoga participants = enhanced mood, increasedlevels of GABA, and decreased anxiety
ReferencesDescilo, T. P. (2010). Effects of a yoga breath intervention alone and in combination with an exposuretherapy for post-traumatic stress disorder and depression in survivors of the 2004 South-East Asiatsunami. Acta Psychiatrica Scandinavica, 121, 289-300.Halsband, U., Mueller, S., Hinterberger, T., & Strickner, S. (2009). Plasticity changes in the brain inhypnosis and meditation. Contemporary Hypnosis (John Wiley & Sons, Inc.), 26, 194-215.doi:10.1002/ch.386Mohan, A., Sharma, R., & Bijlani, R. L. (2011). Effect of meditation on stress-induced changes incognitive functions. The Journal Of Alternative And Complementary Medicine, 17, 207-212.doi:10.1089/acm.2010.0142Netz, Y. (2003). Mood Alterations in Mindful Versus Aerobic Exercise Modes. Journal Of Psychology,137(5), 405-419.Paul, N. A., Stanton, S. J., Greeson, J. M., Smoski, M. J., & Wang, L. (2013). Psychological and neuralmechanisms of trait mindfulness in reducing depression vulnerability. Social Cognitive & AffectiveNeuroscience, 8, 56-64.Streeter, C. C., Whitfield, T. H., Owen, L., Rein, T., Karri, S. K., Yakhkind, A., & ... Jensen, J. (2010). Effectsof yoga versus walking on mood, anxiety, and brain GABA levels: A randomized controlled MRSstudy. The Journal Of Alternative And Complementary Medicine, 16, 1145-1152.doi:10.1089/acm.2010.0007