Yoga

The term yoga encompasses many different styles of physical and spiritual practice aimed at uniting the mind, body and spirit.

The most common yoga practices combine asanas (physical postures), pranayama (controlled breathing practices) and dhyana (deep relaxation, meditation, or chanting).

  • Asanas or poses
    • Asanas, or yoga poses, are gentle movements, carried out slowly, which are designed to build flexibility and strength, and include a range of movements including standing, twisting, balancing, etc.
  • Pranayama
    • Pranayama are breathing exercises designed to ease tension and enhance relaxation, and focus the mind
    • There are many different techniques, with many variations.
  • Dhyana
    • Dhyana are meditation or relaxation exercises which aim to calm the mind
    • They can involve visualisation, chanting and a mantra

Yoga can be practiced alone, using a book, video or podcast, or in classes – private or group. Yoga can be practiced at any level, from beginner to advanced.

Yoga for mental health

Mindhealth_infografica_AerialYoga01

https://www.health.harvard.edu/mind-and-mood/yoga-for-anxiety-and-depression

Along with the physical benefits of yoga, such as increased flexibility, improved cardiovascular health and decreased muscle stiffness, yoga also has profound mental, psychological and cognitive benefits. Ross, A. and Thomas, S. (2010). The Health Benefits of Yoga and Exercise: A Review Of Comparison Studies. [online] The Journal of Alternative and Complementary Medicine, 16 (1), pp. 3-12. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20105062 [accessed 12 Sept. 2017].

Given its impact on our biochemistry, it is not surprising that a regular yoga practice can bring about improvements in a variety of mental health conditions. There is a growing body of evidence supporting yoga’s mental health benefits.

  • A regular yoga practice can significantly reduce anxiety and depression and create a marked increase in positive moods and energy Hofmann, S. G., Curtiss, J., Khalsa, S. B. S., Hoge, E., Rosenfield, D., Bui, E., Keshaviah, A. and Simon, N. (2015). Yoga For Generalized Anxiety Disorder: Design Of A Randomized Controlled Clinical Trial. [online] Contemporary Clinical Trials 44, pp. 70-6. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26255236 [accessed 12 Sept. 2017].  
  • Emerging evidence shows that yoga does this by regulating brain chemicals and hormones which influence mood, behaviour and pain Khalsa, S. B. (2004). Treatment of Chronic Insomnia With Yoga: A Preliminary Study With Sleep Wake Diaries. [online] Applied Psychophysiology and Biofeedback, 29 (4), pp. 269-78. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15707256 [accessed 12 Sept. 2017].
  • Indeed, yoga helps to balance hormones and neurotransmitters, especially stress hormones such as cortisol, and helps to balance the autonomic nervous system – deactivating the sympathetic nervous system, and activating the parasympathetic nervous system

Yoga is an effective complementary practice to improve resilience and mental health, and practising yoga can bring about improvements in mental health symptoms. Khalsa, S. B. (2013). Yoga for Psychiatry and Mental Health: An Ancient Practice with Modern Relevance. [online] Indian Journal of Psychiatry, 55 (3), S334-S336. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768207/ [accessed 12 Sept. 2017].

Alongside its many physical benefits, yoga:

Yoga for anxiety: the theory

  • Yoga can help to reduce anxiety Telles, S., Gaur, V. and Balkrishna, V. (2009). Effect of a Yoga Practice Session and a Yoga Theory Session on State Anxiety. [online] Perceptual and Motor Skills, 109 (3), pp. 924-30. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20178291 [accessed 12 Sept. 2017]., Holt, S. and Macdonald, I. (2011). Depression: Natural Remedies That Really Work. Auckland, NZ: Press, p. 173.
  • Yoga can benefit those with anxiety from many causes ranging from social anxiety disorder to cancer Hofmann, S. G., Sawyer, A. T., Witt, A. A. and Oh, D. (2010). The Effect of Mindfulness-Based Therapy On Anxiety And Depression: A Meta-Analytic Review. [online] Journal of Consulting and Clinical Psychology, 78 (2), pp. 169-83. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20350028 [accessed 12 Sept. 2017].
  • Yoga enhances the relaxation response
    • Yoga asanas and pranayama help to switch off the sympathetic nervous system, reduce stress hormones, and encourage the relaxation response
    • This activates the parasympathetic nervous system
    • The parasympathetic nervous system initiates muscular relaxation, activates digestion and assimilation and primes the body to sink into a long, restful sleep
  • Yoga can train the brain to unlearn fear and learn safety, which reduces symptoms of anxiety Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., Berger, Z., Sleicher, D., Maron, D. D., Shihab, H. M., Ranasinghe, P.D., Linn, S., Saha, S., Bass, E. B., Haythornthwaite, J. A. (2014). Meditation Programs For Psychological Stress And Well-Being: a systematic review and meta-analysis. [online] JAMA Internal Medicine, 174 (3), pp. 357-68. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24395196 [accessed 12 Sept. 2017].
  • The physical exercise of yoga puts the body into an active but controlled state, which allows for more effective stress management
    • The practitioner must be in touch with their bodily sensations and be comfortable with holding and transitioning through difficult poses, which can be good training for resilience to difficult life situations
  • People with anxiety often find it difficult to focus on the present, feeling overwhelmed with worries about what might happen in the future, and yoga encourages being in the present moment
  • Yoga can help with obsessive compulsive disorder, and yogic breathing may reduce the symptoms of OCD

Yoga for anxiety: the practice

Practice yoga for anxiety. 

  • Yoga combines conscious breathing with purposeful movement to enhance awareness and give the mind something on which to focus in the present moment
  • Yoga cultivates mindfulness to help the mind stop wandering to the future or the past and increases the connection between the mind and body

Yoga for depression: the theory

  • Yoga can help improve depression Uebelacker, L. A., Epstein-Lubow, G., Gaudiano, B. A., Tremont, G., Battle, C. L. and Miller, I. W. (2010). Hatha Yoga for Depression: Critical Review Of The Evidence For Efficacy, Plausible Mechanisms Of Action, And Directions For Future Research. [online] Journal of Psychiatric Practice, 16 (1), pp. 22-33. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20098228 [accessed 12 Sept. 2017]., Holt, S. and Macdonald, I. (2011). Depression: Natural Remedies That Really Work. Auckland, NZ: Press, p. 111.
  • Yoga can help ease the symptoms of mild to moderate depression by promoting a sense of calm and happiness Shapiro, D., Cook, I., Davydov, D., Ottaviani, C., Leuchter, A. and Abrams, M. (2007). Yoga as A Complementary Treatment of Depression: Effects Of Traits And Moods On Treatment Outcome. [online] Evidence-Based Complementary and Alternative Medicine, 4 (4), pp. 493-502. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2176141/#B8 [accessed 12 Sept. 2017].
  • The mind-body connection involved in yoga can help us come into balance and harmonise the relationship between the wisdom of our bodies and that of our minds
  • Certain yoga poses have been found to enhance positive mood Shapiro, D. and Cline, K. (2004). Mood changes associated with Iyengar Yoga practices: a pilot study. [online] International Journal of Yoga Therapy, 14, pp. 35-44. Available at: http://iynaus.org/sites/iynaus_files/pages/research/MoodDisordersIyengaryoga.pdf [accessed 14 Sept. 2017].
  • Yoga was found to reduce depression symptoms similar to certain antidepressants Janakiramaiah, N., Gangadhar, B. N., Naga Venkatesha Murthy, P. J., Harish, M. G., Subbakrishna, D. K. and Vedamurthachar, A. (2000). Antidepressant Efficacy Of Sudarshan Kriya Yoga (SKY) In Melancholia: A Randomized Comparison With Electroconvulsive Therapy (ECT) And Imipramine. [online] Journal of Affective Disorders, 57 (1-3), pp. 255-9. Available at: https://www.ncbi.nlm.nih.gov/pubmed/10708840/ [accessed 13 Sept. 2017]. 

Yoga for depression: the practice

Practise yoga for depression.

  • Yoga practiced in a group setting counters the sense of isolation often felt when dealing with challenges Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., Berger, Z., Sleicher, D., Maron, D. D., Shihab, H. M., Ranasinghe, P. D., Linn, S., Saha, S., Bass, E. B. and Haythornthwaite, J. A. (2014). Meditation Programs For Psychological Stress And Well-Being: a systematic review and meta-analysis. [online] JAMA Internal Medicine, 174 (3), 357-68. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24395196 [accessed 13 Sept. 2017].
  • Moving the body in a group setting like a yoga class helps break the cycle of inactivity and isolation often characteristic of depression Medina, J. (2016). How Yoga Is Similar To Existing Mental Health Therapies. [online] Psych Central. Available at: https://psychcentral.com/lib/how-yoga-is-similar-to-existing-therapies/ [accessed 13 Sept. 2017].

Yoga for sleep: the theory

  • A regular yoga practice has been shown to improve sleep quality, total sleep time and the ability to fall asleep easily Khalsa, S. B. (2004). Treatment of Chronic Insomnia With Yoga: A Preliminary Study With Sleep-Wake Diaries. [online] Applied Psychophysiology and Biofeedback, 29 (4), pp. 269-78. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15707256 [accessed 13 Sept. 2017].
  • Yoga is particularly helpful for relieving insomnia since it addresses both the physical and psychological aspects of insomnia Khalsa, S. B. (2004). Treatment of Chronic Insomnia With Yoga: A Preliminary Study With Sleep-Wake Diaries. [online] Applied Psychophysiology and Biofeedback, 29 (4), pp. 269-78. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15707256 [accessed 13 Sept. 2017].
  • Through its reduction of stress hormones and enhancement of the relaxation response, yoga helps the body relax more easily and deeply, making it easier to fall and stay asleep
  • Yoga helps quiet and slow racing thoughts, a common issue contributing to insomnia
  • Stress hormones like cortisol, which can cause insomnia, decrease with regular yoga practice Corey, S. M., Epel, E., Schembri, M., Pawlowsky, S. B., Cole, R. J, Araneta, M. R., Barrett-Connor, E. and Kanaya, A. M. (2014). Effect of restorative yoga vs. stretching on diurnal cortisol dynamics and psychosocial outcomes in individuals with the metabolic syndrome: the PRYSMS randomized controlled trial. [online] Psychoneuroendocrinology, 49, pp. 260-71. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174464/ [accessed 14 Sept. 2017].

Yoga for sleep: the practice

Practice yoga to sleep better. 

Zyoga to sleep better. 

Yoga can help combat exhaustion and lack of motivation. Medina, J. (2016). How Yoga Is Similar To Existing Mental Health Therapies. [online] Psych Central. Available at: https://psychcentral.com/lib/how-yoga-is-similar-to-existing-therapies/ [accessed 13 Sept. 2017].

Studies suggest that yoga can help increase pain tolerance. Villemure, C., Ceko, M., Cotton, V. A. and Bushnell, M. C. (2014). Insular Cortex Mediates Increased Pain Tolerance in Yoga Practitioners. [online] Cerebral Cortex, 24 (10), pp. 2732-40. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23696275 [accessed 13 Sept. 2017].

Regular practice of yoga can help those with schizophrenia remain stable. Holt, S. and Macdonald, I. (2011). Depression: Natural Remedies That Really Work. Auckland, NZ: Press, p. 219.

Yoga, due to its effects on balancing the nervous system, hormones and neurotransmitters, as well as its support of detoxification systems in the body, can help with recovery from addictive substances and behaviours. Reddy, S; Dick, A; Gerber, M; Mitchell, K (2014), The effect of a yoga intervention on alcohol and. drug abuse risk in veteran and civilian women with posttraumatic stress disorder, Journal of Alternative Complementary Medicine, Oct. 1; 20(10): 750-756 (available at): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195227/ [accessed march 2018]. Khalsa, SB, Khalsa, GS, Khalsa, HK, Khalsa, MK (2008) Evaluation of a residential kundalini yoga lifestyle pilot program for addiction in India, J Ethn Subst. Abuse 2008; 7(1):67-79. (available at) https://www.ncbi.nlm.nih.gov/pubmed/19842301 [accessed march2018]

Yoga for addiction: the practice

The Science of Yoga and Mental Health

Practitioners of yoga have asserted its ability to balance emotional, physical and spiritual health for decades.

More recently, scientific research has deepened our understanding of yoga’s effects on the brain, neurochemistry, hormones and mental health.

These studies suggest that specific yogic techniques help alleviate anxiety, depression, stress and related illness through calming the nervous system, balancing neurochemicals and influencing brain function. Brown, R. P. and Gerbarg, P. L. (2005). Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II–clinical applications and guidelines. [online] Journal of Alternative and Complementary Medicine, 11 (4), pp. 711-7. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16131297 [accessed 13 Sept. 2017]., Khalsa, S. B. (2004). Treatment of Chronic Insomnia With Yoga: A Preliminary Study With Sleep Wake Diaries. [online] Applied Psychophysiology and Biofeedback, 29 (4), pp. 269-78. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15707256 [accessed 12 Sept. 2017].

Yoga’s effects on neurotransmitters and other brain chemicals

Neurotransmitters are chemical messengers in the brain which play a key role in relaying information, regulating behavior and modulating mood.

Although the relationships are often complex, neurological and mental health issues often involve imbalances in neurotransmitters and other brain chemicals including:

  • GABA – for calm and focus
  • Serotonin – for mood, sleep and appetite regulation
  • Norepinephrine – for arousal, alertness, attention and action
  • Dopamine – for pleasure, motivation and reward
  • BDNF (brain derived neurotrophic factor) – a brain chemical which enhances neuroplasticity and increases neuronal connections
  • Recent studies show that people who regularly practice yoga asanas have increased GABA levels Streeter, C., Whitfield, T. H., Owen, L., Rein, T., Karri, S. K., Yakhkind, A., Perlmutter, R., Prescot, A., Renshaw, P. F., Ciraulo, D. A. and Jensen, J. E. (2010). Effects of Yoga Versus Walking on Mood, Anxiety, and Brain GABA Levels: A Randomized Controlled MRS Study. [online] The Journal of Alternative and Complementary Medicine, 16 (11), pp. 1145-52. Available at: http://online.liebertpub.com/doi/abs/10.1089/acm.2010.0007 [accessed 13 Sept. 2017].
  • This suggests that the mind-body practice of yoga may counteract anxiety and improve focus and concentration more than increased physical activity alone

A regular meditation practice and controlled breathing techniques such as those incorporated in yoga, have been shown to increase serotonin levels Newberg, A. B. and Iversen, J. (2003). The Neural Basis of the Complex Mental Task Of Meditation: Neurotransmitter And Neurochemical Considerations. [online] Medical Hypotheses, 61 (2), pp. 282-91. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12888320 [accessed 13 Sept. 2017].Brown, R. P. and Gerbarg, P. L. (2005). Sudarshan Kriya Yogic Breathing in the Treatment Of Stress, Anxiety, And Depression: Part I—Neurophysiologic Model. [online] The Journal of Alternative and Complementary Medicine, 11 (1), pp. 189-201. Available at: https://www.researchgate.net/publication/7984597_Sudarshan_Kriya_Yogic_Breathing_in_the_Treatment_of_Stress_Anxiety_and_Depression_Part_I-Neurophysiologic_Model [accessed 13 Sept. 2017].

  • Regular yoga and meditation can help regulate norepinephrine levels
  • This may decrease anxiety and calm the stress response Infante, J. R., Torres-Avisbal, M., Pinel, P., Vallejo, J. A., Peran, F., Gonzalez, F., Contreras, P., Pacheco, C., Roldan, A. and Latre, J. M. (2001). Catecholamine Levels In Practitioners Of The Transcendental Meditation Technique. [online] Physiology & Behavior, 72 (1-2), pp. 141-6. Available at: https://www.ncbi.nlm.nih.gov/pubmed/11239991 [accessed 13 Sept. 2017].

Studies show that yoga can increase dopamine levels in the brainKjaer, T. W., Bertelsen, C., Piccini, P., Brooks, D., Alving, J. and Lou, H. C. (2002). Increased dopamine tone during meditation-induced change of consciousness. [online] Cognitive Brain Research, 13 (2), pp. 255-9. Available at: https://www.ncbi.nlm.nih.gov/pubmed/11958969 [accessed 13 Sept. 2017].

Stress is known to reduce BDNF, which is an important brain chemical promoting neuro-regeneration and neuroplasticity Lee, B. H. and Kim, Y. K. (2010). The Roles Of BDNF In The Pathophysiology Of Major Depression And In Antidepressant Treatment. [online] Psychiatry Investigation, 7 (4), pp. 231-35. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022308/ [accessed 13 Sept. 2017]. Individuals with untreated depression often have decreased BDNF levels and impaired neuroplasticity.

  • Possibly due to yoga’s well documented stress-relieving benefits, it has been shown to increase BDNF and improve symptoms of depression and chronic pain Lee, M., Moon, W. and Kim, J. (2014). Effect of Yoga on Pain, Brain-Derived Neurotrophic Factor, and Serotonin in Premenopausal Women with Chronic Low Back Pain. [online] Evidence-Based Complementary and Alternative Medicine, Article ID 203173. Available at: https://www.hindawi.com/journals/ecam/2014/203173/ [accessed 13 Sept. 2017].
  • Yoga has been shown to increase neuroplasticity through stress reduction in depressed patients Brunoni, R. A., Lopes, M. and Fregni, F. (2008). A Systematic Review and Meta-Analysis of Clinical Studies On Major Depression And BDNF Levels: Implications For The Role Of Neuroplasticity In Depression. [online] The International Journal of Neuropsychopharmacology, 11 (8), pp. 1169-80. Available at: https://academic.oup.com/ijnp/article/11/8/1169/696736/A-systematic-review-and-meta-analysis-of-clinical [accessed 14 Sept. 2017]., Naveen, G. H., Varambally, S., Thirthalli, J., Rao, M., Christopher, R. and Gangadhar, B. N. (2016). Serum Cortisol and BDNF In Patients with Major Depression—Effect Of Yoga. [online] International Review of Psychiatry, 28 (3), pp. 273-8. Available at: http://www.tandfonline.com/doi/abs/10.1080/09540261.2016.1175419?journalCode=iirp20 [accessed 14 Sept. 2017].
  • Practitioners of the yogic breathing technique called Sudarshan Kriya showed increased BDNF levels along with clinical improvements in depression Zope, S. A. and Zope, R. A. (2013). Sudarshan Kriya Yoga: Breathing for Health. [online] International Journal of Yoga, 6 (1), pp. 4-10. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573542/ [accessed 14 Sept. 2017].

Yoga’s effects on hormones and brain waves

Several studies show that yoga helps manage stress, a main component of many mental health conditions such as depression, anxiety, chronic pain and insomnia.

Indeed yoga helps to balance stress hormones as well as sex hormones and sleep hormones.

  • Melatonin levels increased following an evening practice of meditative yoga compared to quiet rest Tooley, G. A., Armstrong, S. M., Norman, T. R. and Sali, A. (2000). Acute increases in night-time plasma melatonin levels following a period of meditation. [online] Biological Psychology, 53 (1), pp. 69-78. Available at: https://www.ncbi.nlm.nih.gov/pubmed/10876066 [accessed 14 Sept. 2017].
  • Similar increases in melatonin were seen when subjects practiced asanas, pranayama and meditation for three months, which resulted in an improved sense of well-being Harinath, K., Malhotra, A. S., Pal, K., Prasad, R., Kumar, R., Kain, T. C., Rai, L. and Sawhney, R. C. (2004). Effects of Hatha yoga and Omkar meditation on cardiorespiratory performance, psychologic profile, and melatonin secretion. [online] Journal of Alternative and Complementary Medicine, 10 (2), pp. 261-8. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15165407 [accessed 14 Sept. 2017]..

These hormonal shifts may help yoga practitioners get more sound and restorative sleep.

  • Yoga has been shown to increase female hormones such as estrogen and progesterone in perimenopausal women who practiced yoga every day for one month Khadka, R., Paudel, B., Majhi, S., Shrestha, N., Regmi, M., Chhetri, S., Das, A., Sharma, D., Gautam, V. and Karki, P. (2013). Yogic practices can increase estrogen and progesterone levels and heart rate variability in peri-menopausal women. In: 37th Congress of IUPS. [online] Birmingham, UK: Proceedings of The Physiological Society. Available at: http://www.physoc.org/proceedings/abstract/Proc%2037th%20IUPSPCA264 [accessed 20 Aug. 2017].
  • Estrogen is linked to serotonin, and progesterone to GABA, both essential for healthy mood and anxiety levels as well as sleep
  • Yoga has also been shown to decrease serum testosterone and luteinising hormone levels in conjunction with vegetarian nutrition over a three month period Schmidt, T., Wijga, A. H., Von Zur Mühlen, A. and Wagner, T. O. (1997). Changes in Cardiovascular risk factors and hormones during a comprehensive residential three-month kriya yoga training and vegetarian nutrition. [online] Acta physiologica Scandinavica. Supplementum, 640, pp. 158-62. Available at: https://www.researchgate.net/publication/13827827_Changes_in_Cardiovascular_risk_factors_and_hormones_during_a_comprehensive_residential_three_month_kriya_yoga_training_and_vegetarian_nutrition [accessed 14 Sept. 2017].

As little as one hour of yoga increases alpha waves in the brain, which are associated with wakeful relaxation and creativity. Tsutomu, K., Kimura, H. Ohno, S., Kumano, H. and Kimura, K. (2000). Decrease in serum cortisol during yoga exercise is correlated with alpha wave activation. [online] Perceptual and Motor Skills, 90, pp. 1027-32. Available at: https://www.researchgate.net/profile/Satoshi_Ohno2/publication/12434908_Decrease_in_serum_cortisol_during_yoga_exercise_is_correlated_with_alpha_wave_activation/links/562f751808ae4742240add8a.pdf [accessed 14 Sept. 2017].