Anxiety and Depression
Anxiety is a very common mental illness in the U.S., affecting 40 million people in the US within the age group of 18 years and older, or 18.1% of the population every year. Hence, there is an immense need to cure anxiety with yoga or other natural methods. According to WHO estimates, 7.5% Indians suffer from some mental disorder and it predicts that by end of 2020 roughly 20% of India will suffer from mental illnesses. According to the numbers, 56 million Indians suffer from depression and another 38 million Indians suffer from anxiety disorders.
Having been the birthplace of yoga, the ancient art of mind control, it’s appalling that a large number of Indians are projected to suffer from mental health issues in the coming years. There are various questions raised regarding the scientificity of yoga, its effectiveness in treating these ailments, its benefits over other techniques etc. Also, given that there are multiple brands of yoga available these days, choosing the right and authentic one becomes difficult. This article however explores the scientific benefits of yoga in treating anxiety and stress, and also delves into the key tenets of yoga (beyond postures) which one can practise oneself and achieve mental wellness, with minimal dependence on pharmacological solutions. But can yoga really cure anxiety and depression?
Yoga for Anxiety and Depression
- A study published in 2010 titled “Effects of Yoga Versus Walking on Mood, Anxiety, and Brain GABA Levels: A Randomized Controlled MRS Study”, concluded that a 12-week yoga intervention was associated with greater improvements in mood and anxiety than a metabolically matched walking exercise. This was the first study to demonstrate that increased thalamic GABA levels are associated with improved mood and decreased anxiety. This was the first time that a behavioral intervention (i.e., yoga postures) was associated with a positive correlation between acute increases in thalamic GABA levels and improvements in mood and anxiety scales.
- During 2014-15, a group of researchers in Iran conducted a study on the effect of yoga on stress, anxiety, and depression in women. The research concluded that yoga has an effective role in reducing stress, anxiety, and depression and that it can be used as complementary medicine.
- Another research report published in 2016, “Effect of Hatha Yoga on Anxiety: A Meta-Analysis”, concluded that Hatha yoga is a promising method for treating anxiety and that treatment efficacy was positively associated with the total number of hours Hatha Yoga practice. People with higher levels of anxiety derived the maximum benefit.
- “Effect of mindfulness and yoga on quality of life for elementary school students and teachers: results of a randomized controlled school-based study” was the title of yet another research study published in 2016, whose aim was to assess the impact of a yoga curriculum in an elementary school on student quality of life, and to assess teacher and staff perception of yoga and mindfulness in the classroom. And it concluded that the intervention was associated with a significant improvement in emotional and psychosocial quality of life in the intervention group when compared to the control group, suggesting that yoga/mindfulness interventions may improve symptoms of anxiety among students. Yoga/mindfulness activities may facilitate stress management among elementary school students and may be added as a complement to social and emotional learning activities.
- A study that was published in 2017 titled, “A Breathing-based Meditation Intervention for Patients with Major Depressive Disorder Following Inadequate Response to Antidepressants: A Randomized Pilot Study” aimed at evaluating feasibility, efficacy and tolerability of Sudarshan Kriya yoga (SKY) as an adjunctive intervention in patients with major depressive disorder (MDD) with inadequate response to antidepressant treatment affirmed the feasibility and promise of an adjunctive SKY-based intervention for patients with MDD who have not responded to antidepressants.
Given that multiple scientific studies have proven the benefits of yoga in controlling anxiety and stress, it’s worth giving a shot. The proof of pudding lies in eating. If a simple 5-minute breathing exercise can significantly improve one’s mental health, it’ll just be foolish not to follow it.
What is anxiety?
Anxiety is commonly described as a feeling of fear, dread, and restlessness. One may sweat, feel uncomfortable and stressed, and have a fast heartbeat. This may be a normal response to stress. For instance, when faced with a difficult situation at workplace, when taking a test or making an important decision in life. Anxiety can give one energy or help focus. But for people with anxiety disorders, fear is not temporary, it can be overwhelming. Anxiety disorders are conditions in which anxiety does not go away and gets worse over time. Symptoms may even affect normal daily activities such as job performance, schoolwork, and relationships.
But anxiety is nothing but your body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come. The first day of school, going to a job interview, or giving a speech may cause most people to feel fearful and nervous.
But if your feelings of anxiety are extreme, last for longer than six months, and are interfering with your life, you may have an anxiety disorder.
Anxiety is a key part of several different disorders, which include:
- panic disorder: experiencing recurring panic attacks at unexpected times. A person with panic disorder may live in fear of the next panic attack.
- phobia: excessive fear of a specific object, situation, or activity
- social anxiety disorder: extreme fear of being judged by others in social situations
- obsessive-compulsive disorder: recurring irrational thoughts that lead you to perform specific, repeated behaviors
- separation anxiety disorder: fear of being away from home or loved ones
- illness anxiety disorder: anxiety about your health (formerly called hypochondria)
- post-traumatic stress disorder (PTSD): anxiety following a traumatic event
Symptoms of anxiety
Some symptoms of anxiety are:
- increased heart rate
- rapid breathing
- trouble concentrating
- difficulty falling asleep
Cure for Anxiety
Increased stress, depression and anxiety are the features of modern lifestyle. Modern medicine has primarily behavioral therapy and pharmacological interventions as the main two methods of treatment. Due to the adverse effects of drugs in the treatment of anxiety and depression, and in some cases their lack of effectiveness, researchers seek nonpharmacological and noninvasive treatment for these disorders. Yoga in this context is a great alternative. It is easily doable, doesn’t need external gadgets and one can follow open-source videos available on YouTube to pick up a simple breathing technique or a posture. Yoga exercises have improved the variables of self-description, psychological status, and the quality of life. Research studies suggest that yoga as an intellectual and mental exercise, improves health feeling. Furthermore, yoga can improve the psychological conditions for monitoring and managing stress and negative emotions, increase positive emotions, and help mental balance. Studies have also demonstrated the effect of yoga for many conditions, including multiple sclerosis, asthma, irritable bowel syndrome, lymphoma, hypertension, drug addiction, osteoarthritis, and mental health issues. It therefore means, yoga can cure anxiety, perhaps not fully.
Yoga for Stress Relief
Maharshi Patanjali described yoga in the Yoga Sutras as having eight limbs (अष्टाङ्ग aṣṭ āṅga, “eight limbs”) as follows:
- yama (abstinences)
- niyama (observances)
- asana (yoga postures)
- pranayama (breath control)
- pratyahara (withdrawal of the senses)
- dharana (concentration)
- dhyana (meditation)
- samadhi (absorption)
Each of these 8 limbs have further sub-components. This article, however, focuses only on niyama, the second limb and its parts. Niyama includes a bunch of behaviors, auto-suggestion, virtuous habits and observances (the “dos”). This is nothing but a behavioral therapy that enables one to think and behave differently to cope up with various mental health problems. The benefits of yoga are far higher than just curing mental health issues; however, this article tries to bring out the relevant techniques from this ancient text that help people overcome anxiety and stress.
Sadhana Pada Verse 32 lists the niyama as a combination of the following:
- Shaucha (शौच): purity, clearness of mind, speech and body
Shaucha literally means purity, cleanliness and clearness. It refers to purity of mind, speech and body. It is a virtue in many eastern religions and is necessary for happiness and general well-being. External purity is achieved through daily ablutions, while internal purity is cultivated through physical exercises, including asana (postures) and pranayama (breathing techniques). Besides the daily bath to cleanse one’s body, the concept of Shaucha suggests clean surrounding, clean food, clean clothes, and everything that surrounds you. This term has another connotation, beyond physical cleanliness. A place like Kashi may look physically dirty but is considered sacred due to various other factors.
Shaucha also means purity of speech and mind. Lust, ego, anger, hate, prejudice, greed, pride, fear, negative thoughts are an impurity of mind. The impurities are overcome with a process of self-examination, devotion (bhakti yoga), selfless action (karma-yoga) or knowledge of self (Adhyatma-Vidya).
If you constantly have negative thoughts or any form of impurity, which you’re not able to overcome using your will power, you can just supplicate yourself to your beloved deity or guru. Letting go of one’s feeling of doership, accepting reality as a gift or mercy of God, and performing a complete surrender helps instantly overcome impurity of mind. This, also called as Sharanagati, is one of the easiest ways to obtain chitta-shuddhi, purity of mind.
- Santosha (संतोष): contentment, acceptance of others, acceptance of one’s circumstances as they are to get past or change them, optimism for self
It’s an attitude of contentment, one of understanding and accepting oneself and one’s environment and circumstances as they are, a spiritual state necessary for optimism and effort to change the future.
We’re conditioned to be ambitious and not taught to be contented. Being rich, powerful, or great has nothing to do with the feeling of having ‘enough’. If you adopt a fatalistic mindset, that whatever is destined to happen will eventually happen, you are at ease with the world. If your car had a cruise/auto-pilot mode, then why drive?
- Tapas (तपस्): persistence, perseverance, austerity, asceticism, self-discipline
It is a variety of austere spiritual meditation practices in Indian religions. According to various traditions, it means a combination of asceticism, austerities, body mortification, spiritual practices including meditation and self-discipline. Tapas involves solitude and is a part of monastic practices that are believed to be a means to liberation.
People have a lot of misconceptions about this term. To describe it in simple and secular terms, performing an act selflessly qualifies as Tapas. If you perform an act of charity, it qualifies as Tapas. If you help someone without seeking anything in return, it’s a Tapas. It need not always be a religious ritual. Feeding a stray dog is Tapas. Anything you do for others’ welfare, without ego and any form of expectation, is indeed a penance or Tapas.
- Svadhyaya (स्वाध्याय): study of scripture, self-study, self-reflection, introspection of self’s thoughts, speech and actions
The term Svadhyaya has other meanings. In its true sense, it refers to the historical practice of self-reciting Vedas to ensure it is memorized and faithfully transmitted, without writing, by the word of mouth, to the next generation. In some traditions, it means a virtuous behavior. As a virtue, it means “study of self”, “self-reflection”, “introspection, observation of self”. Some translators simply use the word “study” without qualifying the type of study. It may mean, in today’s times, engaging in a hobby like reading or acquiring a new skill that you need to practise daily, like playing the violin or cooking.
- Ishvarapranidhana (ईश्वरप्रणिधान): contemplation of the Ishvara (God/Supreme Being, Brahman, True Self, Unchanging Reality)
In a religious translation of Patanjali’s Eight-Limbed Yoga, the word Īśvarapraṇidhāna means committing what one does to a Lor. In more secular terms, it means acceptance, teachability, surrender, relaxing expectations, adventurousness.
Besides the niyamas, Maharshi Patanjali describes breath control as the 4th limb of Yoga, called as Pranayama. Prāṇāyāma is the control of the breath, and the word is derived from the Sanskrit prāṇa (प्राण, breath) and āyāma (आयाम, restraint). There are various types of Pranayama. One simple method is Anulom Vilom, i.e., single nostril breathing (one must start with inhalation through the left nostril, hold the breath and exhale through the right nostril and vice versa to complete one cycle). Breath is closely related with one’s sate of mind. Frequency of breath is also related to one’s lifespan. The more frequent the breath is, the more agitated one’s mind is and the shorter the lifespan is. Hence, regular practice of Pranayama, not only helps one overcome mental health problems but also live a long and peaceful life.