Kelsey Craig

Kelsey Craig
CSOCS3452.01
Laura Douglas
Lesley University
May 2nd, 2011




Anxiety & Yoga Practice in the US




Introduction

Since World War II, anxiety levels in the United States have risen alarmingly. In fact, at the turn of the 21st century, anxiety disorders constitute the most prevalent mental health problems around the globe, which now affects millions upon millions of people. For the purpose of this paper, the focus will be primarily on the United States. Before the 19th century, the majority view was that most social anxiety was normal. After World War II, however, there was a rise in symptoms such as difficulty breathing, racing pulse, sweaty palms, and tingling limbs. By this time the world was in an ”age of progress”—a time when many of the old dangers that threatened humanity, such as starvation and epidemic diseases, diminished (Dowbiggin, 430). This allowed more personal symptoms, like the ones aforementioned, to be more noticeable. In response to this, when the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) came out in 1980, depression and anxiety were separated and anxiety was sub-divided for the first time (Dowbiggin, 430).
Over the past several decades, Eastern yogic practices have become much more popular in the United States. Another trend in the United States, while much more modern than even yoga, is alternative medicine. Many physicians and psychologists have found a way to incorporate yoga into treatment plans for anxiety disorders because over time research has shown that yogic postures help to reduce stress, which is generally the initial cause of anxiety.

Anxiety
According to the encyclopedia of Mental Disorders, anxiety is “an unpleasant emotion triggered by anticipation of future events, memories of past events, or ruminations about the self” (EMP, NP). A significant contributor to anxiety is stress and generally stress and anxiety disorders are grouped together. People usually experience stress and anxiety because of a traumatic experience that happened to them so they develop an unhealthy avoidance to a certain stimulus. As mentioned previously, in 1980 when the DSM-III came out, depression and anxiety were separated. Also in this edition, anxiety was sub-divided for the first time. Some of the sub-divisions include Obsessive-compulsive Disorder, Social Anxiety Disorder, Post Traumatic Stress Disorder, specific phobias, and Generalized Anxiety Disorder (APA, 2000).
When soldiers came back onto US soil after the war was over, doctors, psychologists, and physicians found that several of the same symptoms were affecting many of them. As these numbers increased, it was evident that much of this population was suffering from something much more serious than just the social anxiety that was normalized so many years ago (Dowbiggin, 429). This is one of the main reasons why anxiety was altered in the new version of the DSM in 1980. This way, veterans would be diagnosed with a disorder so that there would be an excuse as to why they are acting so out of the ordinary. For example, those who were experiencing flashbacks, dreams of being back in the war zone, and having it affect their everyday lives were usually diagnosed with Post Traumatic Stress Disorder (PTSD) (Collins, p. 156). Unfortunately, American society needs an explanation for anything that appears to be different.
As veterans and eventually civilians were characterized by their symptoms, trends started to become apparent. Certain genders or populations of people were commonly diagnosed with the same disorder. For example, men were more likely to suffer from PTSD than women at the time because only men could serve in the military. Once it became normalized to diagnose civilians with the same disorders, however, PTSD became more of a gender-neutral disorder (Dowbiggin, 433).
Throughout the years, the media has had a crucial role in propagating a culture of fear. With newspapers, radio, television, and now the internet, and social media, news spreads like wild-fire. For example, after the tragedies of September 11th, 2001, the fear and anxiety of the US rose exponentially. Due to our nation that is so dependent on knowing what is going on and not being able to block our ears and close our eyes, people were continuously exposed to this terrible information and what followed for days, weeks, months, and years at a time. Here we are ten years later and we are still glued to our televisions and computers waiting for the next move.
Presently in America, anxiety disorders are the most prevalent mental illness. Anxiety affects millions of people and the severity of some disorders associated with anxiety is very much underestimated. Unlike in the past where it was normal to experience a bit of anxiety, now that it is in the DSM, anxiety disorders “impact work performance by reducing employment opportunities, work functioning, and attendance” (Erickson, 1166). In an attempt to optimize opportunities for people who suffer from anxiety disorders, physicians and psychologists are continuously searching for additional means of treatment. Research has recently shown that yoga practice is effective in treating anxiety.

A Brief Background of Yoga
First, it is important to discuss where yoga derives from. Yoga comes from the Sanskrit word “yug”, meaning yoke, referring to the discipline of aligning the mind and body for spiritual goals (Birdee, 1653). Yoga was first developed in the Indian culture. Most original practioners of yoga were either Hindu or Buddhist. For some people, yoga is a way of life rather than just an exercise practice--we call these people yogis. For yogis, everything from the postures themselves down to the way they dress and what they eat is incorporated in their yoga practice. It is important for us to keep in mind though that with time, the modern view of yoga that is often portrayed by American culture is also very trendy in contemporary India.

Yoga in America
Yoga is perhaps the trendiest forms of physical activity in the past several decades in the United States. Many people believe that yoga is a good way to be healthy and fit. While some people may practice yoga as it was once portrayed in traditional Indian culture, yoga has become a commercialized, sex-appeal-evoking practice. In America, yoga is seen to cater to young, sexy, attractive women who spend a great deal of money to look as good as they do. The ideas have seemed to switch from yoga being a spiritual way of life to being a form of exercise that will keep the body in shape. Sadly, American culture is to blame for this. We tend to have the mindset that the body is kept in shape so one can appear attractive to others as they go through life to seek a partner, rather than the body being kept in shape for oneself and being interconnected with the mind, body, and spirit. Another reason for incongruence between Eastern and Western beliefs of yoga is that the word “yoga” has been incorporated into the English language and adopted to include a large range of practices from various different cultures (Chaoul, 146).
According cross-sectional survey data from the 2002 National Health Interview Survey, 5.1% of Americans utilize yoga practice for health reasons, which accounts for over 10 million adults. Yoga users are predominantly Caucasian (85%) and female (&6%) with an average age of 39.5 years old. Yoga users also tend to be college-educated, have better health status, and are usually normal weight versus obese. A majority of these people felt that yoga is important in maintaining health (Birdee, 1658).

Yoga as Alternative Medicine
As yoga has become more popular in America, psychologists and clinicians have found a way to incorporate yoga practice into treatment plans for people with physical, mental, and emotional disorders. Not only is yoga used in some physical therapy clinics, counselors and psychologists are finding it effective to use in their practices as well. For mental and emotional disorders, research has shown that these practices modulate brain activity and diminish the psychological and biological effects of stress, which we will call “mind-body medicine” (Chaoul, 145). Yoga can also be characterized as “energy medicine” which focuses on the breath associated with yoga. In American culture, we are more comfortable considering yoga practices as mind-body medicine rather than energy-medicine, because energy is simply an obscurity, and just as with the diagnoses of veterans with unordinary symptoms, we need justification and reasoning to back up everything that we know.
Evidence shows that yoga is associated with increased brain GABA levels Streeter, 1145). GABA is “gamma-aminobutyric acid, which is a neurotransmitter that controls the action of epinephrine, norepinephrine, and dopamine…it filters out unnecessary messages by terminating signals from the excitatory neurotransmitters” (Integrative Psychiatry, NP). One who is suffering from anxiety, depression, or similar disorders has trouble filtering out these static messages, therefore, GABA levels are be relatively low in these people. A significant amount of studies have been done to support that this is true. “A meta-analysis of 116 studies found that mind-body therapies could reduce anxiety, depression, and mood disturbance” (Chauol, 153).
In a study conducted in 2009, young adult professional musicians volunteered to be in a 2-month program of yoga and meditation and were randomized to a yoga lifestyle intervention group. With another group recruited as a no-practice control group, both groups attended three yoga or meditation classes each week. All participants completed an end-program self-report questionnaire that evaluated music performance, anxiety, mood, perceived stress, and sleep quality. Results from the study indicated that yoga and meditation techniques successfully reduce performance anxiety and mood disturbance in young professional musicians (Khalsa, 288). This goes to show that yoga is not only effective in treating diagnosed anxiety and stress disorders, but also in single situations that would be generally characterized as anxiety- or stress-ridden.

The Present and Future of Mind-Body Medicine
Techniques of stress management, which ultimately reduces anxiety, that have proven helpful include progressive muscle relaxation, diaphragmatic breathing, guided imagery, social support, and meditation. According to Chaoul’s article, participating in stress-management programs prior to treatment has enabled patients to tolerate therapy with fewer side effects and psychosocial interventions have been shown to specifically decrease depression and anxiety and to increase self-esteem (166). At the very least, yoga is great for lowering blood pressure and heart rate and people only get out of it what they choose to put into it. The practice of yoga is about testing the bounds of the body and if a person has the desire to heal and effectively go through therapy, they will figure out the proper way to do so.
Presently in America, many medical centers have already incorporated mind-body practices as part of standard care. Although practices are not necessarily prescribed and still definitely not thought of in the same way as conventional medicine, they have come a long way in that they are being delivered alongside medical treatment to improve outcomes. Since the use of yoga with anxiety reduction is still so new, there is not much evidence present to make extensive conclusions. Because of this, I think scientists should push the boundaries even further and examine the clinical implications and focus on cost-effective research to deepen the understanding of the role that yoga practice can take in treating anxiety. We can only hope that with more evidence, mind-body practices will someday be their own form of medical treatment.
In addition to this, as more evidence is shown that yoga is an effective way to heal mentally and physically, perhaps this will be a way for more Americans to understand and appreciate the traditional Eastern ideals that once prevailed.

Works Cited

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders. Fourth edition, text revised. Washington DC: American Psychiatric Association.

Birdee, G., et al. (2008). Characteristics of Yoga Users Results of a National Study, Journal of General Internal Medicine, p. 1653-1659. DOI: 10.1007/s11606-008-0735-5. Retrieved from Academic Search Premier on April 29th, 2011.

Chaoul, A.M., Cohen, L. (2010). Rethinking Yoga & the Application of Yoga in Modern Medicine, Cross Currents, p. 144-167. Retrieved from Academic Search Premier on April 28th, 2011.

Collins, Barbara and Collins, Thomas (2005). Crisis and Trauma: Developmental-
Ecological Intervention. Houghton Mifflin Company, Boston.

Dowbiggin, I.R., (2009). High Anxieties The Social Construction of Anxiety Disorders, Canadian Journal of Psychiatry, 54(7), p. 429-436. Retrieved from Academic Search Premier on April 29th, 2011.

Encyclopedia of Mental Disorders (2011). Anxiety and anxiety disorders. Advameg, Inc. http://www.minddisorders.com/A-Br/Anxiety-and-anxiety-disorders.html Retrieved May 2nd, 2011.

Erickson, S. et al., (2009). Severity of Anxiety and Work-related Outcomes of Patients with Anxiety Disorders, Depression and Anxiety. Vol26, p. 1165-1171. Retrived from Academic Search Premier on May 1st, 2011.

Integrative Psychiatry (2011). Natural GABA- “gamma-aminobutyric acid, which is a neurotransmitter that controls the action of epinephrine, norepinephrine, and dopamine…it filters out unnecessary messages by terminating signals from the excitatory neurotransmitters”. http://www.integrativepsychiatry.net/natural_gaba.html Retrieved from Google on May 2nd, 2011.

Khalsa, S. B. S., et al., (2009). Yoga Ameliorates Performance Anxiety and Mood Disturbance in Young Professional Musicians, Applied Psychophysiology & Biofeedback, p. 279-290. DOI 10.1007/s10484-009-9103-4. Retrieved from Academic Search Premier on April 28th, 2011.

Streeter, C.C., et al., (2010). Effects of Yoga versus Walking on Mood, Anxiety, and Brain GABA Levels- A Randomized Controlled MRS Study, The Journal of Alternative and Complementary Medicine, Mary Ann Liebert, Inc. 16(11), p. 1145-1152. DOI: 10.1089/acm.2010.0007. Retrieved from Academic Search Premier on April 28th, 2011.