Tuesday, May 3, 2011

Nicole Inglis - Yoga and its Ability to Reduce the Effects of Anxiety

ABSTRACT

This paper explores the uses of yoga as a therapeutic treatment for people suffering symptoms of anxiety. Although medical support on the anxiety reducing qualities of yoga practices is limited, there are studies that have proven meditation, yoga, and other stress relieving activities and techniques are helpful in the treatment of anxiety.

INTRODUCTION

At the start of the 21st century, anxiety disorders became the most prevalent mental health problem worldwide (Dowbiggin, 2009). Anxiety is a normal human reaction to stress. The National Institute of Mental Health defines anxiety as a natural coping mechanism toward stress. People deal with stress everyday, whether it is the stress of cramming for an exam or dealing with issues at the office. Among medication and psychotherapy, the National Institute of Mental Health does not mention yoga in discussing treatment plans for patients suffering anxiety and anxiety disorders (from “Anxiety Disorders,” n.d., para. 1). However, some literature suggests that anxiety can greatly decrease through the practice of yoga.

Frank Macshane discusses the release anxiety through yoga in his journal article, Walden and Yoga. In this article, he mentions that Yoga means union. He talks about one’s unity between their Atman, also referred to as one’s individual self and Brahman, or the universal self. The individual self reflects a person’s physical, spiritual, and mental being, for yoga is connection between mind, body, and spirit. All of these are aspects of yoga’s stress reducing qualities. Brahman is considered to be a higher power, often considered God to many people. Yoga also means path. A person’s path to this union with Brahman is unique to each individual (Macshane, 1964).

For some yogis, this path may consist of using yoga to release stress and anxiety.

“Desire for the fruits of work must never be your motive in working. Perform every action with your heart fixed on the Supreme Lord. Renounce attachment to the fruits. Be even-tempered in success and failure; it is this evenness of temper which is meant by yoga” (Macshane, 1964, pg. 328). This means that meditation and devotion in yoga practice can completely ease a person of their anxieties and give them peace. For this reason, Macshane refers to yoga as a liberating method (Macshane, 1964).

RESEARCH STUDIES

Studies show that yoga techniques, “enhance well-being, mood, attention, mental focus, and stress tolerance” (Brown, 2005, pg.711). In Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression, authors Richard P. Brown and Patricia L. Gerbard, advised by health care providers, recommend a 30-minute yoga practice everyday to maintain levels of mood in order to reduce effects of anxiety disorders. It is important to continue a ritualized practice even when symptoms of anxiety begin to cease (Brown, 2005).

Yoga, meditation, and other stress reducing techniques have been studied as treatments for anxiety since the 1970’s. Unfortunately, evidence that supports yoga in reducing anxiety and stress is limited in medical literature because most of the medical studies evaluating the effects of yoga on anxiety and stress have been too small to determine valid results and poorly designed. (from “Yoga for Anxiety and Depression”, 2009, para. 3) However, outside of medical texts, there are articles and reviews of studies done, which do support this theory. An article written by Harvard Public Health describes an analysis report from 2004, which indicates results from randomized, controlled trials. Data recorded indicated changes in people’s moods after being introduced to the practice of yoga. (from “Yoga for Anxiety and Depression”, 2009, para. 3) The results of this 2004 analysis indicate that yoga modulates stress response systems. Yoga allows the body to respond to stress more flexibly by lowering heart rate and blood pressure, and easing respiration (from “Yoga for Anxiety and Depression”, 2009, para. 4).

When discussing yoga in terms of an anxiety release, Walden mentions the four principal types of yoga. Karmayoga is the yoga of action. Jnanayoga is the path of knowledge. The path of devotion is known as Bhaktiyoga. Lastly, Rajyoga is referred to as the royal path of yoga. All of these individual paths enable a person to reach liberation from stress and anxiety as well as a connection with Brahman, or the universal self (Macshane, 1964).

Another small study, done in 2008 by researchers from the University of Utah, supported these findings about yoga and the effect on anxiety and stress responses in the body. These researchers used this information to discover a correlation between stress response and pain sensitivity. Participants included twelve yoga practitioners and a total of thirty other volunteers who had no experience with yoga. These thirty people consisted of sixteen healthy volunteers, and fourteen people with fibromyalgia, which is a stress-related illness where people are highly sensitive to pain. These participants were all subjected to thumbnail pressures and were asked when they began to perceive pain. The participants with fibromyalgia felt pain at low pressures. Also, MRIs suggested that brain activity was associated with pain response. The yoga practitioners had the highest pain tolerance and they lowest brain activity related to pain response. This indicated that yoga could help regulate stress and anxiety and in turn regulate pain response (from “Yoga for Anxiety and Depression,” 2009, para. 5).

Personally, I agree that these findings are an accurate portrayal of the benefits of yoga. Prior to this semester, I have had no experience with yoga practice. After taking this course, I slowly became more interested in yoga and began taking a ninety-minute Bikram yoga class about three to four times a week. Not only did I notice a change in my posture and sleep patterns, I discovered that I was no longer bothered by lower back pain from sitting in a classroom for hours or aching feet from walking everywhere. I also noticed an improvement in my mood. After each yoga class, I was instantly in a more pleasant mood and my level of stress has decreased significantly.

Although I do agree with these findings, I also believe that there are some limitations in this study. Nowhere in the literature, published by the Harvard Health Association, mentions which type of yoga the yogi volunteers practiced. This may not have been mentioned in the study because participation in yoga was not a requirement for this study. This study may have benefited from using the pain response testing alongside yoga therapy for the people with fibromyalgia.

According to one study, which took place in 2007, yoga affects a person’s mood and anxiety because of its link to the amino butyric acid (GABA) in the brain. GABA levels in the brain are reduced, causing an imbalance in people suffering anxiety. In order to test this theory that GABA levels are connected to yoga during therapeutic treatment for anxiety patient’s researchers compared physical activity, specifically walking, and yoga activity in the studies participants (Streeter, 2010).

All participants of this study were healthy people between the ages of eighteen and forty five years old, and had not been diagnosed with medical or psychiatric disorders. Participants took place in a twelve-week therapeutic plan, which either consisted of walking for sixty minutes a day, or participating in sixty minutes of yoga each day. Nineteen participants did yoga each day, while fifteen participated in walking. Researchers classified walking as the physical activity and yoga as the mental activity because although yoga has physical aspects, it connects the mind in its practice (Streeter, 2010).

The participants of this study who were exposed to yoga as a therapeutic means, showed greater improvement in mood and decreased anxiety than the walking group. MRIs showed GABA activity levels in the brain, which correlated with the practice of yoga, linking yoga to mental processes, such as mood and anxiety (Streeter, 2010).

I truly believe that this idea that in the practice of yoga, we are essentially creating a pathway toward an ultimate goal. Jeffery Gold, in his journal article, Plato in the Light of Yoga, describes one of Patanjali’s key theories that kaivalya, or liberation of thought, is a central aspect of yoga. He states that the only way to experience this absolute freedom is through the practice of yoga (Gold, 1996). Although I do not believe yoga to be the only way to liberate one from their thoughts, I do believe in the idea that clearing one’s mind and being in the peaceful, meditative state that yoga can induce, relieves stress and symptoms of anxiety.

There are some limitations in doing research studies on the effects of yoga and anxiety, like previously mentioned in the study relating pain response and mental capacity for stress. Some postures and poses in different types of yoga are found to induce stress while others have been found to reduce stress. Although overall, yoga has been found to have a positive affect on mood, it can have negative affects. For example, Robertshawe, in an article based on a study of the stress reducing properties of Hatha yoga, states that one major limitation of the study was the variety of postures. Different asanas have different strengths. Handstands and shoulder stands improve the health and functioning of both emotions and the nervous system. These can induce stress however, especially in beginners. Forward bends tend to be more relaxing and reduce stress. Also, forward bends tend to be easier to those who are new to yoga (Robertshawe, 2007).

YOGA TECHNIQUES THAT REDUCE THE EFFECTS OF ANXIETY

There are many different types of yoga including Bikram Yoga, Hatha Yoga, Iyengar Yoga, Sivananda Yoga, Vinyasa, and many others. In this section, I touch upon a couple different aspects of yoga and particular techniques that research studies have shown to decrease stress and anxiety.

In most yoga practices pranayama breathing is combined with asanas or yogic postures. Different yogic postures target different areas of the body. Yoga postures involve stretching, lengthening, tightening, and relaxing of muscles, which induces relaxation in the body. This physical relaxation aids mental awareness and eventual relaxation of the mind.

SKY Yogic Breathing Techniques

One of the major aspects of yoga that contributes to reducing the effects of anxiety disorder is the technique of yogic breathing, or pranayama. In the article Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression, Brown and Gerberg, describe four major yogic breathing techniques that are used in patients suffering mood disorders. Brown and Gerbard refer to this series of breathing techniques as SKY breathing techniques, short for Sudarshan Kriya Yoga breathing techniques (Brown & Gerberg, 2005).

The first technique described is called Ujjayi, or “Victorious Breath” or “Ocean Breath” is created by the muscle contractions of the laryngeal muscles. An ocean-like sound is made during these contractions, as air is released through the partially closed glottis, one of the throats sphincters. This breathing technique is meant to be done slowly, with about two to four breaths per minute, and is meant to provide physical and mental calmness (Brown & Gerberg, 2005).

The second technique mentioned in the article is called Bhastike, or “Bellows” Breath. This technique is when air is inhaled and exhaled rapidly, about 30 breaths per minute, using the stomach muscles to create force. During the breaths, the body is energized. However, calmness follows this breathing exercise as the old air is recycled with fresh air and the body can relax. “Om”, which is breathing technique in the form of a chant, is the third breathing technique (Brown & Gerberg, 2005).

Sudarshan Kriya is the fourth technique talked about in the article. This breathing technique is also known as “Proper Vision by Purifying Action”. It is a breathing technique that combines different rates; slow medium, and fast. It is referred to as a cyclical breathing technique, which circulates the air through breaths (Brown & Gerberg, 2005).

According to the Harvard School of Public Health, a study took place, which compared thirty minutes of SKY breathing, done six days a week to bilateral electroconvulsive therapy and tricyclclic antidepressant impipramine. Forty-five people diagnosed with anxiety and depression participated in the study. After four weeks of treatment, 93% of those receiving electroconvulsive therapy, 73% taking antidepressants, and 67% of the participants who participated in the yogic SKY breathing techniques had fully recovered from this diagnosis (from “Yoga for Anxiety and Depression,” 2009, para. 7).

Hatha Yoga

Penny Robertshawe discusses Hatha Yoga and how its techniques result in an improvement in stress, anxiety, and overall health status. Hatha yoga classes typically contain postures that focus on balance, breathing, stretching, and strengthening muscles with both standing and sitting positions. Both “supine and semi-inversion positions” are used in Hatha yoga. All of these different postures help to improve posture and stimulate digestion. After these postures and breathing techniques, most classes end with a progressive muscle relaxation, which Robertshawe explains is a “guided sequence of tensing and relaxing muscle groups from head to toe” (Robertshawe, 2007, pg. 225).

Iyengar Yoga

Iyengar yoga is considered a yoga that can be easily accessible to everyone. Props, such as mats, ropes, chairs, blankets, and blocks enable beginners to learn poses more easily, without causing any strain on the body. Unlike the SKY technique, Iyengar Yoga is very focused on the physical aspect of yoga in the relaxation of the mind and body. The practice of Iyengar yoga consists of specific poses, postures, and positions, both sitting and standing. Many of these specific asanas have been linked to therapeutic use in patients with anxiety because their practice has been connected to positive mood enhancement. In Iyengar yoga, pranayama is combined with yoga postures to achieve maximum focus and performance of each asana pose. This increased attention and concentration, which in this form of yoga is important in reaping its benefits (Shapiro, 2007).

DRAWBACKS TO YOGA AS THERAPY

Although yoga as a therapeutic means to recovery is generally a safe, beneficial treatment plan, it is not meant for everyone. Different types of yoga vary in length, pace, and amount of strenuous activity. There is meditation, breathing exorcises, chanting, Hatha Yoga, Power Yoga, and many other forms of yoga, which are all very different from one another. Because of this, many types of yoga may not be appropriate for the elderly population or people with physical injuries and mobility problems. Although in many cases, yoga can increase flexibility and help a person regain healthy joints, it could also provoke injury. In contrast, slower forms of yoga, such as Hatha Yoga and meditative breathing techniques may not be appropriate for people looking to work up a sweat to find peace of mind and stress relief. Approval from a medical care provider is always good practice when entering any physical activity, no matter what level of difficulty (from “Yoga for Anxiety and Depression,” 2009, para. 8).

Along with the drawback of physical injury, yoga may cause more anxiety for some people. Yoga can be difficult. Yoga takes concentration and dedication. Often times, this can be a struggle for many people. I am one of those people. When I began taking this course, I could not focus or concentrate. The practice was slow and poses were held for way too long. All I could think about was what I was going to have for lunch as soon at 10:30 hit and class would be over. If anything, at the beginning of my experience with yoga, it caused more anxiety for me. However, I have found a type of yoga that is right for me.

CONCLUSION

Multiple resources support the findings and evidence that yoga can help improve anxiety levels in the entire spectrum of people ranging from the healthy, undiagnosed persons to those suffering from severe anxiety and mood disorders (from “Yoga for Anxiety and Depression,” 2009, para. 2). “The undertaking of yoga concerns the entire person, resulting in a reshaping of mind, body, and emotions” (Ravindra, 2006, pg.4). Ravi Ravindra summarizes the theories discussed in the articles written by both Macshane and Gold. Each individual practicing yoga is on their search or path to freedom, whether that be a freedom from stress and anxiety, or another aspect of one’s life.

Mind, body, and spirit are all needed to center the self, free the body from mind rigidity, and to complete the transformation sought by practitioners. Although unity with the individual self and the higher power of Brahman is a major goal in yoga, silencing and liberating the mind as well as strengthening the body share equal importance (Ravindra, 2006).

This paper discusses yoga and anxiety specifically through the eye of a westerner. However, anxiety is a worldwide issue and yoga is a transforming practice, which is becoming more and more popular throughout the globe. Thanks to eastern cultures, yoga has been brought to the United States to help citizens cope with the on-the-go, highly stressful lifestyle we live. (Dowbiggin, 2009). “There is a correspondence between the microcosmos, which is a human being, and the macrocosmos or the universe. The more developed a person is, the more that person corresponds to the deeper and subtler aspects of the cosmos” (Ravindra, 2006, pg.xvi) In other words, yoga is not only a helpful therapeutic tool to reduce stress and anxiety, but in the process of liberation from anxiety in one’s path toward unity, one will find a deeper connection in all aspects of life.

WORKS CITED

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