The Effectiveness of Yoga on Anxiety
Disorders
Katie McCarthy
Lesley University
Introduction
Anxiety
in the United States has consistently become more and more prevalent as a
pathological disorder. Its
prevalence is among the highest of all psychiatric disorders in the U.S. at
about 29% (Sharma & Haider, 2012).
An anxiety diagnosis is commonly a comorbidity to several other
disorders (Sharma & Haider, 2012), which is the likely cause of the high
rates of anxiety disorders. Anxiety
disorders are “subdivided into panic disorder, obsessive-compulsive disorder,
phobias, and generalized anxiety disorder” (Li & Goldsmith, 2012, p.
22). This research paper was
originally going to focus on obsessive-compulsive disorder, but because of the
lack of research available, I have broadened my topic to include anxiety
disorders collectively.
Forms
of therapy used to control or treat anxiety “include hospitalization,
prescription drugs, and counseling” (Sharma & Haider, 2012, p. 1). However, there has been increasing
interest in alternative and complementary forms of treatment for psychiatric
disorders. Yoga has been
previously used to lower heart rate and blood pressure, thus it could be a good
alternative for individuals suffering from anxiety disorders (Sharma &
Haider, 2012). In Western culture,
the type of yoga used is mainly Hatha Yoga (Joshi & De Sousa, 2012), though
“many of the yoga interventions used in research studies also include breathing
exercises, concentration and awareness meditation” (Bonura, 2011, p. 132).
According
to Li & Goldsmith (2012), “In America, the yoga market emerged as a 5.7
billion dollar industry in 2008” (p. 21).
Yoga’s increasing popularity and “emphasis on a spiritual connection
between mind and body” (Li & Goldsmith, 2012, p. 21) makes it a reasonable
treatment for mental disorders like stress and anxiety. In an article focusing on the
psychological benefits of yoga for older adults, the author notes that “yoga is
free from the stigma of medical care, this yoga is particularly appealing to
older adults with cultural and personal beliefs that create resistance to
medical treatment, especially for psychological issues” (Bonura, 2011, p.
129). Though this article is
specific to the older adult population, it suggests that individuals in the
Western society may prefer alternative forms of therapy as opposed to the more
medical types of treatment.
Techniques and Interventions
The
entire point of yoga is in its practice.
Yoga, according to Sharma & Haider (2012), “is most notably
specified as a mind-body therapy composed of various breathing and relaxation
techniques, including meditation, postures, and phrase recitation to improve
physical and mental illness” (p. 6).
There are multiple types of yoga that meet specific needs. The practices are “intended to
facilitate self-transformation at every level of functioning, with the goal of
improving the overall quality of life” (Joshi & De Sousa, 2012, p. 3). The theory behind yoga is about
developing and integrating the human body, mind, and breath “to produce
structural, physiological, and psychological effects” (p. 3).
Shannahoff-Khalsa
(2003, 2004) has spent a significant amount of time studying Kundalini Yoga
Meditation Techniques for individuals with obsessive-compulsive disorder and
other obsessive-compulsive spectrum disorders. In one of his articles, he discusses Kundalini Meditation
and chanting techniques for OCD, phobias, learning disorders, sleep disorders,
addictive disorders, depression, and grief (Shannahoff-Khalsa, 2004). For each disorder, disease, etc., he
provides specific techniques that originate from Kundalini Yoga theory. A majority of the techniques used in
two of his articles can be performed sitting in a chair (Shannahoff-Khalsa,
2003), making the techniques accessible for many different populations. According to Russell (2008), who
reviewed one of Shannahoff-Khalsa’s books, “a constant across all successful
use of Kundalini Yoga Meditation was the commitment to practice by the individual”
(p. 221). In my opinion, this is
the case for any yoga practice. In
order for the practice to be beneficial in any way, there needs to be some
consistency and commitment. It can
be difficult to keep a practice, but it is necessary to see any long-term
positive effects. Some of
Shannahoff-Khalsa’s techniques for people with OCD and anxiety include “tuning
in” (p. 221), spine flexing and shoulder shrugging, and various breathing
exercises. While reading each of
the techniques, I was tempted to try them. The titles of each technique sound effective and
empowering. I wondered how
effective they were or if each title was made to sound appealing and
marketable. From my own
experience, though, making simple adjustments in a seated position and tuning in
to a meditative state can have immediate positive effects.
Another
common form of yoga that is used for treating anxiety disorders is Sudararshan
Kriya Yoga (SKY). In the treatment
of anxiety disorders, SKY breathing techniques are commonly used (Brown &
Gerbarg, 2005). Breathing is a
vital part of being alive. Four of
the breathing techniques used in SKY are the Ujjayi breath, also called
victorious breath or ocean breath; the Bhastrika breath, or bellows breath; Om;
and Sudarshan Kriya, or proper vision by purifying action (Brown & Gerbarg,
2005). The breath is present in
every kind of yoga practice. When
it comes to anxiety, the breath may become shallow. Therefore, breathing “may be useful for restoring a sense of
control when an individual is confronted by an anxiety-inducing trigger”
(Bonura, 2011, p. 130).
Research Studies
Yoga
is effective in its practice, but in order for it to gain proper recognition as
an alternative therapy, research is needed. In the United States, healthcare providers “have not
endorsed yoga as an alternative therapy.
This was typified in a recent news item, published by the American
Medical Association, in which yoga practice is included in a list of
alternative therapies referred to as ‘unproven treatments’” (Li & Goldsmith,
2012, p. 21). Recently, there has
been more attention surrounding the effectiveness of yoga with psychiatric
disorders.
Several studies are composed of
systematic reviews of research done in the past. In a majority of the studies looked at, there is evidence of
significant increases in brain GABA (gamma amino butyric acid) levels after a
yoga session in experienced yoga practitioners (Joshi & De Sousa, 2012, p.
4), which helps in relieving anxiety (Sharma & Haider, 2012). Experienced yoga practitioners also
have lower mental health disturbances than short-term yoga practitioners (Joshi
& De Sousa, 2012). Across
almost every study examined, researchers found that yoga intervention is really
only effective in treating or lowering levels of anxiety when practice is
regularly implemented for two or three months, and found that yoga intervention
may be more effective with the use of an instructor as opposed to a home
practice (Sharma & Haider, 2012).
Regular yoga practitioners have also been found to have lower levels of
cortisol, a stress hormone, in saliva samples (Bonura, 2011). Specific types of yoga that have been
observed in the use of treating anxiety disorders include Iyengar Yoga,
Sudarshan Kriya Yoga, Yoga Nidra, Hatha Yoga, and other unspecified yoga
techniques (Sharma & Haider, 2012).
Consistently, yoga has been known to
decrease stress, “especially through the use of rhythmic breathing techniques,
allowing its benefits to cross many cultural and regional boundaries, although
its origins are in India” (Sharma & Haider, 2012, p. 6). Yoga has been adapted in Western
culture because of its universal techniques. Yoga has a high potential for reducing stress-related
symptoms, and “the National Institutes of Health recommend meditation over
prescription drugs as the preferred treatment for mild hypertension in 1984”
(Bonura, 2011, p. 130). Many of
the studies have been careful to conclude that the research evidence simply
supports yoga as a “safe and effective method” (Joshi & De Sousa, 2012, p.
7) in treating anxiety disorders. Each
study done on the effectiveness of yoga on levels of anxiety supports the
suggestion that yoga be considered as a complementary therapy (Joshi & De
Sousa, 2012).
Although there have been several studies
on the benefits of yoga on anxiety disorders, there are some drawbacks. Because the yoga practice can be
difficult to measure, Yogi Bhajan says, “It may take centuries before medical
science will understand” (Russell, 2008, p. 222) the effects of yoga, specifically
Kundalini Yoga Meditation. In an
effort to recognize the significant benefits yoga has on anxiety and stress, Li
& Goldsmith (2012) look at the research done in the past, but found that
“the data regarding the usefulness of Yoga and meditation in the short-term
reduction of anxiety are inconsistent” (p. 27). They observed that the studies were weak, although the
studies do hold some validity.
They noticed that many of the anxiety levels and perceived stress was
measured using scores from questionnaires, some of which were created by the
researchers themselves and therefore not necessarily valid (Li & Goldsmith,
2012). In a recent study comparing
the effects of yoga versus walking on anxiety and mood, “yoga intervention was
associated with greater improvements in mood and decreases in anxiety…compared
to the metabolically matched walking intervention” (Streeter, et. al., 2012, p.
1150), but then discusses the limitations in the study including sample size
among others. Finally, there are
those who suggest that, “yoga has valuable effects, but that it does not have
any unique value” (Watts, 2000, p. 73).
In other words, practicing yoga is effective in decreasing levels of
anxiety, but Watts (2000) does not necessarily believe that yoga’s effectiveness
is any different from other forms of treatment.
Conclusion
In
the past few decades, yoga has become a preferred form of alternative or
complementary therapy. The Western
culture is very pathologically based, and if there is a problem then there must
a solution. As a society we have
taken yoga’s theory and shifted it into our own form of healing: Kundalini Yoga
becomes a meditative technique as opposed to a recoiling of energy in the lower
chakras is just one example of how we take the original practices and form it
into something that is useful for us.
Yoga
has been around for so long that it is hard to disregard it as effective. However, with the many different types
of yoga, it is important to know which type works best in decreasing anxiety levels. More research needs to be done on its
effectiveness in lowering levels of anxiety and increasing overall
wellbeing. I also believe more
research needs to be done on specific anxiety disorders and which yoga technique
is most effective. The kind of
research that needs to be done is thorough, valid research (Li & Goldsmith,
2012) that is reliable and re-testable.
However, even though these specific studies have weaknesses and
limitations, they do suggest that yoga may improve anxiety symptoms and stress
(Li & Goldsmith, 2012).
My
final thoughts surround the idea of yoga being effective on its own or
alongside other forms of therapy (Sharma & Haider, 2012). This has been mentioned in several of
the studies cited in this paper, but no real conclusions were made. In some cases, participants began the
study on medication and by the end were completely off medication or had
decreased medication significantly.
It is unclear, though, if this is because of comorbid diagnoses or as a
result of the yoga treatment. I
hope that in further research we can draw some valid conclusions that have been
so evident in individual case studies over the years but do not necessarily
have the empirical data to back it up.
Overall, yoga has positive and beneficial results for individuals with
anxiety disorders and other stress-related symptoms.
References
Bonura,
K. B. (2011). The psychological benefits of yoga practice for older adults:
Evidence and
guidelines. International Journal of Yoga Therapy, 21, 129-142.
Brown,
R. P. & Gerbarg, P. L. (2005). Sudarshan Kriya yogic breathing in the
treatment of
stress, anxiety, and depression: Part
II—Clinical applications and guidelines. The
Journal
of
Alternative and Complementary Medicine, 11(4), 711-717.
Joshi,
A. & De Sousa, A. (2012). Yoga in the management of anxiety disorders. Sri Lanka
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of Psychiatry, 3(1),
3-9.
Li,
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Medicine
Review, 17(1), 21-35.
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T. A. (2008). Kundalini yoga meditation (KYM): Techniques specific for
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