Introduction
Air
rushes into your throat as your ears begin to ring and heart starts to race. Yet,
you can’t seem to complete a full breath. This feeling of panic paralyzes your
entire body. It seems that you have lost the ability to make conscientious
decisions, as if there is a blanket pressure covering your entire body that is
keeping you from being your true self. You try to continue breathing in air,
but it feels like you’re experiencing an asthma attack. All of these
discomforts come from something that shouldn’t make you feel afraid or panicked
in the first place. This is an example of a panic attack that could be
triggered by anxiety or stress. Usually, these two conditions are considered to
be a normal part of everyday life. Everyone experiences a form of stress once
in a while, whether it be due to procrastinating on writing a massive paper or
waiting for an important interview, for example. Stress and anxiety can hit you
when you least expect them to, but sometimes these feelings can linger on and cause
severe panic attacks and a major sense of instability in one’s life.
Mental
health issues affect nearly 50% of people in the United States during some
point of their lives (Forfylow, 2011). According to the Indian Journal of Physiology
and Pharmacology, anxiety, in
particular, has an “adaptive value, as it signals potential danger and can
contribute to mastery of a difficult situation and thus to personal growth” (Gupta
et al., 2006, pg. 42). Many people normally react with fear or stress when
thrown into a situation that might cause actual harm; therefore the behavior is
a reaction to the situation. However, a persistent amount of anxiety is
considered maladaptive due to it being triggered by fears that rarely present
any harm (Joshi, 2012). An unhealthy lifestyle can develop after one begins to
experience regular anxiety, leading to greater physical and mental health
issues. Some of these include social phobia, separation anxiety disorder, panic
disorder, and obsessive-compulsive disorder (Finks, 2012, pg. 251). When this
begins to interfere with the activities of everyday life, one might try to seek
help from a therapist or primary care physician. Complementary or alternative
medicine (CAM), such as yoga, acupuncture, or massage, might be suggested to
those experiencing symptoms of anxiety (Shapiro et al., 2007).
This
is relevant to my personal experiences. After dealing with the effects of
severe panic attacks over the course of several months, I began regularly
seeing a therapist. She helped me understand that I did have a good sense of
identity; however my lack of self-confidence stemmed from being in an unhealthy
relationship and later experiencing a traumatic event. I was “triggered” by
certain images and experiences, which would cause severe panic attacks that
eventually lead to a development bronchial asthma. With the support of my
therapist, primary care physician, friends, and family, I chose to take a stand
and make changes in my life that would help me move toward feeling more
mentally and physically healthy. At this time, I was already practicing yoga
due to lower back pain. I then became more serious about my practice, and soon
realized that yoga actually allowed me to not only take control of some of my
anxieties, but also develop self-confidence. I discovered that serious
commitment is required in order to personal change to occur. My experiences
with yoga as a therapeutic approach towards healing made me curious as to how
deeply movement and breathing affect our psychophysiological states and overall
well-being.
Numerous
research articles have proved that yoga has a positive affect on improving
one’s well-being and lowering levels of anxiety through participation in
intervention programs. Yoga has become extremely popular in western culture in
recent years, but mostly as a physical exercise rather than a complementary or
alternative medicine. The Harvard Mental Health Letter states that a survey
“estimated about 7.5% of U.S. adults had tried yoga at least once, and that
nearly 4% practice yoga in the previous year” (Harvard Public Health, 2009, pg.
1). In addition, about 75% of adult Americans have tried a form of CAM, usually
with the motivating reason being anxiety or depression (Shepiro et al., 2007,
pg. 493). The purpose of yoga is not easy to define; however, a common theme
between traditional and modern definitions is that yoga allows one to discover
a balance between the mind and body, leading to a sense of inner-peace and self-understanding.
Ravindra even writes that that word yoga comes
from the root yuji, which translates
to “yoke”, “unite”, or “harness”. He concludes that when the body and mind are
united, one is truly practicing yoga (Ravindra, 2006, pg. 4). In addition, the
Sri Lanka Journal of Psychiatry suggests that yoga was “designed to facilitate
development and integration of the human body, mind, and breath to produce
structural, physiological, and psychological effects” (Joshi et al., 2012, pg.
3). Therefore, yoga is widely known to create a balance between mental and
physical well-being, but it is not always practiced that way.
There are
different forms of yoga that are based on various teachings and traditions;
however, they are all mostly are built on components of asanas (posture), meditation, and pranayama (breathing exercises) (Joshi, 2012). It’s obvious that
our modern western culture steers itself away from anything seen as spiritual
or therapeutic. We typically see yoga as a full body workout and do not always
believe in the significance of its healing and relaxing effects on the mind.
The most common form of yoga practiced in the United States is hatha yoga, which places an emphasis on
balancing out the mind and body through asana
postures and pranayama breathing exercises
(Forfylow, 2011). When looked at with a more open perspective, many have found
that a combination of all these varieties of practice helps aid in the process
of healing anxiety related symptoms, which can lead to self-realization and
confidence.
Techniques
& Studies
Modern
hatha yoga practices involve an
assortment of “standing, seated, and balancing postures followed by forms of
twists and backbends or inversions” (Forfylow, 2011, pg. 134). The flow of
these movements allows one to focus inward and stay in the present moment while
changes in energy levels can be stimulating or soothing. Certain restorative
poses that involve props, such as forward bends, inversions, and backbends, can
help cultivate a sense of relaxation. This is key for those who spend their
days standing on their feet or sitting at a desk. For example, reversing the
body’s position in an alternative shoulder stand allows one to feel a sense of
calm and focus (Shapiro et al., 2007). This rise in improved mood and decrease
in anxiety is possible due to the increase in thalamic GABA levels and
parasympathetic nervous system activity (PNS) after a session of yoga (Streeter
et al., 2010). Gamma-aminobutyric acid, also known as “GABA”, is a
neurotransmitter associated with anxiety and depression. Practicing the
different movements and postures in yoga, regardless of the style, has been
found to increase GABA levels in the brain. Therefore, levels of anxiety and
depression are decreased (Forfylow, 2011).
Many yoga
practices end with meditation or breathing exercises such as those in the Sudarshan
Kriya Yoga (SKY) practice. This therapeutic approach to yoga also includes asanas, meditation, and learning yogic
philosophies (Brown and Gerbarg, 2005). The first main SKY breathing exercise, ujjayi (“victorious breath”) is very
common and involves a “gentle contraction of the laryngeal muscles and partial
closure of the glottis” which creates the sound of the sea or a wave crashing
(Brown and Gerbarg, 2005, pg. 711). This form of breathing controls airflow, therefore
allowing one to feel alert and able to focus on their breath. The second exercise,
bhastrika (“bellows breath”), brings
about excitement followed by calm as one quickly forces inhalations and
exhalations at a rate of 30 breaths per minute. This might not work well for
some, as it may be an intense trigger for panic attacks (Brown and Gerbarg,
2005). I have personally struggled with fast paced breathing in classes because
of my asthma, but have also felt triggered due to overstimulation, as if I were
experiencing a panic attack. The last two SKY breathing exercises include chanting
“om” three times and practicing sudarshan kriya (“proper vision by
purifying action”), or various speeds of cyclical and repetitive breathing. These
controlled breathing exercises can allow one to feel relaxed yet fully alert. Deep
relaxation is caused balancing the ANS (autonomic nervous system), therefore reducing
the activation of sympathetic nervous system activity (triggered by anxiety,
stress, and panic) and an increase in parasympathetic nervous system activity (reactions
to slowing down heart rate and breathing). Anxiety and stress are triggered by these
psychophysiological components. When one is able to gain control of their
responses to stress through pranayama
and asana techniques, an opportunity
to begin healing and develop self-confidence can appear.
A
study was conducted at the Integral Health Clinic at All India Institute of
Medical Sciences that involved a lifestyle change involving regular yoga
practice for 175 people who had a history of hypertension, anxiety, and other
psychiatric disorders. The participants practiced and learned about yoga over
the course of ten days and assessed the levels of their anxiety using a
questionnaire. The results displayed a significant decrease in anxiety levels
after the course; however, they show that simply practicing yoga is not enough
(Gupta et al. 2006). A combination of practicing asana, breathing techniques, meditation, therapy, group discussion,
and increased knowledge of stress management is important to becoming
significantly more in control of anxiety. One cannot simply be healed or cured
by practicing these techniques. Yoga studios in the U.S. occasionally advertise
themselves as helping one become better, successful, and more attractive.
However, what they do not say is that yoga doesn’t promise you anything. Instead,
it allows you to dust off all the things that cover your true self, which is
all under your own control.
Limitations
Sometimes
one might begin practicing yoga with false expectations. I started yoga only
when my back specialist told me that it was the alternative to healing my lower
back pain if I didn’t want to relief from pain medications or regular
injections. Practicing yoga can alleviate back pain but can also cause injury
if not done properly or with support. Eventually, my practice allowed me to
feel more mentally balanced because I was finally able to let go of my fears
and emotions. In “Rethinking Yoga and the Application in Modern Medicine”, Chaoul
and Cohen describe this realization as the “belief that what we think and feel
can influence our health and healing” (Chaoul and Cohen, 2010, pg. 145). To
some, however, finding the will to go through with recovering from anxiety or
panic attacks can be difficult.
There
are several limitations and drawbacks that one with a mental health related
issue must understand before beginning a yoga practice. The fast paced
breathing of bellows breath can trigger a panic attack and sense of
hyperventilation for those with anxiety. People experiencing bipolar disorder
should avoid this technique entirely as it may cause a feeling of hysteria.
However, slowing down and focusing on the breath using the ujjayi technique can decrease irritability and over activity in the
mind if one feels triggered and panicked. Feeling safe and comfortable, as well
as finding a welcoming group setting is also crucial for those who experience a
social phobia as part of their anxiety (Brown and Gerbarg, 2005). Regardless of
these limitations, it’s important one to understand that the feelings of
anxiety and stress during the practice are only temporary. Being connected with
the body will reveal emotions, fear, and possible flashbacks of past traumatic
situations. When I first began my practice, there was one class during which I
broke down in the middle of child’s pose. It felt safe and comforting, so I was
confused as to why I felt so emotional. I soon understood that there were
insecurities and emotions that were lingering at the surface and were ready to
be released at any moment. For some, this realization is an opportunity to deal
with these anxieties first hand and let go of them through movement and deep
breathing.
Although
many research studies show a significant drop in anxiety after one yoga
practice, it’s important to recognize that yoga will not cure anxiety or
completely wipe out stress. These studies do not discuss if ethnicity, age,
sex, or socio-economic status play a role in the way yoga affects anxiety. In
my previous paper, I discussed how most yoga studios primarily cater to
upper-class, middle aged, white women. Yoga is advertised as something that,
for example, will grant you a nice butt or toned body. However, does it
alleviate the anxiety that comes with lack of self-confidence and stress about
body image? Would it be possible to a younger man to go to one of these studios
if his therapist suggested trying yoga for relieving anxiety? Would someone
with low self-esteem want to enter a room filled with physically fit women in
tight clothing and practice yoga? It’s hard to say whether or not these kinds
of studios that claim to be welcoming are really as open as they think. However,
I don’t personally believe that they have bad intentions or should change the
way they practice. Our modern culture simply dwells on and has commercialized the
importance of becoming “better”. The healing and spiritual aspects of yoga are
therefore rarely discussed as being part of developing strong mental and
physical well being, especially as forms of alternative therapy. Practicing
yoga allows one to shake off those feelings of anxiety and helps place emotions
and fears into perspective. Going to class, facing their fears first hand, and
eventually moving forward will come to those who are willing to open up new
opportunities for change.
Conclusion
There
are many research articles that provide solid findings on how yoga can help
alleviate anxiety and stress. Practicing various asana postures and breathing
techniques has been found to drop significant levels of tension, anxiety,
depression, anger, hostility and fatigue (Harvard Public Health, 2009). Certain
postures, such as forward bends and inversions, can calm anxiety by increasing
GABA levels and parasympathetic nervous system activity. In combination with relaxing
breathing techniques such as the ujjayi
breath, an overall sense of balance or homeostasis takes over the mind and
body. At times, it might feel like the body and mind are connected, which
allows one to be fully focused on the self and face fears and emotions first
hand. Only practicing yoga on it’s own, however, will not fully eliminate
anxiety or stress. It’s important to consult a therapist or primary care
physician to discuss progress and limitations, and receive encouragement and
support for a complete lifestyle change that will reduce symptoms of anxiety.
Practicing
yoga has been a transformational process that allowed me to directly face and
heal my symptoms of anxiety. Although it’s not usually advertised as
therapeutic or an option to heal emotional stress, yoga will give those with
busy lifestyles a chance to slow down and be in tune with their inner self. Unfortunately,
the practice might increase anxiety for those with more serious cases. It’s
important to recognize that like many things, yoga is simply a process. As Ravindra
writes, “the practice and discipline are necessary only for removing the
obstacles to this unfolding, just as a gardener removes the weeds for the sake
of a healthy crop” (Ravindra, 2006, pg. 47). In order to move forward and feel
balanced mentally and physically, we must take care of our entire selves.
Works Cited
Brown, R., & Gerbarg, P. (2005).
Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and
Depression: Part II – Clinical Applications and Guidelines. The Journal of Alternative and Complimentary
Medicine, 11(4), 711-717
Joshi, A., &
De Sousa, A. (2012). Yoga in the Management of Anxiety Disorders. Sri Lanka Journal of Psychiatry, 3(1), 3 – 9
Gupta, N., Khera,
S., Vempati, R., Sharma, R. & Bijlani R. (2006) Effect of Yoga Based
Lifestyle Intervention on State and Trait Anxiety. Indian Journal of Physiology and Pharmacology, 50(1), 41 – 47
Finks, K. (2012)
Symptoms and Treatment of Anxiety Disorders. NASN School Nurse, (27) 251 – 253
Harvard Public Health. (2009) Yoga for Anxiety and
Depression. Harvard Mental Health Letter, 1 – 3
Yadav RK., Magan D., Mehta
M., Mehta N., & Mahapatra SC. (2012) A Short-Term, Comprehensive,
Yoga-Based Lifestyle Intervention is Efficacious in Reducing Anxiety, Improving
Subjective Well-Being and Personality. International
Journal of Yoga, 5(2), 134 – 139
Shepiro, D.,
Cook, I., Davydov, D., Ottavieni, C., Leuchter, A., & Abrams, M. (2007)
Yoga as a Complementary Treatment of Depression: Effects of Traits and Moods on
Treatment Outcome. Evidence Based
Complementary and Alternative Medicine, 4(4),
493 – 502
Streeter, C.,
Whitfield, T., Owen, L., Rein, T., Karri, S., Yakhkind, A., … Jensen, E. (2010)
Effects of Yoga Versus Walking on Mood, Anxiety, nd Brain GABA Levels: A
Randomized Controlled MRS Study. The
Journal of Alternative and Complementary Medicine, 16(11), 1145 – 1152
Khalsa, S.
(2004) Yoga as a Therapeutic Intervention: A Bibliometric Analysis of Published
Research Studies. Indian Journal of
Physiology and Pharmacology, 48(3),
269 – 285
Forfylow,
A. (2011) Integrating Yoga with Psychotherapy: A Complementary Treatment for
Anxiety and Depresion. Candian Review of
Counseling and Psychotherapy, 45(2),
132 – 150
Chaoul,
A., & Cohen, L. (2010) Rethinking Yoga and the Application in Modern
Medicine. Cross Currents Association for
Religion and Intellectual Life, 60(2),
144 – 167
Ravindra,
R. (2006). The Spiritual Roots of Yoga: Royal Path to Freedom. Sandpoint, ID: Morning
Light Press.
Hickey, L. (2012). Yoga Comic
(Illustration), Retrieved April 23, 2013, from: http://lizzhickey.tumblr.com/post/24933263659/yoga-comic-continued
No comments:
Post a Comment