Thursday, April 25, 2013


Yoga Will Give You a Nice Butt. More Importantly, 
Yoga Will Help You Stop Having Anxiety Attacks 
About Your Butt’s Appearance.

REBECCA VOLYNSKY
Yoga: Theory, Culture and Practice - Lesley University, Cambridge, MA
Spring 2013

Illustration by Lizz Hickey



Abstract
            This paper discusses the practice of hatha style yoga asanas and pranayama as a form of complementary or alternative medicine to alleviate the symptoms of anxiety and stress. The representation of yoga in our modern western culture does not advertise it as an opportunity for healing; however, many research studies have suggested that yoga does indeed greatly affect our nervous system and overall well-being.  

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




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