Wednesday, May 2, 2012

Yoga for Depression- Kelly Saramago













                                     
   Yoga as a Form of Therapy for Depression

       Kelly A. Saramago

        Lesley University





























Introduction
Depression is seen to be one of the most common illnesses seen in individuals today all over the world. Depression impacts one’s physical and mental health. One’s mental health “plays a large role in determining their quality of life” (Bonura, 2009, p.79). Why individuals become depressed can vary as well as the forms of treatment one can receive. Although it is incredibly common for one to see a doctor or therapist for treatment, there is an increasing amount of evidence demonstrating how the practice of yoga can help an individual in the battle of depression (Bonura, 2011, p.135).

Yoga
Yoga is widely viewed from culture to culture. In some cultures, such as India, it is viewed more on a spiritual level whereas in other cultures, such as America, it is viewed more on a physical level. When using yoga as a form of therapy for individuals with depression, it is important to acknowledge both levels in order to ensure positive and productive growth. Experiencing both levels can help an individual see which level of yoga helps as a therapeutic treatment for their depression. Based on Bonura’s article (2011) about the psychological benefits of yoga for older adults, benefits that can result from yoga are “increased ability to continue activities on a daily basis, reduce stress, anxiety, anger, and depression, increase self-control over thoughts and emotions, and provide an opportunity for self discovery” (p. 131). The reduction of these symptoms are achieved in either the physical, breathing, relaxation, or meditation practices (Bonura, 2011, p. 129).
            Yoga is a practice that anyone can perform. The willingness to learn and step out of one’s comfort zone are two factors that will help with one’s experience with yoga. The different forms of yoga can be seen to help individuals at any age with depression although depression is more commonly seen in adolescence and older adults. No matter what age, the engagement of the yoga practice is seen to have great potential in the reduction of depression and improving one’s mood (Woolery, et al., 2004, p. 63).

Medical Research

There has been much research conducted on the effects of yoga use for young adults with depression. In one case study, 28 volunteers were examined over a five-week period to see if the short-term practice of Lyengar yoga could have a significant effect in the change of their mild levels of depression (Woolery, et al., 2004, p. 60). By the end of this study, researchers found that there was a positive effect on the participant’s moods. The changes noted were a much more uplifting mood and lower levels of fatigue  (Woolery, et al., 2004, p. 60). In addition, by focusing on the movement of the muscles during the practice, it was shown to relieve stress and bring much more attention to the body.
This study demonstrated the effects of Lyengar yoga as treatment for individuals suffering with depression. When looking at this study, I found that the emphasis of expanding the chest as well as improving one’s posture is a great method in the yoga practice. By engaging in this style of yoga, participants are encouraged to lengthen much of their body. I feel as though this style of practice can help in an individual coping with depression feel much more relaxed. In addition, the importance of posture stressed in this style of yoga can help in redeveloping one’s confidence.    
            In addition to there being much research and evidence on the effects of yoga in young adults, there has also been much done on older adults and elderly with depression as well. The older one gets, the harder it is for one to participate in a lot of physical activity. Some of the best forms of yoga for this population are forms of yoga that are “gentler than high intensity aerobic exercise, but share the same mental and physical benefits” (Donna, 2009, p. 91).
In Bonura’s article (2011) on the psychological benefits of yoga practice for older adults, it is stated that yoga can have a positive influence in the life of an older adults coping with depression. It has been seen by many individuals that yoga can “reduce hostility, modulate the fear of death, and improve the overall mood” (p. 130). This can be done by coming to terms with their issue, and focusing on what is going on in the present moment of the practice. In this article, there is an example of a study that discusses the views of patients who participated in a form of yoga therapy. Through their experience, they noted a great decrease in the negative emotions they were feeling. This was seen after three days of the therapy that incorporated 20-25 minutes of basic yoga asanas in addition to particular deep-breathing exercises (Bonura, 2011, p. 130).
When reading this article, much of what is talked about can be connected to Traditional culture’s views on suffering. In cultures like India, there is this idea that things should just be left alone. If one is has a problem, they are just to not dwell on it or try and fix it. They are encouraged to let it go and focus on what is going on in the present moment. In the study, there was no emphasis on the issues people were facing. The therapy practice was just seen to relax participants and stress the importance of staying in the present moment.
This article also stresses the benefits one can receive from controlled and focused breath work. The example that this article gives is the practice of Sudarshan Kriya yoga. This form of yoga incorporates various amounts of cyclical breathing patterns. The patterns can range from slow and relaxed to quick and stimulating (N.a., 2009, p. 5). In one study, the practice of Sudarshan Kriya yoga was used to determine if it could have an effect on a group of 60 alcohol dependent men shown to have symptoms of depression (N.a., 2009, p.5). At the end of the study, the results showed that there was a “75% percent drop in depression levels from the group that participated in the yoga class, and there was only a 60% drop from the group that participated in the standardized treatment group” (N.a., 2009, p.5).
While reading the results of this study, it is interesting to see that in addition to stress hormones being dropped, the high levels of cortisol often seen in depressed individuals dropped as well. This study demonstrates the Western cultural views of suffering. In cultures such as America, there is such an important focus on progress. We are constantly always trying to fix our issues or problems. This study willingly let all participants know that they were going to be tested to see if there would be a reduction of symptoms experienced from depression after the session. This form of treatment is a perfect example of how we are always trying to change things about ourselves that we feel as though is not “right” or “normal”.   
In Bonura’s article (2009) about the effects of yoga versus exercise, there was a case study conducted to see if yoga or common physical exercise classes had a greater effect on the elderly with depression. “There was a total of forty-five elderly individuals, ages 74 to 92, who were randomly assigned to one of four interventions: a chair yoga class, a chair aerobics class, a walking program, and a game-playing group” (Bonura, 2009, p.80). Looking at the chair yoga class specifically, it was seen to be a customized form of Hatha yoga that incorporated stretching, meditation, and focusing one one’s ability to balance with the use of the chair, and maintaining a steady breath throughout the practice.
When looking at the results section of this study, it is shown that out of all four classes, the chair yoga class was seen to have greater beneficial results. By looking at the statistical data given in the article, one is able to recognize that the symptoms associated with depression were reduced significantly. The author of this article mentions that “in Traditional Yoga philosophy, as well as research on other forms of mindful exercise, point to one potential reason why yoga may provide additional mental health benefits: the inclusion of mindfulness and the practice of complete present-moment awareness” (Bonura, 2009, p.85). This form of yoga demonstrates how yoga does not always necessarily need to be practiced on the ground. The inclusion of a chair provides a unique spin on the practice and can help in the therapy as a metaphorical treatment tactic for “support”.  
Often times, depression can arise or expand with thoughts of one’s past or what is to come of their future. The importance of focusing on what is going on in the present moment and accepting things for what they are, rather than feeling the need to change what is going on can be seen as a great approach in helping individuals, especially those suffering with depression. Bonura (2009) states, “for older adults facing physical health impairments, loss of independence, the death of loved one’s, and their own impending death, this acceptance might be a profound tool for increasing psychological well-being” (p.85). This concept is something that every form of yoga stresses.

Laughter Yoga

Although there are a various amount of yoga styles, one that is not as widely

recognized or talked about is Laughter yoga. Laughter yoga incorporates constant

laughter along with the well-known practice of yogic breathing (Shahidi, et al., 2011, p.

323). It has been proven that the effects of both real and fake laughter in Laughter yoga

can have great beneficial effects on one’s body system. Potential results one can

experience vary from “muscle relaxation and changes in the immunological, hormonal,

and mental parameters” (Shahidi, et al., 2011, p. 323).

An example of a specific study that studied the effectiveness of Laughter yoga

took a group of about sixty depressed elderly women who lived in Tehran, Iran. The

levels of depression experienced ranged from mildly to severely depressed. This was

determined by the GDS, also referred to as the Geriatric depression scale (Shahidi, et al.,

2011, p. 323). Participants were randomly selected to take part in either Laughter therapy

or exercise therapy.

By the end of this study, it was found that there was much improvement in the

GDS scores in both groups, but individuals in the laughter therapy group had

significantly higher scores in their LSS, or life satisfaction scores (Shahidi, et al., 2011, p.

323). This study showed that practice of yoga is widely used all around the world. It is

becoming a much better known technique in the therapy treatment for individuals with

mental illnesses like depression. Although yoga is seen to be culturally adapted from

country to country, its main purpose in healing an individual remains the same. 

Discussion
Like most of the case studies discussed above, it has been proven how effective yoga therapy can be for individuals with depression. Although these case studies provide helpful examples of the different forms of yoga used and how they can be used for different populations, it lacks the extended valuable information needed to help one understand what specific symptoms of depression can be cured with this approach to therapy. It would have been helpful if I could have found more research on individuals personal experiences, or just more informational data without the inclusions of case studies to learn the long term or short term effects of yoga therapy and which forms of yoga are seen to be potentially more effective.
In much research that can be found on the connection of yoga therapy to depression, there is a common element seen throughout many articles. Although this approach to therapy for mental illnesses is widely used around the world, the majority is practiced more so in the Western part of the world. Seeing this to be true, it is found that yoga has become incredibly Americanized. In countries like India, yoga is viewed on a much more spiritual level where as in the country of the United States, yoga is viewed on much more of a physical level. In Hauschild’s article (2007) about yoga between Indo-Aryan nationalism and multisited fieldwork, it is expressed how in America, “founders of modernized movements tried to develop yoga into a science” (p. 464). This is something that the Eastern cultures try to repress. In Indian cultures, they try and view yoga on an “anti-clinic” level (Hauschild, 2007, p. 463).
            “Traditionally, yoga has been associated with religion” (N.a., 2003, p. 4). As the practice of yoga evolves, it gradually shifts and changes. “The ideas and practices are transformed as they traverse cultural boundaries” (Strasussi, 2004, p. 29). In Western cultures, the practice of yoga as a form of therapy for depression can be looked at differently than the practice of yoga as a form of therapy for depression in Eastern cultures. Individuals with depression who participant in yoga session in America for example will not get the same experience as if they were to take a yoga class in India.
            In American classes, religion is not as emphasized. The instructor of an Americanized class may start out with a “brief meditation with emphasis on the breath and to ignore thoughts that pop into your head” (N.a., 2003, p. 4). Shortly after this though, the instructor will go right into all the asanas, and that would be the main focus of the class. For individuals with depression, I feel as though it would be more effective for them to practice yoga in a more Traditional way. The emphasis of spirituality and focusing on the mind can be great outlet for individuals to form a mental and emotional connection to themselves, rather than just a physical connection.
            When looking at the research analysis in this paper, it is obvious that many of the yoga therapy sessions for individuals with depression is Americanized. Stated by Strasussi (2004), “values of health and freedom have shifted in meaning over time, allowing them to popularize yoga” (p. 29). Yoga is quickly emerging and transforming into something that is completely different than when it originated. Although yoga is adapting to more of a physically based practice, it is evident how incredibly effective it can be with individuals suffering with depression.   

  Works Cited
Bonura, K. (2009). The Effects of Yoga Versus Exercise on Stress, Anxiety, and   

Depression in Older Adults. International Journal Of Yoga Therapy, 19(2), 79-89.

Bonura, K. (2011). The Psychological Benefits of Yoga Practice for Older Adults:

Evidence and Guidelines. International Journal Of Yoga Therapy, 21(1), 129-

142.
Butler, D., Waelde, C., Hastings, T., Xin-Hua, C., Symons, B., Marshall, J., & Spiegel,

D. (2008). Meditation with Yoga, Group Therapy with Hypnosis, and

Psychoeducation for Long-Term Depressed Mood: A Randomized Pilot Trial.

Journal Of Clinical Psychology, 64(7), 806-820.

Donna, W. (2009). The Use of Yoga for Physical and Mental Health Among Older

Adults: A Review of the Literature. International Journal Of Yoga Therapy,

19(6), 91-96.

Hauschild, T. (2007). Yoga between Indo-Aryan Nationalism and Multisited Fieldwork.

Current Anthropology, 48(3), 463-465.

Shahidi, M., Mojtahed, A., Modabbernia, A., Mojtahed, M., Shafiabady, A., Delavar, A.,

& Honari, H. (2011). Laughter Yoga Versus Group Exercise Program in Elderly

Depressed Women: A Randomized Controlled Trial. International Journal Of

Geriatric Psychiatry, 26(3), 322-327.

Strasuss, S. (2004). Re-orienting Yoga. Expedition, 46(3), 29-34.
  
Woolery, A., Myers, H., Stemliebm, B., & Zeltzer, L. (2004). A Yoga Intervention for      Young Adults with Elevated Symptoms of Depression. Alternative Therapies In         Health & Medicine, 10(2), 60-63.      
Yoga for Anxiety and Depression. (2009). Harvard Mental Health Letter, 25(10), 4-5.

Yoga Gets into a Popular Position. (2003). Harvard Health Letter, 29(2), 4.  

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