At Minded, yoga’s value in anxiety is very close to our hearts. Heather, our founder, is very open and honest about her own struggles with anxiety, and this has sparked much of Minded’s mission.
Anxiety is a powerful mental and physical experience that, at some point, almost everyone will experience. Some of us less, some of us more. Although often unpleasant, anxiety is natural response to stressful situations, allowing us to react appropriately to danger, which is important if there is an imminent threat. In fact, our life may rely on the cascade of physiological processes that are part of the anxiety response, such as pumping cortisol through the body that give us the capacity to run away! However, much of the time we experience high level anxiety in relation to things that would be much better dealt with through calm and wise consideration, rather than rumination, fear and the desire to flee.
These days anxiety is rife in society and the pandemic has only augmented this mental health complication. Some might say anxiety is its own pandemic.
Anxiety reaches disordered status when a host of factors lift to a critical level impairing daily functioning [1]. Currently, anxiety is the most common mental health disorder and even before the pandemic anxiety affected approximately 19.1% of the population or 40 million adults over the age of 18 in the United States [2]. The most recent anxiety prevalence statistic available in the UK, pre-pandemic is 17% of the population in 2014 [11].
Related Alternative Treatments
The USA is good at offering stats so we will use some of theirs, even though we are interested in world-wide data. An estimated 31% of adults experience a form of an anxiety disorder at some point in their lives [8], and 62% percent of adults in the United States utilise some form of complementary and alternative medical treatment [4].
The benefits of physical activity (PA) and exercise are well known. They include: improving sleep quality, balance, and muscle strength; lowering blood pressure; management and illness prevention (including type 2 diabetes, obesity, heart disease, osteoporosis, stroke, etc.); and promoting mental health, specifically anxiety and depression [7].
Studies reveal that this reduction in anxiety and depression from PA, is related to the release of endorphins [6], and the arousal of the sympathetic nervous system. Like exercise, anxiety increases sympathetic arousal, causing bodily reactions such as increased heart rate and hyperventilating. These same responses to exercise may increase a level of tolerance for being in this state of alert [12].
Likewise breathing technique are receiving ever increasing popularity for their ability to reduce anxiety, as is mindfulness [10]. Zoogman et al (2019) noted that it is this connection of both the body and the mind, that is thought to reduce symptoms of anxiety.
Although all of us whom practice yoga know that yoga is so much more than exercise, it certainly can also be classed under this umbrella within research. At the same time yoga incorporates breathing exercises, with mindfulness intrinsic to the practice. Via this triad we naturally enhance the mind-body connection, so Zoogman would likely give us a thumbs up!
This begs the question; would yoga be superior to other forms of exercise in terms of reducing anxiety? And, if yoga is as good or better than exercise in reducing anxiety, should it be prescribed within healthcare?
Thankfully, we are not the only ones asking this question. We found a recent literature review (April 2021) by Cole et al [4], which analysed alternative & complementary therapy, aerobic exercise, and yoga, to determine which is the most beneficial in reducing symptoms of anxiety.
The raison d’etre beyond this paper, was unsurprisingly, burgeoning levels of anxiety seen in the pandemic, and hopes of effective treatments.
Excitingly, researchers found significant evidence for as the most beneficial modality to reduce anxiety. In this review, yoga practice included the physical practice of hatha yoga (incorporating branches of hatha such as vinyasa or Iyengar), as well as mindfulness practice. These results contrasted with aerobic exercise, which although promoting many health benefits, has only a trace benefit in lowering anxiety symptoms.
One study [5], covered in the review found that the greater the symptoms of anxiety, the great benefit hatha yoga practice offered. Interestingly, another study [10] reported that the more traditional the yoga practice, the greater the reduction in anxiety. Traditional yoga practice involves dim lighting & a clear space, within the context of a yoga studio space.
Suggestions for Clinical Practice
Cole et al (2021) in response to the results of their literature review, noted that when treating patients for anxiety, “providers can explore both the customary management options of medication and CBT while including a conversation about the benefits of yoga.”
This could be as a sole treatment for those not wishing to partake in pharmacological or talking therapies, or as a complementary therapy to those partaking in, for example medication or cognitive behavioural therapy (CBT).
A key benefit to the use of yoga as a treatment option for anxiety is the ease of accessibility. Yoga classes rarely require a waitlist as is commonly the case with treatment such as CBT, and can be accessed through yoga studios, gyms, one-to-one home classes, or online. They are also relatively low-cost with access to funding through many yoga charities, for disadvantaged persons. However, not all yoga is the same and it is important that students go to a class where teachers understand how to use yoga to reduce anxiety.
We are thrilled to be offering the first training in Yoga Therapy and CBT for clinicians that want to combine the two. For yoga and health professionals wishing to use yoga therapy in their work specifically for anxiety, join Heather’s renowned training: Yoga Therapy for Anxiety.
Study Access
You can read the abstract and gain paid access to the study here: https://pubmed.ncbi.nlm.nih.gov/34436979/
References
- American Psychiatric Association. (2017). What are anxiety disorders? https://www.psychiatry.org/patients-families/anxiety-disorders/ what-are-anxiety-disorders
- Anxiety and Depression Association of America. (2020). Facts and statistics. https://adaa.org/about-adaa/press-room/facts-statistics
- Brown, K.W., & Ryan, R.M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848.
- Cole, K. A., Pearson, T., & Knowlton, M. (2021): Comparing Aerobic Exercise with Yoga in Anxiety Reduction: An Integrative Review, Issues in Mental Health Nursing, DOI: 10.1080/01612840.2021.1965269
- Hofmann, S. G., Andreoli, G., Carpenter, J. K., & Curtiss, J. (2016). Effect of Hatha yoga on anxiety: A meta-analysis. Journal of Evidence-Based Medicine, 9(3), 116–124. https://doi.org/10.1111/ jebm.12204
- Kanniyan, A. (2015). Isolated and combined effect of brisk walking and yoga training on the physiological parameters of sedentary males. Journal of Human Sport and Exercise, 10(2), S666–S671. https://doi.org/10.14198/jhse.2015.10.Proc2.04
- McIntyre, K. M., Puterman, E., Scodes, J. M., Choo, T. H., Choi, C. J., Pavlicova, M., & Sloan, R. P. (2020). The effects of aerobic train- ing on subclinical negative affect: A randomized controlled trial. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 39(4), 255–264. https://doi.org/10.1037/hea0000836
- National Institute of Mental Health. (2017). Statistics: Any anxiety disorder. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml
- Vollbehr, N. K., Bartels-Velthuis, A. A., Nauta, M. H., Castelein, S., Steenhuis, L. A., Hoenders, H. J., & Ostafin, B. D. (2018). Hatha yoga for acute, chronic and/or treatment-resistant mood and anxiety disorders: A systematic review and meta-analysis. PLOS One, 13(10), e0204925. https://doi.org/10.1371/journal. pone.0204925
- Zoogman, S., Goldberg, S. B., Vousoura, E., Diamond, M. C., & Miller, L. (2019). Effect of yoga-based interventions for anxiety symptoms: A meta-analysis of randomized controlled trials. Spirituality in Clinical Practice, 6(4), 256–278. https://doi.org/10.1037/scp0000202
- https://www.anxietyuk.org.uk/wp-content/uploads/2019/08/Key-Facts-and-Figures-2019.pdf
- Egil W. Martinsen (2008) Physical activity in the prevention and treatment of anxiety and depression, Nordic Journal of Psychiatry, 62:sup47, 25-29, DOI: 10.1080/08039480802315640
