- Depression and Yoga Therapy
- Depression: A Background
- Why Use Yoga as a Adjunct Treatment for Depression?
A complex illness which has a profound societal impact, depression is thought to be caused by an intricate variety of genetic, biochemical, psychological and circumstantial factors. Within a wider treatment plan, yoga for depression is a multidimensional response to this multidimensional illness.
According to the World Health Organisation (WHO), by 2030 depression will be leading cause of disability worldwide. At the time of writing, it is the predominant mental health problem, followed by anxiety, schizophrenia and bipolar disorder – as well as being the 10th leading cause of early death.
Sadness is an inevitable part of life and we all face times where we find it difficult to take pleasure in daily activities. The experience of depression, however, goes beyond normal fluctuations in mood and can negatively impact an individual’s personal, social and professional life.
Depression and Yoga Therapy
“If your autonomic nervous system is balanced out, then the rest of the brain works better”
Dr. Chris Streeter, associate professor of psychiatry and neurology at Boston University School of Medicine
Anyone who has been diagnosed with depression will meet diagnostic criteria, sharing commonalities with others who suffer
The experience of depression varies from individual to individual. Depression can develop the wake of difficult circumstances, or it may have no definable cause. Similarly, the illness may last for months, or appear intermittently over the course of decades. Symptoms can also manifest themselves in varying ways – for example, one person might be affected by a draining and persistent sense of sadness, but another may experience emotional numbness and lack of interest in life.
Medication is, for many people, a vital and sometimes life-saving intervention, and doctors will often also recommend counselling or other psychological therapies. Yoga therapy offers an additional treatment which can be adapted to the individual needs of the patient, while also empowering them with a tool they can immediately take into their everyday life. This is particularly pertinent considering that people can sometimes wait months for access to talking therapies.
An estimated 10 – 30% of people diagnosed with depression are treatment resistant, defined in the NICE guidelines as people who have not responded to courses of two different antidepressants. In cases such as these, yoga therapy can step into the gap and provide support while an appropriate pharmaceutical response is found.
Depression: A Background
Clinical depression be expressed through a variety of symptoms, which include:
- Persistent low mood and sadness.
- Feelings of hopelessness.
- Suicide ideation and thoughts of self-harm.
- Lack of motivation, tiredness and loss of interest in life.
- Weight gain or weight loss.
- Loss of pleasure in activities that were previously enjoyed.
It is very hard to explain to people who have never known serious depression or anxiety the sheer continuous intensity of it. There is no off switch.
Matt Haig, bestselling author.
These symptoms often reflect in social ramifications for patients, including the avoidance of occasions with friends and family, poor professional performance and no longer taking part in hobbies. Sometimes, depression can occur through a “downward spiral” of events, where an initial misfortune triggers a sequence of actions and emotions which contribute to the eventual development of clinical depression. For example, someone losing touch with friends and becoming isolated after a divorce.
Chronic illness, bereavement and job redundancy are other triggers for depression, but some cases, the reasons why someone may have developed the illness are less clear. Gender, social circumstances, drug/alcohol use and whether a person has a family history of mental illness can all increase a person’s vulnerability to depression – and a chemical imbalance of key neurotransmitters is the theorised, if unproven, physical cause.
While doctors may follow a “wait and see” approach (and recommend self-help) for mild depression, frontline treatment for moderate to severe depression – where the illness is having a significant impact on a person’s ability to function – includes antidepressants and talking therapies. There are almost 30 types of antidepressant, but patients are most likely to be prescribed an selective serotonin reuptake inhibitor (SSRI) and they may also be referred for counselling or cognitive behavioural therapy.
Why Use Yoga as a Adjunct Treatment for Depression?
Depression is such a varied and complex illness that a “one size fits all” approach is unlikely to be fully effective for a significant proportion of patients. People with depression often have to weigh up the benefits of antidepressants with their well-reported side effects. Unfortunately, the fact that depression is still far from being entirely understood means that there is no perfect solution.
Within the context of pharmaceutical and other therapeutic remedies, yoga therapy can assist people in symptom management and recovery – and in cases of mild depression, it can be their primary self-help tool which prevents their symptoms from worsening.
“Yoga-based interventions have promise as an intervention for depressed mood and that they are feasible for patients with chronic, treatment-resistant depression”
Nina Vollbehr, MS, of the Center for Integrative Psychiatry in the Netherlands
People with depression exhibit elevated levels of cortisol, which is related to brain changes in the hippocampus, prefrontal cortex and amygdala. While the hippocampus and prefrontal cortex (which are involved in emotion regulation, memory forming and decision making) appear to lose volume, the amygdala (responsible for our fear and stress response) becomes enlarged and more active (1). Known as the “stress hormone”, those with depression exhibit greater cortisol levels at all points during the day than people without depression.
Studies have demonstrated reduced levels of cortisol in those who practice yoga (2). It’s thought that the breathing exercises that are a key part of yoga induce the body’s relaxation response, and mindfulness meditation (another aspect of yoga) is also associated with lowering cortisol in study subjects (3) as well as reductions in the size of the amygdala (4). In one study, participants exhibited lower cortisol levels immediately after a yoga class – which suggests the effect isn’t confined to long-term practice.
Depression also appears to be linked to reduced levels of certain GABA neurotransmitters, with “increasing evidence points to an association between major depressive disorders (MDDs) and diverse types of GABAergic deficits.” (5) A 12-week yoga intervention found greater improvements in mood than a metabolically matched walking exercise, and also was “the first time that yoga postures have been associated with a positive correlation between acute increases in thalamic GABA levels”. (6)
One promising study showed a reduction in suicide ideation (7) for people suffering
Another benefit of yoga is that it offers a form of exercise to people living with or prone to depression. The efficacy of exercise for decreasing symptoms of depression has been well established (8) and given that depression is known to drain motivation, yoga can offer a gentle and enjoyable way to begin
This is important for people living with depression, as feelings of worthlessness and self-blame might be a barrier to physical activity. Another barrier is the experience of depression itself. When someone is suffering
To find out more about the science behind yoga for depression, order your copy of Yoga for Mental Health. If you are a health, psychological or yoga professional you can also explore our upcoming CPD courses to discover options for further training. For those experiencing depression and who are interested in working with a yoga therapist, please see our Minded Clinic.