Yoga for Mood
Yoga boosts vitality. A vibrancy occurs. A lift happens. The mind clears. The body relaxes and strengthens. We feel on balance, aligned. Anchored. We find home in our bodies.
Yoga for Mood:
Evidence + Theory + Practice
I was recently asked my opinion as to whether a friend's friend, with some mild signs of depression, could benefit from yoga. This inspired the article below.
I often hear how friends or clients with mild issues with anxiety or low mood find that a regular yoga practice prevents their nerves from getting in the way of their life. In psychiatry, anxiety and low mood are not considered disorders unless they prevent you from functioning in your life. So, yoga seems to be preventative, maybe therapeutic, and potentially a useful wellness strategy. But how effective is it?
~ Note: The term "yoga" comprises a vast array of approaches, but is traditionally used in the West to denote the physical practice of the postures, or asana. To clarify, yoga as such is described as "yoga asana" in the writing below. ~
Studies show that, for every person who practices yoga asana, a total of $2360 per year per person is saved in USA health care dollars (1). The authors explain that the reduced cost is due to reduced stress. As many illnesses are made worse by stress, and some caused by stress, the reduction of stress that yoga provides prevents illness onset or increased degree of severity.
For chronic illnesses, yoga has been shown to reduce chronic pain, stress, enhance sleep, and improve overall quality of life, leading to a new field of "Medical Yoga Therapy" (2,3,4).
For mood, we know that mindfulness is effective in depression. Yoga is essentially a form of mindfulness that is deeply embodied. Research has been difficult to randomize as to the efficacy of the physical asana practice of yoga for depression, but there are potentially promising results.
Reported in 1993 by Wood and colleagues, a study compared visualization and relaxation to yoga asana practice in 71 adults. Those practicing yoga asana had significantly greater improvements in mental and physical energy, alertness, enthusiasm, and positive mood (5).
In a pilot study at an inpatient ward in a psychiatric setting, 113 adults improved when practicing Hatha Yoga. They improved based on measurements on the Profile of Mood States. Negative emotion factors decreased in the following realms: tension-anxiety, depression-dejection, anger-hostility, fatigue-inertia, confusion-bewilderment (6).
Numerous other studies have found some efficacy of yoga asana for depression and anxiety. Reduced symptoms and some full remission (remission means recovery as in no longer depressed) in clinically mildly depressed patients were measured on well respected scales such as the Beck Depression Inventory, the HAM-D17, and other scales for anger, anxiety, and sleep (7,8). However, the studies have yet to be randomized, controlled, and blinded according to clinical research guidelines and many studies had to be excluded when looked at for rigorous scientific methodology: 1112 studies were weeded out to find only 9 studies suitable for evidence-based approaches for example (9). However, exercise is supported for mild to moderate depression, and yoga is a form of exercise so could be included in a preventative wellness or recovery regime in alliance with a physician or psychologist.
What is the reason yoga may boost mood, decrease anxiety and stress, and enhance wellness?
The neurobiology of stress is fascinating. I had the honour and pleasure of reading about this in detail last year when three new addiction textbooks came out in the fall of 2016. In preparation for an international certification in addiction medicine, I read about the tiniest detail as to how stress works, how it can fuel addiction, and potential ways to reduce stress. The vulnerability to stress is measured in science as a combination of neuron circuits in the brain, hormones, sleep patterns, emotion regulation, and reactive habits. Mindfulness helps us reduce our immediate reaction. Yoga may help us to reduce this reaction physically. As the body reacts before the mind, as proven through neurobiological studies, yoga may therefore act to reduce stress by accessing the body to shift state, before the mind kicks in.
Patricia Kinser and colleagues consider depression a reaction to stress characterized by withdrawal and learned helplessness (10). She exhaustively reviews the areas of the brain and the chemistry of the brain that is impacted by depression, and how these areas are transformed in yoga asana. For example, she reviews that studies show yoga asana practice results in an increase in GABA, a chemical that brings the brain to relaxation. GABA reduces the numbers of neurons firing, which can reduce cyclical thinking or anxious thinking. Yoga asanas also increase dopamine (the "drive" molecule), norepinephrine (the "alert" and "energized" molecule), and serotonin (the "calm" and "soothe" molecule). So yoga can be a reset tool for your brain!
How does yoga improve overall health and promote longevity?
Kutsevich and Bushell theorize on four key pathways: the effects on the circulation system, the nervous system, cellular exchanges, and bioelectromagnetism. Although they write as to theoretical possibilities, the recognition that yoga may be anti-aging and optimizing is a growing body of literature, important to address as wellness and wellness certification criteria develop over the next few years (11).
Yoga itself is a "science" or method of study that has existed and evolved for over 400 years. As such, yoga practitioners explain the effects of yoga asana in a different language. Some of the words of this other language are: prana, chakra, bandha, kosha, vayus. These words may in part refer to some of the electromagnetic properties of the body, and the "energy" that can be seen and felt by energy workers and medicine people of various traditions; however, we now enter a realm of theoretical discussion as the physics of the body and health has not been empirically reviewed by modern science. Yet contemplation of this area warrants interest as we are electromagnetic in nature. Could yogic principles hold a key to electromagnetic health?
The following are several yoga theories followed by possible scientific correlates, to incite your interest:
Prana is the life force energy. Yogis explain that negative emotions or negative thoughts block the flow of prana, creating physical and mental unrest. Deeply breathing while practicing yoga asana is thought to remove these blockages, by the wave of the breath combined with fascial plane movement unblocking areas of non-flow.
Chakras are energy whorls that match specific areas of the human experience. Basic physical needs, creativity, self agency, relationships, truth, direction and vision, and connection to something greater are some of the areas delineated by the chakras. Chakras are seen by energy workers and medicine people as funnels extending from areas along the spine outside of the human form. Some researchers have measured electromagnetic changes at chakra locations but this is not yet formally researched and published. As with prana, these energy centres can be too weak and small or too large and expansive, or running too slowly or blocked or hyperactive. Scientifically, the chakras align with concentration of nerves and/or endocrine glands, and thus are an ancient map for your neuroendocrine system. Yoga is thought to balance the chakras, and thus balance mood as part of the balancing of the overall human body, mind, and psyche.
The bandhas, koshas, and vayus, speak to other areas of the subtle energy body described in yoga. In sensing and understanding these, the yoga philosophy presents that, not only can the physical poses of yoga be enhanced and advanced, but also the mental abilities of the practitioners. The koshas and vayus speak to layers of the human energy field that can also be in balance and flowing smoothly, or not. So, yogis explain that reseting these areas into balance can stabilize mood and mind.
A scientific approach explains the human energy field through physics. Basically, your human body is composed of particles that vibrate, and the vibration creates an electromagnetic field. The field changes when psychological or emotional energies, travelling as neuronal impulses, move through your body (12).
Srinivasan of a Yoga University in India writes as to the known electromagnetic properties of the body, and the physics that could explain some yoga theories on energy (13). He also posits that the subtle energy yogis describe can't be measured by current scientific instruments. Joseph Loizzo reviews that the Tibetan and Indian system of chakras corresponds as maps to the nervous system, with correlates to the neuroendocrine system. As such, yoga may be a practice for balancing the nervous and endocrine system (14).
On a practical note for physicians, Adam Rindfleisch of the University School of Medicine and Public Health speaks to patients choosing energy medicine in addition to primary care, and the associated research to date, possible mechanisms of action, and how to talk with patients about this mode of care (14).
Certainly, our biological understanding of health and wellness has not ventured as far into the realm of physics and electromagnetism as has our technological development. People extensively trained in physics and technology are now taking an interest in human health, and as to how their disciplines may add to greater understanding and perhaps even cure of diseases currently understood as chronic. In the era when electric cars are finally being produced for regular use, perhaps it is time for a more physics-based understanding of wellness and health.
If you are interested to experiment with the possible benefits of yoga asana, below is a simple approach to using yogic principles to guide a brief practice. Try it, as far as is safe and relaxing for you, and notice if you do feel different with respect to overall mood, mental clarity, relaxation, and energy. Or not.
An invitation to practice:
All yoga practice starts with intention. A key foundation to practice is Patanjali's quote or sutra that identifies much of our experience as fluctuations in the mind, that are interpretations of reality, rather than pure reality:
Yoga means to unite, chitta refers to the mind, vritti to the fluctuating and changing nature of the mind, and nirodha to the stilling or quieting of the fluctuations. So through yoga, you can quiet the mind.
For a low mood or the unsettled thoughts of anxiety, the intention from this sutra is to note that the mind keeps changing, like constant waves on a sea. Each wave is different. We can choose to catch the wave of thought, or not. So, the negative thoughts are just series of one kind of wave, but not the ocean of possible experience. Or, the anxious thoughts are simply waves rippling across the water, but not the water itself. The idea is to bring the attention back to the water, the ocean, the breath, the movement of the body, and to cultivate in this space a curiousity to discover the intrinsic happiness of simple pure existence. And to invite stillness. Much like a mindfulness practice.
Through this focus, you may reset the frequency and quality of neuronal impulses that travel through your body. By bringing the mind back to the "ocean" or stillness, you set up a different nervous system state.
Focus on the Breath:
A breathing practice is a common next step in a yoga asana class or home practice. The focus on breath engages the parasympathetic nervous system which relaxes us, and can also bring the mind into a state of "alpha brain waves" or daydreaming, thus out of the excess "beta brain waves" of low mood and anxiety. However, for some people, a focus on breathing can be unbearable, and becoming more aware of the body can also be terrifying, thus the breath and asana postures of yoga would not be suited. If a breathing focus does suit you, try engaging a deep breath that includes movement of the diaphragm, so you trigger the vagus nerve and involve the relaxation part of the nervous system through a simple mechanical trigger.
After the focus on breathing, the asana / postures help invite the body into a state of more flow. Postures suggested by yoga principles for mood rebalancing include cat-cow and other moving postures that flex the spine. There is quite an array of asana suggested on the Yoga Journal site (for those who can enter the poses safely and without injury): butterfly, bridge, savasana, puppy, feathered peacock, firelog, handstand, legs up the wall, forward bends, wheel and wild thing. I am not aware of any specific evidence-based research as to the poses for depression, and certainly think it best to work with a medical doctor when dealing with an actual disorder that impacts function. However, for those without disorder and a wellness focus, you may enjoy practicing these poses once daily if you can do so safely, and see if there is a balancing in mood over the course of 1 to 2 weeks, as your own personal experiment.
Mudras are less commonly known in popular yoga. Ancient texts describe the mudras, which is a word usually meant to identify specific hand positions, as powerful ways to run energy through the body for benefit. The mudras suggested for preventing low mood are (1) the "blues banishing gesture" and (2) "crocodile gesture".
The "blues banishing gesture" is also known as pitta-energizing, and believed to help when you perceive something or someone as preventing or limiting, or when an opportunity is missed, or there is loss. The right underside of the thumb touches the left side of the ring fingernail and the right index finger touches the middle joint of the thumb. The left thumb tip and little finger tip touch. A book on mudras by Swami Saradananda recommends this mudra be held for three minutes, two times a day with at least 25 minutes between each mudra hold.
The "crocodile gesture" or Mukara Mudra is based on the character of a crocodile to sit still for long periods of times, and then pounce forward with sudden lightning speed. As such, this mudra is believed to help you access and unleash your own potent energy reserves. It is also believed to calm, bring serenity, reduce bags under the eyes, and strengthen the kidneys. To do the mudra, join your left thumb tip and ring finger. Bring your right thumb between the left ring and little finger and then place the right thumb tip on the base of the left thumb. Place the right palm flat against the back of the left hand. Hold for 5-10 minutes three times a day.
Summary for practice:
Set aside 30 minutes per day in a clean space in which you can practice yoga and meditation in your home. For each 30 minutes, try the following as an experiment to see how you can create your optimal wellness with yoga asana, and find the flame of you, the fire, the energy of your essence:
- Focus on breath
- Asana poses
- Intention: set an intention to see thoughts or emotions as simply superficial waves and be curious if you can sense an infinite source of bliss inherent in your very cells of your body; simply be curious and then notice, moment to moment, what you sense.
- Focus on breath: with movement or while sitting still, play with how long and deep you can breathe, how far deeply into your lungs, how much of the body can be involved in the breathing, keep your eyes open and find a pattern of breath that calms you. If you can close your eyes and stay calm, try increasing the perception of breathing by closing the eyes. You can try the deep breathing in cat cow, or standing with your arms moving overhead and then coming down.
- Like: set an intention to also discover what it is that you enjoy about being you, the experience about being human, what you like about you, even what you love about who you are. See if you can feel that appreciation for who you are in the centre of your heart, thus incorporating some wisdom from heart math that is both physically and emotionally beneficial.
- Asana poses: move through the poses that you know and can safely do, from the selection of the following poses: butterfly, bridge, savasana, puppy, feathered peacock, firelog, handstand, legs up the wall, forward bends, wheel and wild thing. Do so in a sequence that makes sense to your body. If the inversions are part of your safe and knowledgeable practice (only practice these if you have been taught how to do so safely by an instructor), be aware that they increase energy, so do these in the morning. If done before bed, inversions can cause insomnia.
- Mudra: hold each of the blues banishing and crocodile mudras for 3 minutes each. Notice if you feel any changes in your body, in the physical structure, or in the energy of your body.
- Enhance: take a moment of meditation at the end to enhance your experience by giving space to reflect. Either seated comfortably, or lying down in savasana, let the breathing become natural and not directed by you, and simply notice how the mind body feels. You may notice currents of energy in the body, or flows over the surface of the skin. Be curious. Accept your self deeply with honour an integrity, moment to moment. Notice if there is anything about simply being alive that you can savour like the pause you feel as you watch a beautiful sunset evolve, or that you can feel grateful for, or enjoy. Cultivate enjoyment.
1. Stahl et al, 2015. Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization. In: PLOS one. Author location: Massachusetts General Hospital. Also described in the Huffington Post.
2. Woodyard 2011. Exploring the therapeutic effects of yoga and its ability to increase quality of life. In: Int Journal Yoga. Author location: University of Mississippi.
3. Balaji et al, 2012. Physiological effects of yogic practices and transcendental meditation in health and disease. In: N Am J Med Sci. Author location: Bangalore, India.
4. Stephens, 2017. Medical Yoga Therapy. In: Children (Basel). Author location: University of Virginia Medical Centre.
5. Wood 1993. Mood change and perceptions of vitality: A comparison of the effects of relaxation, visualization, and yoga. In: Journal of the Royal Society of Medicine. Author location: University of Oxford.
6. Lavey et al, 2005. The effects of yoga on mood in psychiatric inpatients. In: Psychiatric Rehabilitation Journal. Author location: New Hampshire Hospital, USA.
7. Woolery et al, 2004. A yoga intervention for young adults with elevated symptoms of depression. In: Altern Ther Health Med. Author location: UCLA.
8. Shapiro et al, 2007. Yoga as a complimentary treatment of depression: Effects of traits and moods on treatment outcome. In: Evid Based Alt Complementary Med. Location: authors from UCLA, Russia, Italy.
9. Duan-Porter et al, 2016. Evidence Map of Yoga for Depression, Anxiety, and Posttraumatic Stress Disorder. In: J Phys Act Health. Author location: Durham VA Medical Centre.
10. Kinser et al, 2012. How Might Yoga Help Depression? A Neurobiological Perspective. In: Explore. Author location: University of Virginia.
11. Kuntsevich et al, 2010. Mechanisms of yogic practices in health, aging, and disease. In: Mt Sinai J Med. Author location: Beth Israel Medical Center of Albert Einstein College of Medicine, New York, NY
12. Prakash et al, 2015. Monitoring the Human Health by Measuring the Biofield "Aura": An Overview. In: International Journal of Applied Engineering Research. Author location: Goenka University, India.
13. Srinivasan 2010. Opinion piece. Energy medicine. In: Int J Yoga. Author location: Bangalore, India.
14. Loizzo 2014. Opinion piece. Meditation research, past, present, and future: perspectives from the Nalanda contemplative science tradition. In: Ann N Y Acad Sci. Author location: Center for Integrative Medicine, Weill Cornell Medical College, New York.
15. Rindfleisch 2010. Biofield therapies: energy medicine and primary care. In: Prim Care. Author location: University of Wisconsin School of Medicine and Public Health