Reduce Medical Student’s Stress Response with Yoga
By John M. de Castro, Ph.D.
“By reducing perceived stress and anxiety, yoga appears to modulate stress response systems. This, in turn, decreases physiological arousal — for example, reducing the heart rate, lowering blood pressure, and easing respiration.” – Harvard Mental Health Letter
Medical School is challenging both intellectually and psychologically. Stress levels are high and burnout is common. It’s been estimated that 63% of medical students experience negative consequences from stress while symptoms of severe stress were present in 25% of students. The prevalence of stress is higher among females than among males. High stress levels lead to lower performance in medical school and higher levels of physical and mental health problems, especially anxiety and depression. Indeed 50% of medical students report burnout and 11% have considered suicide in the last year.
Obviously, there is a need to either lower stress levels in medical education or find methods to assist medical students in dealing with the stress. One promising possibility is mindfulness training. It has been shown to reduce both the psychological and physiological responses to stress. It has also been shown to reduce stress in students, to help with the negative consequences of stress, and to reduce burnout in medical professionals. So, it would seem reasonable to suspect that mindfulness would be helpful in assisting medical students cope with the stress of their training.
Yoga practice is a mindfulness technique that has been found to have extensive physical and psychological benefits and has the additional benefit of being also a physical exercise. This may be particularly beneficial for stressed medical students. In today’s Research News article “Medical Students’ Stress Levels and Sense of Well Being after Six Weeks of Yoga and Meditation.” See summary below or view the full text of the study at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174168/
Prasad and colleagues recruited male and female medical students who did not practice yoga. The participants attended a one hour Hatha yoga class, twice a week, for six weeks. They were measured before and after training for perceived stress, happiness, peace, focus, endurance, positivity, personal satisfaction, self-confidence, patience, and fatigue.
They found that after the yoga practice there was a significant reduction in perceived stress and significant increases in peace, focus, and endurance. In addition, there were no adverse effects and the students were very positive about participation. Hence, they found that after yoga practice there was significant improvement in the medical students’ stress levels and psychological state.
This study is a pilot, proof of concept study, that did not include a control condition. So, conclusions need to be tempered. Without an active control condition a large number of confounding factors, including placebo effects, attention effects, experimenter bias, maturation effects, etc., are potential explanations for the significant improvements. The study, though is encouraging and provides evidence supporting conducting a large randomized controlled clinical trial of the effectiveness of yoga for the treatment of stress in medical students.
“The science is now in: practice in mindfulness meditation decreases stress and can help you avoid the negative outcomes of burnout and loss of empathy. Mindfulness practice can also help you study more efficiently and retain more information from class lectures. It can increase your quality of life and, in some people, it protects against depression. And of all of these effects are founded upon changes in basic brain structures and function. “ – Brown University School of Medicine
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Prasad, L., Varrey, A., & Sisti, G. (2016). Medical Students’ Stress Levels and Sense of Well Being after Six Weeks of Yoga and Meditation. Evidence-Based Complementary and Alternative Medicine : eCAM, 2016, 9251849. http://doi.org/10.1155/2016/9251849
Abstract
Objective. To determine the effect of six weeks of yoga and meditation on medical students’ levels of perceived stress and sense of wellbeing prior to taking their exams. Methods. We conducted a prospective case-control study of first-through-third-year medical students at our academic institution, measuring levels of perceived stress and sense of wellbeing before and after a six-week yoga and meditation intervention. Questionnaires used for evaluation included the perceived stress scale (PSS) and self-assessment surveys (SAS). The postintervention surveys were completed on the day of the students’ written exams. Results. A total of thirteen women and fourteen men participated. Median age was 28 (24 yrs–32 yrs). 48.1% were Caucasian, 7.4% Black, 11.1% Hispanic, 11.1% Asian, and 22.2% other. Paired t-tests showed a statistically significant reduction in perceived stress (18.44 versus 14.52; p = 0.004) after the six-week yoga and meditation program. After the yoga intervention, self-assessment survey results showed a significant improvement in feelings of peace, focus, and endurance. Improvements in happiness, positivity, personal satisfaction, and self-confidence were also seen. An improvement in unsubstantiated parameters such as patience and fatigue was observed. Conclusion. Yoga and meditation may be effective in reducing stress levels and improving aspects of personal wellbeing in medical students.