Improve Major depression with Yoga
By John M. de Castro, Ph.D.
“Yoga gives us an active role in healing. And by slowing down mental chatter through breath work, it helps facilitate self-acceptance. In other words, through practicing yoga, we become quieter and more grounded. Yoga can help perfectionists as well as those who tend to be self-critical or lack self-confidence,” – Janeen Locker
Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression. Depression can be difficult to treat and usually treated with anti-depressive medication. But, of patients treated initially with antidepressant drugs only about a third attained remission of the depression. After repeated and varied treatments including antidepressant drugs, therapy, exercise etc. only about two thirds of patients attained remission. Also, many patients who achieve remission have relapses and recurrences of the depression. In addition, antidepressant drugs often have troubling side effects and can lose effectiveness over time.
Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified. Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. Aerobic exercise has also been found to relieve depression. Yoga practice in many ways is ideal as it is both a mindfulness practice and an exercise and it can be practiced in groups or individually at home. It has also been shown to reduce depression.
In today’s Research News article “Treating major depression with yoga: A prospective, randomized, controlled pilot trial.” See summary below or view the full text of the study at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354384/
Prathikanti and colleagues recruited patients with mild to moderate major depression who were not currently taking anti-depressive medications and randomly assigned them to receive 8 weeks of either 90 minutes twice weekly of Hatha yoga practice or a wait list control that received 90 minutes twice weekly of education on the history of yoga. The participants were measured before during, and after treatment for depression, cognitive ability, psychiatric symptoms, self-efficacy, and self-esteem. They found that the yoga group had a significantly greater decline in depression and increase in self-esteem than the education control group and 60% of the yoga group, compared to 10% of the education group, achieved clinical remission of depression. No adverse effects were reported.
The results of this randomized controlled clinical trial suggest that yoga practice is safe and effective in relieving depression when used as the sole treatment. The fact that 60% of the yoga practice participants achieved clinically significant remission of their depression is particularly heartening. Unfortunately, this was a pilot study and no follow up measurements were taken, so it cannot be determined whether the effects endure. Regardless, it appears that yoga can be successfully applied as a monotherapy for mild to moderate major depression.
So, improve major depression with yoga.
“Available reviews of a wide range of yoga practices suggest they can reduce the impact of exaggerated stress responses and may be helpful for both anxiety and depression. In this respect, yoga functions like other self-soothing techniques, such as meditation, relaxation, exercise, or even socializing with friends.” – Harvard Mental Health Letter
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Prathikanti, S., Rivera, R., Cochran, A., Tungol, J. G., Fayazmanesh, N., & Weinmann, E. (2017). Treating major depression with yoga: A prospective, randomized, controlled pilot trial. PLoS ONE, 12(3), e0173869. http://doi.org/10.1371/journal.pone.0173869
Abstract
Background
Conventional pharmacotherapies and psychotherapies for major depression are associated with limited adherence to care and relatively low remission rates. Yoga may offer an alternative treatment option, but rigorous studies are few. This randomized controlled trial with blinded outcome assessors examined an 8-week hatha yoga intervention as mono-therapy for mild-to-moderate major depression.
Methods
Investigators recruited 38 adults in San Francisco meeting criteria for major depression of mild-to-moderate severity, per structured psychiatric interview and scores of 14–28 on Beck Depression Inventory-II (BDI). At screening, individuals engaged in psychotherapy, antidepressant pharmacotherapy, herbal or nutraceutical mood therapies, or mind-body practices were excluded. Participants were 68% female, with mean age 43.4 years (SD = 14.8, range = 22–72), and mean BDI score 22.4 (SD = 4.5). Twenty participants were randomized to 90-minute hatha yoga practice groups twice weekly for 8 weeks. Eighteen participants were randomized to 90-minute attention control education groups twice weekly for 8 weeks. Certified yoga instructors delivered both interventions at a university clinic. Primary outcome was depression severity, measured by BDI scores every 2 weeks from baseline to 8 weeks. Secondary outcomes were self-efficacy and self-esteem, measured by scores on the General Self-Efficacy Scale (GSES) and Rosenberg Self-Esteem Scale (RSES) at baseline and at 8 weeks.
Results
In intent-to-treat analysis, yoga participants exhibited significantly greater 8-week decline in BDI scores than controls (p-value = 0.034). In sub-analyses of participants completing final 8-week measures, yoga participants were more likely to achieve remission, defined per final BDI score ≤ 9 (p-value = 0.018). Effect size of yoga in reducing BDI scores was large, per Cohen’s d = -0.96 [95%CI, -1.81 to -0.12]. Intervention groups did not differ significantly in 8-week change scores for either the GSES or RSES.
Conclusion
In adults with mild-to-moderate major depression, an 8-week hatha yoga intervention resulted in statistically and clinically significant reductions in depression severity.