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 Dr. 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. It is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But, drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).
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 that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Another effective alternative treatment is exercise. But it is difficult to get depressed people, who lack energy, to engage in regular exercise. Yoga is a contemplative practice that is both a mindfulness practice and an exercise. It has been shown to be effective in the treatment of depression and even yogic breathing alone has been found to be effective. So, the combination of yoga practice with breathing exercises should be particularly effective.
In today’s Research News article “Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359682/, Streeter and colleagues examine the amount of yoga practice needed to treat depression. They recruited adult patients with major depressive disorder and randomly assigned them to receive either a low or a high dose of Iyengar yoga practice combined with a coherent breathing exercise. Treatment occurred over 12 weeks. The 90-minute practice consisted of 60 minutes of yoga, 10 minutes of relaxation and 20 minutes of breathing exercise. In the low dose condition, there were two 90-minute yoga sessions and 3 60-minute home practices per week for a total of 6 hours of practice per week. In the high dose condition, there were three 90-minute yoga sessions and 4 60-minute home practices per week for a total of 8.5 hours of practice per week. The participants were measured before and after training and during training at weeks 4 and 8 for the presence of mental illness and depression.
They found that as practice continued over the 12 weeks there were systematic significant decreases in depression. But, there were no significant differences between the low and high dose groups. There were no adverse events other than mild muscle soreness. Hence, they found that yoga practice was safe and effective, producing clinically significant reductions in depression regardless of dose. There wasn’t a control condition, so it might be argued that the results were due to confounding conditions. But, the fact that previous research with appropriate controls demonstrated that yoga practice reduces depression makes it highly likely that the reduced depression in the current study was produced by the yoga practice.
It is interesting that there was no difference between the dosing conditions. It might be argued, however, 6 hours of practice per week for 12 weeks is not a low dose. It is possible that this extensive of a practice is all that is necessary to produce maximal effectiveness. It would be useful if future research employed a range of doses including some much smaller than the current low dose. It would also be important to follow-up the results to investigate the long-term effectiveness of the yoga treatment. Regardless, the present study and previous research make it abundantly clear that yoga practice is a safe and effective treatment for major depression.
So, improve major depression with yoga.
“Some people who haven’t responded to traditional treatments might do well with yoga, because unlike antidepressant drugs, yoga and deep breathing target the autonomic nervous system. If your autonomic nervous system is balanced out, then the rest of the brain works better,” – Chris Streeter
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Streeter, C. C., Gerbarg, P. L., Whitfield, T. H., Owen, L., Johnston, J., Silveri, M. M., … Jensen, J. E. (2017). Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study. Journal of Alternative and Complementary Medicine, 23(3), 201–207. http://doi.org/10.1089/acm.2016.0140
Abstract
Objectives: The aims of this study were to assess the effects of an intervention of Iyengar yoga and coherent breathing at five breaths per minute on depressive symptoms and to determine optimal intervention yoga dosing for future studies in individuals with major depressive disorder (MDD).
Methods: Subjects were randomized to the high-dose group (HDG) or low-dose group (LDG) for a 12-week intervention of three or two intervention classes per week, respectively. Eligible subjects were 18–64 years old with MDD, had baseline Beck Depression Inventory-II (BDI-II) scores ≥14, and were either on no antidepressant medications or on a stable dose of antidepressants for ≥3 months. The intervention included 90-min classes plus homework. Outcome measures were BDI-II scores and intervention compliance.
Results: Fifteen HDG (Mage = 38.4 ± 15.1 years) and 15 LDG (Mage = 34.7 ± 10.4 years) subjects completed the intervention. BDI-II scores at screening and compliance did not differ between groups (p = 0.26). BDI-II scores declined significantly from screening (24.6 ± 1.7) to week 12 (6.0 ± 3.8) for the HDG (–18.6 ± 6.6; p < 0.001), and from screening (27.7 ± 2.1) to week 12 (10.1 ± 7.9) in the LDG (–17.7 ± 9.3; p < 0.001). There were no significant differences between groups, based on response (i.e., >50% decrease in BDI-II scores; p = 0.65) for the HDG (13/15 subjects) and LDG (11/15 subjects) or remission (i.e., number of subjects with BDI-II scores <14; p = 1.00) for the HDG (14/15 subjects) and LDG (13/15 subjects) after the 12-week intervention, although a greater number of subjects in the HDG had 12-week BDI-II scores ≤10 (p = 0.04).
Conclusion: During this 12-week intervention of yoga plus coherent breathing, depressive symptoms declined significantly in patients with MDD in both the HDG and LDG. Both groups showed comparable compliance and clinical improvements, with more subjects in the HDG exhibiting BDI-II scores ≤10 at week 12.