Abstract
Yoga is an ancient mind-body philosophy from the East, commonly associated in the West with physical postures (asana), breath work (pranayama), and meditation. Empirical research has found generally positive effects, with yoga practice and interventions associated with reduced symptoms of depression. This article provides a brief introduction to yoga philosophy and an overview of the current empirical support for yoga as a treatment for depression. Yoga as a monotherapy versus treatment augmentation strategy, as well as potential physiological mechanisms of action and transdiagnostic use, are briefly addressed. Clinical considerations are also discussed from the perspective of the mental health clinician. [Psychiatr Ann. 2019;49(1):11–15.]
- 1.Birdee GS, Legedza AT, Saper RB, Bertisch SM, Eisenberg DM, Phillips RS. Characteristics of yoga users: results of a national survey. J Gen Intern Med.2008; 23(10):1653–1658. doi:.
10.1007/s11606-008-0735-5 Crossref, Google Scholar - 2.Sanacora G, Mason GF, Rothman DL, Reduced cortical gamma-aminobutyric acid levels in depressed patients determined by proton magnetic resonance spectroscopy. Arch Gen Psychiatry. 1999; 56(11):1043–1047.
10.1001/archpsyc.56.11.1043 Crossref, Google Scholar - 3.Gates R, Kenison K. Meditations from the Mat: Daily Reflections on the Path of Yoga. New York, NY: Anchor Books; 2002. Google Scholar
- 4.Bryant EF. The Yoga Sutras of Patanjali. New York, NY: North Point Press; 2009. Google Scholar
- 5.Uebelacker LA, Broughton MK. Yoga for depression and anxiety: a review of published research and implications for healthcare providers. R I Med J. 2016; 99(3):20–22. Google Scholar
- 6.Nyer M, Nauphal M, Roberg R, Streeter C. Applications of yoga in psychiatry: what we know. FOCUS. 2018; 16(1):12–18. doi:.
10.1176/appi.focus.20170055 Crossref, Google Scholar - 7.Cramer H, Anheyer D, Lauche R, Dobos G. A systematic review of yoga for major depressive disorder. J Affect Disord. 2017; 213:70–77. doi:.
10.1016/j.jad.2017.02.006 Crossref, Google Scholar - 8.Nyer M, Roberg R, Nauphal M, Streeter CC. Yoga as a treatment for depression. In: , eds. The Massachusetts General Hospital Guide to Depression. New Treatment Insights and Options. New York, NY: Springer; 2018:223–231. Google Scholar
- 9.Chu I-H, Wu W-L, Lin I-M, Chang Y-K, Lin Y-J, Yang P-C. Effects of yoga on heart rate variability and depressive symptoms in women: a randomized controlled trial. J Altern Complement Med. 2017; 23(4):310–316. doi:.
10.1089/acm.2016.0135 Crossref, Google Scholar - 10.Prathikanti S, Rivera R, Cochran A, Tungol JG, Fayazmanesh N, Weinmann E. Treating major depression with yoga: a prospective, randomized, controlled pilot trial. PLoS ONE. 2017; 12(3). doi:.
10.1371/journal.pone.0173869 Crossref, Google Scholar - 11.Streeter CC, Gerbarg PL, Whitfield TH, Treatment of major depressive disorder with Iyengar yoga and coherent breathing: a randomized controlled dosing study. J Altern Complement Med. 2017; 23(3):201–207. doi:.
10.1089/acm.2016.0140 Crossref, Google Scholar - 12.Uebelacker LA, Tremont G, Gillette LT, Adjunctive yoga v. health education for persistent major depression: a randomized controlled trial. Psychol Med. 2017; 47(12):2130–2142. doi:.
10.1017/S0033291717000575 Crossref, Google Scholar - 13.Janakiramaiah N, Gangadhar BN, Murthy PJNV, Harish MG, Subbakrishna DK, Vedamurthachar A. Antidepressant efficacy of Sudarshan Kriya yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine. J Affect Disord. 2000; 57(1):255–259. doi:.
10.1016/S0165-0327(99)00079-8 Crossref, Google Scholar - 14.Hopkins LB, Medina JL, Baird SO, Rosenfield D, Powers MB, Smits JAJ. Heated hatha yoga to target cortisol reactivity to stress and affective eating in women at risk for obesity-related illnesses: a randomized controlled trial. J Consult Clin Psychol. 2016; 84(6):558–564. doi:.
10.1037/ccp0000091 Crossref, Google Scholar - 15.Hewett ZL, Pumpa KL, Smith CA, Fahey PP, Cheema BS. Effect of a 16-week Bikram yoga program on perceived stress, self-efficacy and health-related quality of life in stressed and sedentary adults: a randomised controlled trial. J Sci Med Sport.2018; 21(4):352–357. doi:.
10.1016/j.jsams.2017.08.006 Crossref, Google Scholar - 16.Janssen CW, Lowry CA, Mehl MR, Whole-body hyperthermia for the treatment of major depressive disorder: a randomized clinical trial. JAMA Psychiatry.2016; 73(8):789–795. doi:.
10.1001/jamapsychiatry.2016.1031 Crossref, Google Scholar - 17.Streeter CC, Gerbarg PL, Saper RB, Ciraulo DA, Brown RP. Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses. 2012; 78(5):571–579. doi:.
10.1016/j.mehy.2012.01.021 Crossref, Google Scholar - 18.Cramer H, Lauche R, Anheyer D, Yoga for anxiety: a systematic review and meta-analysis of randomized controlled trials. Depress Anxiety. 2018; 35(9):830–843. doi:.
10.1002/da.22762 Crossref, Google Scholar - 19.Streeter CC, Whitfield TH, Owen L, Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. J Altern Complement Med. 2010; 16(11):1145–1152. doi:.
10.1089/acm.2010.0007 Crossref, Google Scholar - 20.Streeter CC, Gerbarg PL, Nielsen GH, Brown R, Jensen JE, Silveri MM. Effects of yoga on thalamic gamma-aminobutyric acid, mood and depression: analysis of two randomized controlled trials. J Neuropsychiatry. 2018; in press. Google Scholar
- 21.Herbert J. Cortisol and depression: three questions for psychiatry. Psychol Med.2013; 43(3):449–469.
10.1017/S0033291712000955 Crossref, Google Scholar - 22.Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: a meta-analysis. Psychoneuroendocrinology. 2017; 86:152–168. doi:.
10.1016/j.psyneuen.2017.08.008 Crossref, Google Scholar - 23.Lewis BA, Williams DM, Frayeh AL, Marcus BH. Self-Efficacy versus perceived enjoyment as predictors of physical activity behavior. Psychol Health. 2016; 31(4):456–469. doi:.
10.1080/08870446.2015.1111372 Crossref, Google Scholar - 24.Saper RB, Eisenberg DM, Davis RB, Culpepper L, Phillips RS. Prevalence and patterns of adult yoga use in the United States: results of a national survey. Altern Ther Health Med.2004; 10(2):44–49. Google Scholar
- 25.Cramer H, Lauche R, Langhorst J, Dobos G. Yoga for depression: a systematic review and meta-analysis. Depress Anxiety. 2013; 30(11):1068–1083. doi:.
10.1002/da.22166 Crossref, Google Scholar - 26.Uebelacker L, Dufour SC, Dinerman JG, Examining the feasibility and acceptability of an online yoga class for mood disorders: a Mood Network study. J Psychiatr Pract. 2018; 24(1):60–67.
10.1097/PRA.0000000000000286 . Crossref, Google Scholar - 27.Nyer M, Gerbarg PL, Silveri MM, A randomized controlled dosing study of Iyengar yoga and coherent breathing for the treatment of major depressive disorder: impact on suicidal ideation and safety findings. Complement Ther Med. 2018; 37:136–142. doi:.
10.1016/j.ctim.2018.02.006 Crossref, Google Scholar - 28.Cramer H, Ward L, Saper R, Fishbein D, Dobos G, Lauche R. The safety of yoga: a systematic review and meta-analysis of randomized controlled trials. Am J Epidemiol. 2015; 182(4):281–293. doi:.
10.1093/aje/kwv071 Crossref, Google Scholar - 29.Sweeney M. Ashtanga Yoga As It IS. 3rd ed. revised. Berkeley Vale, NSW, Australia: The Yoga Temple; 2006. Google Scholar
- 30.Jois SKP. Yoga Mala: The Original Teachings of Ashtanga Yoga Master Sri K. Pattabhi Jois. London, UK: Macmillan; 2010. Google Scholar
- 31.Mehta S, Mehta M, Mehta S. Yoga: The Iyengar Way. A.A. New York, NY: Knopf; 1990. Google Scholar
- 32.Ramaswami S. The Complete Book of Vinyasa Yoga: The Authoritative Presentation-Based on 30 Years of Direct Study Under the Legendary Yoga Teacher Krishnamacha. Boston, MA: Da Capo Press; 2005. Google Scholar
- 33.Zope SA, Zope RA. Sudarshan kriya yoga: breathing for health. Int J Yoga. 2013; 6(1):4–10.
10.4103/0973-6131.105935 Crossref, Google Scholar - 34.Choudhury B. Bikram Yoga: The Guru Behind Hot Yoga Shows the Way to Radiant Health and Personal Fulfillment. New York, NY: Harper CollinsPublishing; 2017. Google Scholar
- 35.Baptiste B. 40 Days to Personal Revolution: A Breakthrough Program to Radically Change Your Body and Awaken the Sacred Within Your Soul. New York, NY: Simon and Schuster; 2011. Google Scholar