Using Yoga as an Adjunct in the Treatment of Depression
The Eight Limbs of Yoga
Although the teacher might not talk about it much in your yoga class down at the gym, yoga is an 8 "limbed" or 8 step practice. The physical stretching and holding postures, called asanas, is only one limb (or 12.5%, to be mathematical about it) of the overall practice. The others are
Yamas and Niyamas. Taken together, this set of ten suggestions for how to live life are somewhat like the yoga "ten commandments." They include nonviolence (or an ethic of doing no harm), telling the truth, not stealing, not cheating on your partner, not coveting what other people have, focusing on yourself and being willing to be self critical, seeking growth and spiritual development with a burning passion, and being willing to lay your actions at the feet of God. There are a few more, but that should give you a general flavor for what the ethical practices underlying yoga are all about.
- Asanas. These physical positions are the heart of any yoga class in the US. Asanas are the named poses that you bend and stretch into at various speeds and intensities.
- Pranayama. At the beginning and end of most yoga classes, the teacher will guide you through some intentional ways of breathing. These breathing exercises are called pranayama.
- Pratyahara. This is an interesting practice involving closing off the senses (i.e. closing your eyes and using tools to also close off your ears and nose) to help you "go inward" comparable to being in a sensory deprivation tank.
- Dharana. This specific type of meditation involves focus and concentration (for example, focusing on an image or a word).
- Dhyana. Intense meditation.
- Samadhi. This is the ultimate "point" of practicing yoga. Loosely translated as union with everything, this is the perfection that all the prior "limbs' prepare you for.
Yoga for Depression?
Time for the "so what" question: yoga is a holistic practice that involves your ethical choices as well as your backbends and headstands. How can this help with depression? Focusing upon the mental, or cognitive aspects of depression, yoga can help by shifting away from self critical or negative thoughts. Cognitive behavioral therapy (CBT) is a well- respected treatment approach to many mental illnesses, depression and anxiety topping that list. A yoga practice can work much like CBT, as part of the practice of yoga includes the self-awareness to notice your thoughts, and then the meditative practice of letting them go. During a yoga class, the teacher will invite, remind, and support this noticing and letting go, thus helping and guiding you to be more fully in the moment and the breath. The longer you stay present in the moment, allowing your breath to fill your awareness, the more refreshed and relaxed you feel. It is a bit like taking a vacation from the depression, and offers your mind and body a different way of thinking and feeling. Over time, you learn this new way of being (being in the moment, instead of being "in your head") and it becomes a habit.
In terms of the physical aspect of yoga, many psychiatrists prescribe physical activity for those being treated for depression. Exercise increases circulation and stimulates functioning of all the organ systems. This can improve your response to antidepressant medication, as well as stimulate the production of mood-elevating hormones. Walking is a common form of exercise, but for some the idea of getting dressed and leaving the house is too challenging. When depression is severe, getting out of bed may feel impossible, and taking a walk or a visit to the gym is a distant goal. Yoga can be practiced at home, and some postures and breathing exercises can be adapted to be performed while lying in bed. Thus yoga can meet a person struggling with depression "where they are at," to borrow the old social work adage. Gentle movements and stretches, along with conscious breathing exercises can begin shifting the depression while lying in bed.
Some Specific Suggestions
While providing in depth directions for performing the following exercises is beyond the scope of this article, resources are available on the web and from any yoga teacher or class. As with any new exercise regimen, start slowly and build up to a full expression of the breath or pose.
- To increase energy and combat lethargy and exhaustion, try the breathing exercise called kapalabhati (in English, "skull shining breath"). This is a great breath to use in the morning if waking up and getting moving for the day is especially challenging.
- Knees to chest pose is another good pose to try first thing in the morning while still lying in bed. Do one leg at a time, then both legs together. Increase the stretch as you exhale and relax your legs away from your body as you inhale. Try staying with this for three or four breaths and see how you feel.
- If your depression increases anxiety or makes your thoughts race, try nadi shodhana: the sweet breath. This breath is done by alternately closing off each nostril, and after a few rounds of slow deep breathing in this way, you are guaranteed to feel calmer.
- Warrior poses are done standing up, so you'll need to get out of bed for these. There are three variations, and all of them increase your circulation and warm you up (great for winter mornings!). These poses make you feel stronger, invigorated, and confident.
These are many additional poses to try. Again, start slowly, and pay attention to how you feel. The purpose of yoga is to be present and stay in this moment, focusing on your breath. Practicing just that much for a few minutes a day can help shift an entrenched depression.