Yoga, Meditation & Mental Illness

Yoga for Depression & Anxiety

‘Students come to yoga classes with a variety of physical, mental and emotional conditions that should be given special attention and support by teachers” (Stephens, 697).
When we consider that 18.1% of the US population is afflicted with anxiety disorders and that almost 50% of those diagnosed with anxiety also suffer from depression (ADAA, Facts &
Statistics), we can expect to have students with either or both conditions in our classes. Understanding how yoga can benefit both conditions, while not acting as mental health
practitioners, can create a supportive and safe environment for our students (Stephens, 697).

Let us first look at anxiety which is a generalized term that refers to a multitude of mental illnesses ranging from general anxiety disorder (GAD), to obsessive compulsive disorder
(OCD), panic disorder (PD), phobias and more; including one most have heard of, post traumatic stress disorder (PTSD). While all individual disorders have their own unique characteristics, they
do have common symptoms such as problems sleeping, feelings of panic, fear and uneasiness, the inability to calm and/or still one’s self, circulatory issues in hands and feet (tingles,
numbness etc), heart palpitations, muscle tension, shortness of breath and dizziness (Bhandari). There are no known causes for anxiety disorders and physical illnesses as cause for the above
symptoms must be ruled out by medical doctors (Bhandari).

While the practice of yoga, including pranayama and meditation, cannot and should not be a substitute for treatments by medical and/or mental health practitioners, they can be extremely helpful
for students with the management of symptoms in order to make other interventions more effective. For example, there is a suggestion in many reviews of various yoga practices that they help the body ‘modulate stress response systems’ which can reduce heart rate and blood pressure and calm respiration (Harvard Health, 2009). A student with these symptoms of anxiety could benefit greatly from regular yoga practice.

Simple inversion Asanas such as Setu Bandha Sarvangasana (Bridge Pose) and Legs-up-the-wall Pose (Viparita Karani) can be performed by novice and practiced yogis alike and can calm the mind allowing room for focus and relaxation. Seated forward bend (Paschimottanasana) relieves headaches while leaving the student feeling both calm and energized (The Good Body). Other poses such as Wide-knee Child’s Pose (Balasana), Standing forward bend (Uttanasana) and Corpse Pose (Savasana) can also relieve tension and when practiced at the end of the day, contribute to better sleep (Wei). When combined with meditation and focused breathing practices like Ujjayi Pranayama, students can find
inner quiet and calmer nerves (Stephens, 583).

Much like anxiety, there are many different types of depression and these mental illnesses express themselves differently in men than in women. While men tend to display symptoms such as
anger, irritability and substance abuse, women veer towards symptoms such as feelings of inadequacy, worthlessness and guilt (ADAA, Understanding Anxiety and Depression). With 83% of yoga students being female (Eberle), we shall focus on these symptoms and how they may be alleviated or decreased with a regular yoga, pranayama and/or meditative practice.

We know that depression in almost all variations can be triggered by stress and anxiety. So along with the asanas mentioned above (which are a few of many) that can help students manage those
symptoms, meditation can help students not only replace thoughts of guilt, worthlessness or hopelessness in the moment, it can assist them even when not in a yoga class. According to Dr. John W. Denninger, “Meditation trains the brain to achieve sustained focus, and to return to that focus when negative thinking, emotions, and physical sensations intrude – which happens a lot when you feel stressed and anxious” (Harvard Health, 2018).

Ujjayi Pranayama can create internal quiet and in this environment, is a perfect accompaniment to meditation, especially in a simple, grounding asanas such as Butterfly Pose (Baddha Konasana),
Savasana or Legs-up-a-Wall pose which help with focus, a much needed ingredient to meditation. If a mantra is used for and during meditation such as it is in a traditional dharana practice (Stephens,622), one could create a mantra contrary to the pervading negative thought brought on by a depressive episode. For example if a student has consistent thoughts of unworthiness when stressed, anxious or depressed a student can choose to meditate on the repeating mantra of ‘I am worthy’ or perhaps they have difficulties with body image, a mantra of ‘I am beautiful’, could be used.

When a mantra is focused on in meditation, it becomes a part of our regular thinking pattern, something to quickly refer back to consciously or subconsciously when negative thoughts and emotions surface (Mindworks) as they often do in bouts of depression or extreme depressive episodes (ADAA, Understanding Anxiety and Depression). Even if a mantra is not used during meditation and focus is brought to the breath, an object or a body scan, meditation frees the mind from external stimulation allowing us to concentrate, focus and find inner calm, peace and presence in our own existence. It was this exact reason that brought me first to meditation and pranayama practice as a student before I ever took a single yoga class.

My personal mental health diagnosis in 2001 of Borderline Personality Disorder (BPD) as outlined in my book, ‘Butterfly Dreams – Poetry of hope and Recovery’, had me searching for non-pharmaceutical methods to manage my symptoms. It was suggested to me that without effective symptom management, the psychological therapy and work that was needed for
my illness would not be able to take root. While BPD is not classified as either an anxiety or depressive disorder, this mental illness has a variety of extreme symptoms which include episodes of anxiety and depression, negative thoughts and unstable self image (National Institute of Mental Health). While medication is not a viable treatment for this mental illness and it is a lifelong disease with no cure, it is often prescribed for symptom management which is essential for quality of life and to prevent more serious mental illness development, adverse behaviors or self harm. When first diagnosed, medication was required in order to ‘balance the highs and lows’ of the mood swings associated with the illness. Usually I describe this disease to those unfamiliar with it as similar to bipolar disorder except that the extreme shifts in this particular disease cycle more rapidly and you can move from a manic to depressive state often within hours, even minutes. As you can imagine, living with such symptoms can be chaotic and disruptive and hence the management of them essential.

I am not opposed to medication to treat disease of the body or mind nor am I opposed to treating a sickness of the soul with prayer, but knowing that symptom management for my disease was
to be a life long affair, I had to find another way. Medication served it’s purpose for me the first year after my diagnosis allowing me the peace to delve deeply into the therapy I so desperately needed and I am grateful for it, but today, almost two decades later I am even more grateful to be able to manage those symptoms through pranayama, meditation and yoga although I didn’t at first know that is what I was doing.

Pranayama was first introduced to me by my psychiatrist in an office, as far from a yoga studio physically and spiritually as you can get. These ‘breathing exercises’ as they were called were methods of developing focus, calm nervous energy and alleviating the panic attacks that were (and still could be) a common occurrence with my illness. He began by teaching me to at first just be aware of my breathing to think about it: it’s speed, rhythm, energy much like Mark Stephens discussed in his book, Teaching Yoga, Essential Foundations and Techniques, when he describes teaching breath awareness in chapter eight. Once awareness was established, I moved on to learning how to control it by focusing on it, counting how long I inhaled and exhaled and trying to increase the number to five or more from wherever I started. I now know this to be Vritti Pranayama (Stephens, 589). The natural progression of this breathing practice was and still is, meditation.

The focused breathing, the counting of breath eventually did far more than calm anxiety, it deeply relaxed both my mind and body allowing me find greater focus, peace and eventually include mantras that replaced negative thoughts with more positive messaging. This practical application of both pranayama and meditation as a treatment of mental and emotional illnesses takes it far beyond the realm of the spiritual or religious. Explaining this use and connection to all students, may open their minds and willingness to try a new practice if the thoughts of those spiritual or religious aspects intimidate or deter them.In much the same way as meditation and pranayama did, yoga and especially the principals found in Hatha Yoga have continued to build on that inner calm and balance of mind, body and spirit that is required to manage my illness successfully. The focus on breath and the concentration required to practice or hold an asana leaves little room for much else in the form of thought. A quiet mind cannot obsess on the negative, yoga quiets the mind and creates a clearer consciousness (Stephens, 22).

In addition to the mental clarity, emotional control and spiritual awakening that one can find in a regular yoga practice, the physical benefits far exceed the increase in flexibility and strength students will inevitably develop. Mental illness, anxiety, depression have huge impacts on the body – self care often is overlooked, or all together ignored (NIMH). Poor lifestyle choices as far as nutrition, substance abuse and lack of exercise can have huge impacts on our physical self. Whether these impacts lead to disease, poor body image of even more negative self talk (I am so fat and lazy!), we cannot overlook the impact of mental illnesses and disorders like anxiety and depression on our bodies.

While versions of yoga like Power Yoga have a focus more on intense cardio and muscle building workouts (Stephens, 132), all yoga practices benefit the body and physical health like all regular exercise does. Strength, stability, endurance, flexibility – all are improved through regular yoga practice and as these elements of our bodies can be negatively impacted by mental health issues, yoga again provides us with a treatment or management tool for symptoms. “When teachers create safe and nurturing yoga classes where students can explore anew the body, mind and spirit, amazing things start to happen” (Stephens, 23).

We as yoga instructors do not need to know the innermost workings of our student’s minds, their mental illness diagnosis, personal symptom manifestations or triggers; unless voluntarily shared we should never pry, as we are not their therapists. We can address these symptoms, general illnesses and the benefit of asanas, pranayama and meditative practices without drawing attention to or singling out specific students which in fact can exacerbate symptoms. By creating a gentle, welcoming and accepting environment, yoga can be used to benefit anxiety and depression in our regular practice, even if we never once mention illness. I am grateful that I have found the practices of yoga, pranayama and meditation and the value they have in my life today cannot be quantified. Sharing that gratitude to see it blossom in others is the foundation of my classes and I hope similar feelings have and will continue to motivate others on their journey with their students.

 

Michelle Budiwski

 

Works Cited:
Bhandari, Smitha. “Anxiety Disorders: Types, Causes, Symptoms, Diagnosis,
Treatment.” WebMD, WebMD, 13 Nov. 2019, webmd.com/anxiety-panic/guide/anxiety-
disorders#1.

Budiwski, Michelle. “Butterfly Dreams – Poetry of Hope and Recovery.” Chrysalis Publications,
2018

“Borderline Personality Disorder.” National Institute of Mental Health, U.S. Department of
Health and Human Services, nimh.nih.gov/health/topics/borderline-personality-
disorder/index.shtml

Eberle, Sam. Women’s Yoga VS Men’s Yoga. Satchindananda Ashram Yogaville, 2016,
yogaville.org/2016/05/01/womens-yoga-vs-mens-yoga
“Facts & Statistics.” Anxiety and Depression Association of America, ADAA, adaa.org/about-
adaa/press-room/facts-statistics.

Mindworks Team. “What Is Mantra Meditation? – Match Your Intention: Mindworks.” Mindworks
Meditation, 10 Apr. 2020, mindworks.org/blog/what-is-mantra-meditation.

Publishing, Harvard Health. “How Meditation Helps with Depression.” Harvard Health, 2018
health.harvard.edu/mind-and-mood/how-meditation-helps-with-depression.

Publishing, Harvard Health. “Yoga for Anxiety and Depression.” Harvard Health, 2009
health.harvard.edu/mind-and-mood/yoga-for-anxiety-and-depression.

Stephens, Mark. “Teaching Yoga, Essential Foundations and Techniques”. North Atlantic Books,
2010

The Good Body. “17 Best Yoga Poses for Anxiety (Depression and Stress) ” The Good Body.” The
Good Body, 21 Mar. 2020, www.thegoodbody.com/yoga-poses-for-anxiety-and-depression/.

“Understanding Anxiety and Depression.” Anxiety and Depression Association of America,
ADAA, adaa.org/understanding-anxiety/depression

Wei, Marlynn MD, JD. “Yoga for Better Sleep.” Harvard Health Blog, 17 June 2020,
www.health.harvard.edu/blog/8753-201512048753.

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