Author: Charley Hickey is a practicing yoga therapist and senior yoga teacher who runs group and private yoga classes in Applecross & Fremantle, Perth. She also runs specialised yoga workshops for yoga students & yoga teachers.
Yoga For Anxiety
Anxiety is by far the most common mental health problem that I see in my yoga classes on a weekly basis. In years past, I found that many students coming to yoga for anxiety were too embarrassed to mention that they were suffering. I’d often find out later on as trust built between us.
I felt a little helpless in what to do and how to make it easier for students to approach me about having anxiety. This prompted me to learn more and undertake a “Mental Health First Aid” course. I always renewed my actual First Aid certificates but didn’t realise that a mental health one existed. I feel that the certificate I received quite a few years ago has been more useful to me over the years and used more frequently than my standard first aid by far. I highly recommend it for any person that wants to have a deeper understanding of mental health problems and how they affect people around them and the greater community.
These days, we advertise that our yoga classes are mental health friendly. I am no longer “helpless” and feel very comfortable asking each and every person that comes through our door if they are suffering from anxiety or mental health disorders. It’s sad that so many are suffering but its equally lovely to see them relax a little bit just by being asked the question. One of my students described it as “Phew, they understand, thank goodness I don’t have to try and hide it!”. That’s some of the anxiety gone right there, along with permission to step outside anytime during class to have a breather if things get too much. Yoga for anxiety is not my specific area of expertise but here is a great article written by Jen Shrader, former president of the Australian Association of Yoga Therapists. It explains in a bit more detail how yoga might help those suffering from anxiety.
Yoga Therapy Practices for Anxiety
by Jen Schrader
Natural Breathing
Breathwork may well be the most important practice element for reducing anxiety. According to world-renowned yoga teacher, Donna Farhi “The process of breathing lies at the centre of every action and reaction we make or have, and so by returning to it we go to the core of the stress response.” In her book, The Breathing Book, Farhi stresses the importance of restoring the natural breath before using yogic breathing exercises (pranayamas). She identifies a number of common dysfunctional breathing problems and how to correct them so that the basic underlying structure of your breathing is integrated and functional.
In my own work with patients experiencing post traumatic stress disorder knowledge about natural breathing is invaluable. Much of our time is spent in re-patterning diaphragmatic breathing and restoring the length and ease of the exhalation which is often shortened in anxious people. Natural breathing is an important foundation for everything else, particularly when you consider the relationship between breathing and the sympathetic and parasympathetic aspects of the central nervous system.
Pranayama
Slow and deep breathing are known to increase the parasympathetic tone and are associated with a calm mental state (Kaushik, et al, 2006). A number of yogic breathing techniques encourage this type of breathing rhythm.
For example, Philip Stevens is a Melbourne-based yoga teacher and a consultant neurophysiologist who holds degrees in both psychology and physiology. According to his website, Yoga Links, “How you breathe affects the heart, brain and nervous system, and there is a direct correlation between the breath and anxiety or well-being.”
“Research has shown that increasing the flow of air in the right nostril stimulates the sympathetic nervous system and increases the heart rate, produces more sweaty palms, dilates the pupils and opens up the lungs – the “fight-or-flight” reaction. Increasing the flow of air through the left nostril however, stimulates the parasympathetic nervous system and increases digestion, lowers the heart rate and relaxes the body (Shannahoff-Khalsa-DS, 1993). So by practising alternate nostril breathing (Nadi Shodhana pranayama), you help to balance both of these systems in relation to each other as well as balancing brain activity.”
Stevens also says there is ample evidence to show that the humming breath (bhramari) works as a stress reducer by slowing down the heart and having a calming effect.” A study on yoga practice and yoga theory (Telles et al 2009) found that yoga practice significantly reduced anxiety (14.6% decrease). In this study, 60 minutes was spent in yoga breathing including high frequency yoga breathing (kapalabhati), alternate nostril breathing (nadi shodana), exhalation with specific sounds (bhramari and udgeeth pranayamas) and breathing with a period of breath-holding or with a voluntarily partially constricted glottis (bahya and ujjayi pranayamas respectively).
Yoga Asana
Movement is a wonderful way of creating flow in the body – physically, emotionally and mentally. Movement can support the processing of unused energy from emotions and experiences which are often stored in the body’s tissues.
In the short term, physical work may help to relieve muscular tension and stress, and in the long term may help re-set defensive holding patterns which keep the body in stress response.
A study using magnetic resonance spectroscopic imaging in yoga and non yoga practitioners showed definite changes after a 60 minute yoga asana session compared to a 60 minute session spent reading. The chief difference was an increase in levels of gamma-aminobutyric acid (GABA) in the brain after the yoga session. GABA is a calming brain neurotransmitter used to counter-balance more excitatory brain chemicals.
But it’s important to remember that not all physical yoga is the same. To reduce stress, I would recommend a more gentle, flowing style of movement and personally caution against the more vigorous, powerful styles of yoga asana or anything done in overheated conditions which may promote or exacerbate an anxiety state.
Meditation
Numerous studies exist which espouse the benefits of mindfulness meditation, guided meditation and open meditation. For those experiencing anxiety specifically however, a guided or mindfulness-based meditation practice may be the most beneficial as it provides an agitated mind with something to do. Open meditations may make participants feel like a failure if their over-aroused mind finds difficulty in achieving stillness. Open meditations can also trigger memories of experiences which may be at the root of the anxiety.
I often find it useful to start really small and allow participants to build up at their own pace. An important aspect of meditation is to be non- judgemental about your perceived success or failure. Learn to see every meditation as a worthwhile endeavour in helping to build your skill and when the mind wanders, just begin again – even if you have to do this 50 times in a five minute session.
Yoga Nidra
A study was conducted at the Walter Reed Army Hospital in the US on the use of iRest Yoga Nidra – a technique developed by psychologist and yoga teacher Dr Richard Miller. The technique was practiced by active duty military personnel who reported decreased insomnia, reduced depression, anxiety and fear, improved interpersonal relations, increased comfort with uncontrollable situations and an increased sense of control in daily life. Participants attended 18 classes over 9 weeks as well as a home practice using a guided program on CD.
Another study examined two different meditation techniques compared to an active control group and the results suggested that meditation leads to greater physiological relaxation and better mood compared to listening to an audio book. In addition, the study suggested that meditation, specifically techniques such as iRest Yoga Nidra, lead to significant decreases in cortisol and increases in mood during practice.
Restorative Yoga
Judith Lasater is well known and well respected world-wide for her use of restorative yoga. Lasater believes that one antidote to stress is to rest deeply. She also believes that this rest is different from sleep because deep states of sleep include periods of dreaming which increase muscular tension as well as other physiological signs of tension. However relaxation or deep rest is a state in which there is no movement, no effort and the brain is quiet.
Restorative yoga uses bolsters, blankets and other props to fully support the body in a variety of positions. Once you are 100% comfortable the aim is to let your attention turn to your breath and spend a little time in stillness. If quietness disturbs you some very gentle soothing music can be used.
Yogic Philosophy
The yamas and niyamas and other yogic philosophical ideas were originally used to help bring equanimity to the mind and are still as relevant today as they were 2000 years ago.
In research conducted by Dr Telles, she looked at the use of yoga practice and yoga theory (philosophy) to reduce anxiety. In her study she found that the group using yoga theory decreased anxiety by 3.4% which was considered statistically significant.
Sound
The use of sound through chanting can also be a helpful therapy for alleviating anxiety. The use of sound crosses over into many yoga practices – it can assist with breathing and be used as a meditative practice. The vibratory quality of sound can also be considered as a type of movement practice due to its ability to move energy and impact on body tissues.
Yoga Classes vs. Yoga Therapy
For mild anxiety a general level yoga class may be suitable, particularly if the class is small, gentle and focuses on some of the practices raised above. However, anxiety or other circumstances can temporarily preclude a person from participating in a general class. Once a yoga therapist feels that the anxiety has stabilised enough a suitable regular yoga classes may be highly beneficial.
References:
1. The Breathing Book: good health and vitality through essential breath work, Donna Farhi
2. Relax and Renew: restful yoga for stressful times, Judith Lasater
3. http://www.yogalinks.net
4. Effect of a Yoga Practice Session and a Yoga Theory Session on State Anxiety, Shirley Telles, Vaishali Gaur and Acharya Balkrishna, 2009
5. Yoga Nidra as an adjunctive therapy for post-traumatic stress disorder: A feasibility study, Engel et al.
6. The effect of meditation on cortisol: A comparison of meditation techniques to a control group, Borchardt, Patterson, Seng
7. Effects of mental relaxation and slow breathing in essential hypertension, Kaushik, Kaushik, Mahajan, Rajesh
8. Yoga Asana sessions increase brain GABA levels: a pilot study, Streeter, Jensen, Perlmutter, Cabral, Tian, Terhune, Ciraulo, Renshaw
Copied from Cikitsa Sangati Summer 2013 – Newsletter of the Australian Association of Yoga Therapists, with thanks to Jen Schrader.
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