By Dr. Mercola
According to the National Alliance on Mental Illness,1 16 million adults in the U.S. had at least one major depressive episode in the past year, and it is one of the most common mental disorders in the U.S.2
The diagnosis of major depressive disorder is more than feeling sad. Diagnosis requires a medical evaluation, and symptoms include both physical and cognitive functional changes.3 However this number pales to the number of people who suffer any form of depression.
According to the U.S. Centers for Disease Control and Prevention (CDC) nearly 24 million people experience some form of depression, costing over $210 billion in 2010.4 The financial burden included the cost of lost work, direct and indirect medical costs and suicide-related costs.
If not effectively treated, depression may become a chronic condition. While antidepressant medications are commonly prescribed, they come with a list of side effects that may be dangerous, including low blood pressure, muscle cramps, aggression, confusion and decreased vision.5,6
Not treating depression is also dangerous to your health. Before stopping antidepressants you may have already be prescribed, please talk with your physician.
Recent research demonstrates positive results in the treatment of depression using yoga. You may incorporate yoga with any current medication regimen. This may help to reduce the need for medication to treat depression.
Yoga Intervention May Ease Depression
Unfortunately, antidepressant medications not only come with a list of significant side effects, but 40 percent of individuals with major depressive disorder treated with antidepressants do not achieve full remission.7
In an evaluation of clinical trials, researchers found 34 percent of participants did not achieve full remission when they chose to change antidepressant medications.
In a recent study,8 researchers studied the effect of Iyengar yoga classes on participants who suffered from depression. The study split 30 people between 18 and 64 years into two groups.
Both groups contained individuals who were diagnosed with major depressive disorder and were either not taking medication or had been on the same medication for three months.9
One group was assigned to take a 90-minute yoga class three times a week, plus participate in a 30-minute session at home four times a week. The second group participated in two 90-minute classes and three 30-minute at home sessions.10
After three months both groups experienced a reduction in symptoms by at least 50 percent,11 with no differences in compliance.12
Not surprisingly, the group who participated seven days a week experienced the greatest reduction in symptoms. Many of the participants mentioned the larger time commitment was challenging, which influenced the researchers to recommend two classes each week.
According to Dr. Chris Streeter, study author, associate professor of psychiatry and neurology at Boston University School of Medicine, yoga has the advantage of avoiding side effects from drug treatments. He commented:
"While most pharmacologic treatment for depression target monoamine systems, such as serotonin, dopamine and norepinephrine, this intervention targets the parasympathetic and gamma aminobutyric acid system and provides a new avenue for treatment."
Benefits of Yoga in Treatment of Depression
In this study, researchers advised the participants to use a specific form of yoga that focuses on detail and precise alignment of posture combined with deep breathing.13
Prior studies using other forms of yoga for treatment of depression have had positive results. Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, reviewed the findings and commented:
"The mechanism of action is similar to other exercise techniques that activate the release of 'feel good' brain chemicals … [and may] reduce immune system chemicals that can worsen depression.
It has been demonstrated that 'mindful' movement — conscious awareness — has a much more beneficial impact on the central nervous system."
The findings from the current study corroborate findings from a 2016 study from the University of Pennsylvania,14 in which researchers found participants who suffered from depression found significant relief using yoga. The patients in that study had an inadequate response to antidepressant medications.
One of the goals of the study from Boston University was to identify a "dose-response relationship" and develop a standard against which future studies could be established to evaluate the efficacy of incorporating yoga and other types of controlled breathing exercises into the treatment protocols for depression.
Major Depressive Disorder May Have a High Cost
Many people affected by depression often fail to consult a physician or seek help to confirm their illness and get treatment. This may be a result of societal pressure to deny mental health issues, or it may be the result poor access to care. When depression goes untreated, it can be both debilitating and life threatening.
Depression may interfere with personal and work relationships, reduce work or academic performance and may affect your physical health as well.
Depression reduces your ability to care for yourself properly and make adequate decisions about your health, including nutrition and sleep. Imbalances in nutrition, weight fluctuations and poor sleep habits may lead to compromised immune function.15
Specific medical conditions, such as cancer, heart disease, diabetes and stroke are linked to a higher risk of major depressive disorder. Depression may also lead to drug or alcohol abuse.16
Up to 70 percent of people who commit suicide are clinically depressed,17 and it's estimated that more than 90 percent of people who suffer from thoughts of suicide experience a combination of depression and substance abuse.18 Yoga focuses on bringing harmony between your mind and your body.
The origins of yoga are believed to have existed before many other belief systems were born.19 Today it is commonly used as a form of therapy or exercise to achieve better health and greater fitness. Yoga has spread throughout the world through the teachings of yoga masters and personalities, including Iyengar yoga.
Sixteen million people in just the U.S. practice yoga every year.20 The principles of all yoga practices include relaxation, breathing, diet, exercise and meditation, which people use to help reduce stress, improve fitness and gain clarity.21
There are several different types of yoga and within each type teachers may identify with a style, tradition or lineage.22
Stress Reduction Is Important for the Treatment of Depression
Stress has an impact on your mental and physical health. For instance, a study led by Massachusetts General's Institute of Technology found patients who regularly tried to relax and achieve a relaxation response had a 43 percent decrease in their use of the healthcare system.23 The researchers found those with gastrointestinal disorders, neurological disease, cardiovascular and musculoskeletal disorders had the most dramatic reductions.
The researchers used a patient group of over 4,400 who they examined over a two-year period. They compared those against more than 13,000 people who did not participate in the Relaxation Response Resiliency Program. Relaxation and the reduction of a stress response improved the health of the participants.
Chronic stress may trigger depression in some people and resilience in others. One study found 20 percent of mice who were repeatedly exposed to stress became depressed.24 The mice who suffered more depression also had greater activity in the medial prefrontal cortex of their brain. The mice who didn't have depressive symptoms also didn't have changes in their brain.
This study builds on previous studies25 that demonstrate stress is related to depression. Initially stress has a direct effect on your mood and sleep habits, which may lead to cognitive changes such as decreased concentration. However, it is the indirect effects that may trigger depression.26
These indirect effects may include a disruption in healthy coping strategies, disrupted relationships that may have offered support, taking on unhealthy coping strategies such as alcohol or drugs, and disrupted routines. Reducing stress through deep breathing exercises and yoga may have a significant impact on preventing depressive symptoms.
Yoga Has a History of Improving Mental and Physical Health
Practicing yoga improves both your physical and mental health. Past studies have demonstrated yoga improves back pain, flexibility and core strength,27 without side effects or drug interactions. Yoga has also had some limited success in management of cancer related symptoms.28
Aside from core strength and flexibility, the greatest improvements are seen in decreased stress, anxiety and improved mood with the practice of yoga. Research has linked these improvements to changes in gamma-amino butyric acid (GABA), an amino acid that acts as a neurotransmitter in your central nervous system. GABA is responsible for blocking nerve impulses, telling the adjoining nerve cells not to "fire" or send an impulse.
Without GABA your nerve cells would fire frequently and easily, triggering anxiety disorders, seizures and conditions such as addiction, headache and cognitive impairments.29 Research has identified the practice of yoga as associated with an increase in thalamic GABA levels.30 They found using yoga postures would create a positive correlation between increased GABA and improvements in mood and reduction in anxiety. They concluded:31
"Given that pharmacologic agents that increase the activity of the GABA system are prescribed to improve mood and decrease anxiety, the reported correlations are in the expected direction. The possible role of GABA in mediating the beneficial effects of yoga on mood and anxiety warrants further study."
Improvements in stress response, elevated mood and function and a possible role in the treatment of post-traumatic stress disorder are also attributed through scientific study to the use of yoga poses and breathing.32 Yoga also made a significant difference in depression of addicts going through rehabilitation.33
Tips to Beating Depression With Yoga and Other Mind-Body Techniques
Addressing the issue of clinical depression is critical to your health. While medications may reduce the immediate sadness for a short time, side effects and poor long-term results make opting for natural choices a much better option for your health and wellness. Here are several ways to address your mind-body connection to make a positive change in your mental health:34
Follow the recommendations of the study from Boston University and do two to three yoga sessions a week and practice at home when you don't go to class. Focus on yoga classes that stress controlled breathing techniques and end your practice with a period of relaxation and deep breathing.
Studies show there is a strong correlation between improved mood and aerobic capacity. There's also a growing acceptance that the mind-body connection is very real, and that maintaining good physical health can significantly lower your risk of developing depression in the first place.
Exercising creates new GABA-producing neurons that help induce a natural state of calm. It also boosts your levels of serotonin, dopamine and norepinephrine, which help buffer the effects of stress.
✓ Emotional Freedom Techniques (EFT)
EFT is a form of psychological acupressure. Gentle tapping with the fingertips is used to transfer kinetic energy onto specific meridians on your head and chest while you think about your specific problem and voice positive affirmations.
This works to clear the "short-circuit" — the emotional block — from your body's bioenergy system, thus restoring your mind and body's balance, which is essential for optimal health and the healing of physical disease.
✓ Mindful Music
The practice of yoga incorporates the use of mindful breathing, or staying in the present moment. Research using mindfulness skills listening to music enabled participants in the study to have greater self-awareness and emotional regulation.35 The practice also strengthened the bond between client and therapist.
✓ Cognitive Behavioral Therapy (CBT)
CBT has been used successfully to treat depression,36 and is recommended for depression triggered by the stress of moving from one culture and country to another.37 In this case, the therapy assumes mood is related to the pattern of thought. CBT attempts to change mood and reverse depression by directing thought patterns.
The mind-body connection works in both directions. In other words, keeping your gut microbiome healthy has a significant effect on your moods, emotions and brain. You can read more at my previous article, "Mental Health May Depend on the Health of Your Gut Flora."
✓ Biofeedback and Progressive Muscle Relaxation
Biofeedback and progressive muscle relaxation may also help to reduce stress levels and therefore a primary environmental trigger for depression.
In biofeedback, electrical sensors attached to your skin allow you to monitor your biological changes, such as heart rate, and this feedback can help you achieve a deeper state of relaxation. It can also teach you to control your heart rate, blood pressure and muscle tension through your mind.
Biofeedback is commonly used in the treatment of stress related conditions such as migraine and tension headaches, fibromyalgia, depression and anxiety. Progressive muscle relaxation may achieve the same level of stress reduction through tensing and relaxing all the major muscle groups from head to toe, thereby helping you to recognize muscle tension.
Visualization and guided imagery have been used for decades by elite athletes prior to an event, successful business people, and cancer patients — all to achieve better results through convincing your mind you have already achieved successful results.38,39 Similar success has been found in people with depression.40
✓ Neurostructural Integration (NST)
This innovative practice originated in Australia where Dr. Michael Nixon-Levi developed a technique of using a series of gentle moves on specific muscles at precise points to create an energy flow and vibrations between the points. Theoretically, triggering your autonomic nervous system, your body communicates better with itself and balances tissues, muscles and organs.
The primary objective is to remove pain and dysfunctional physiological conditions by restoring the structural integrity of the body. In essence, NST provides your body with an opportunity to reintegrate on many levels, and thus return to and maintain normal homeostatic limits on a daily basis.
NST is done with a light touch and can be done through clothing. There are pauses between sets of moves to allow your body to assimilate the energy and vibrations. To learn more, please review the article, "Gentle Hands Can Restore Your Health."