Person Doing Yoga Grey

R x for Mental Health: yoga?

By Natalia Bonneville

yogaś-citta-vr̥tti-nirodhaḥ” (yoga is the control of the modifications of the mind). – Patanjali’s Yoga Sutras, I.2.

Mental health and yoga are two topics to which I seem to be inextricably bound. I’ve been practicing yoga on and off for at least ten years and have been dealing with mental illness since childhood, beginning with night-terrors (a burgeoning sign of a developing anxiety disorder) and as recently as June 22nd of this year being diagnosed with bipolar II.  I even majored in psychology in university to shed light on how to fix my brain. I later developed an interest in yoga as it was often suggested by the anxiety disorder self-help books that I read.  In the following paragraphs I am going to attempt to explain why yoga is being increasingly prescribed by health care practitioners with regards to mental health issues;  in particular, I will cover the benefits and possible downsides, as well as some suggestions on how to continue your personal journey to mental health the yogic way. I will focus on mood and anxiety disorders because these are the most prevalent disorders and as such, have the most documented research available.

Disclaimer: Please remember that most, if not all mental disorders exist on a spectrum from light to moderate to severe. Many yoga techniques are excellent at managing light to moderate cases, but severe cases are best dealt with by a mental health professional. Yoga is a great tool to have and can be modified to suit your specific needs, but please don’t feel discouraged if other modalities (e.g., therapy, medication, better nutrition, etc.) are required for your recovery. We’re all different and I encourage everyone to find what works best for them.

Now let’s take a look at why mental illness seems more prevalent now than ever before in modern society. Firstly, the DSM-V (the American Psychiatric Association’s Diagnostic and Statistical Manual) includes approximately 300 diagnostic categories compared to 22 diagnostic categories in the original DSM published in 1952. Another reason is big pharma. Oh how we love to hate pharmaceutical companies! Psychiatry sought legitimacy by linking mental issues to brain chemistry and drug companies took full advantage. Connecting as many mental issues to biology as possible meant a pill could be manufactured for that exact problem – and maybe a few others. All that was needed was to convince the doctors and the potential patients and voilà! However, psychology is not a hard science.  In other words, 1+1 does not always equal 2; what works for one person may not work for another. Why? Even though we have made great strides in understanding the brain, we still don’t know exactly how the mind works (not to mention the interplay between environment, culture, and social factors). Recent studies are showing that for some, mental illness does not even start in the brain, but the gut (don’t worry, big pharma is on it). It is in the pharmaceutical companies’ best financial interest to diagnose as many people as possible with mental health issues even when lifestyle changes would do just as well and often better.  Finally, there’s media – television commercials, talk shows, social media, print ads, radio shows, etc. Mental illness seems more prevalent because we see or hear about it everywhere. Sadly, this increase in visibility has not helped break the stigma of mental illnesses, but that’s another blog post altogether. Statistically, 20% of Canadians will experience mental illness (at its broadest definition) in their lifetime. If there are 20 individuals in attendance in your yoga class, there is a good chance that up to four of them are currently suffering from some sort of mental disorder.

So why are all these “crazy” people attending yoga? Some may have been called to yoga despite the mental problem(s) that they are dealing with; some may have read or heard that it can help, while others may actually be following doctor’s orders.  The first line of defense in mental health care is either the emergency room or a family doctor – the knee-jerk reaction to hearing a list of symptoms in line with depression and/or anxiety is to write a prescription for an anti-depressant or a benzodiazepine (or both). Unfortunately, it can take several attempts to find a medication that works effectively; if at all (assuming the diagnosis is correct). Furthermore, it can take up to 8 weeks for some of these drugs to take effect, often with serious side effects. Finally, many people fear these medications and with good reason. What is a doctor to do? Mindfulness therapy has been gaining traction as a method to heal or at least manage a variety of mental health problems and yoga encompasses many aspects of mindfulness (exercise, meditation, breathing, remaining in the present, etc.) in one neat little practice.

Let’s take a look at the three most common psychiatric disorders: anxiety disorders, mood disorders, and personality disorders. Yoga helps modulate the stress response which is essential for people who suffer from near-constant anxiety. By regulating the sympathetic nervous system (fight or flight), blood-pressure lowers, heart-rate decreases, and breathing eases. It also forces you out of your disordered thought process and into the present. The latter point is paramount for those of us dealing with mood disorders. Asanas, like any other physical activity is encouraged for depressive souls as moving the body can affect both serotonin and dopamine levels – two neurotransmitters often linked to depression. In this case, the more vigorous the workout, the better. I could not find any significant studies regarding how yoga is helpful for those dealing with personality disorders. However, there were many anecdotal accounts of how yoga was part of the healing process for individuals with BPD (borderline personality disorder).  The mindfulness integral to any yoga practice taught them to take a beat before reacting to a triggered emotion.

As mentioned in the introduction, I was recently diagnosed with bipolar II. Researching my new diagnosis led me to an interesting caution with regards to different disorders and the type of yoga best suited to healing. The most obvious symptom of bipolar disorder is extreme mood swings and how quickly they can change.  Sometimes it seems like there is no particular reason for the change in mood, while at other times there are definite triggers.  Heat or extreme temperatures can be one of those triggers and therefore caution should be used if practicing hot yoga. If you are dealing with a mental health issue, speak to your medical provider, psychologist, or yoga therapist to see if there are any types of yoga or poses that may be counterproductive to your overall health.

Adding yoga (be it asanas, pranayama, pratyahara, dharana, or all eight limbs) to your mental health regime can only be beneficial, in this writer’s opinion. Luckily, the Montreal yoga community has many options available. I recently participated in a workshop offered by Sun and Moon Yoga, taught by Joanna Mathioudakis called Yoga for Depression. Over the course of four sessions, we learned:

  • a variety of calming poses (asanas)
  • our Ayurvedic constitution and how to cater our practice to our specific dosha
  • breathing exercises (pranayama)
  • mandala making

While the workshop was geared toward depression, it also touched upon anxiety as well. The number one thing I learned was, no matter what your state, getting on your mat was paramount; you could just stand on it, sit on it, or lie on it for five minutes, as long as you get on it. This instills a connection of self-care (you are worth being cared for!) between your mat and your brain. Specific to depression, I learned that being upside down is great for improving one’s mood. You don’t even need to get into a handstand; you can get the same result with a simple standing forward bend or Uttanasana. Regarding anxiety, just about any restorative pose will help in my experience, but the following poses are particularly good for easing over-wrought nerves: bridge poses (Setu Bandha Sarvangasana), extended triangle pose (Utthita Trikonasana), and dolphin pose (Makarasana). Finally, since I spoke of personality disorders, here are some calming poses that may help process strong emotions in the long run by helping you slow down just enough to process what you are feeling: child’s pose (Balasana), easy pose (Sukhasana), and cow pose (Bitilasana). Everyone’s constitution is different and if you are curious, I encourage you to try the online Dosha Quiz offered by The Chopra Centre. Once you have tabulated the results, you can try implementing some of the suggestions to see if they improve your overall health.  Breathing techniques that may be helpful for depression or anxiety are:  Dirga Pranayama, Sama Vritti, and Adham Pranayama.

To conclude, I would like to leave you with some excellent resources offered in and around Montreal to help you on your quest for improved mental health.

Yoga Therapists

Kundalini Yoga (particularly great for anxiety sufferers)

Yoga in the Park (a little dose of sunshine is great for those dealing with depression and costs little or nothing to try!)