Should caregivers include yoga into their daily activities?

Manas Bhattacharyya’s day begins at 5:30 in the morning. After a quick protein drink, he heads to the gym near his home in Calcutta. His one hour exercise regime includes some light weight lifting, lathi (stick) exercises and then some yoga. “It’s a good combination so my whole body is well exercised,” says the octogenarian who after retiring from the Indian Railways became a distributor for Amway India.

Bhattacharyya is the sole caregiver to his 45 year son, Pinaki, who was diagnosed with schizophrenia in 1993. “He came home one day and shut himself up in his room and didn’t come out for days. He had failed his Costing exam,” says Bhattacharyya, recalling the first time his family felt alarmed by his son’s behavior. “He said he could hear voices,” he adds. Since then, he and his wife dedicated their lives to caring for their son. “After my wife passed away last year, it’s just been me,” says Bhattacharyya who spoke to us when on a psychiatric consultation visit to NIMHANS in Bangalore.

He attributes his ability to care for his son in the best possible way to his own selfcare regimen. “I believe that one should eat well, sleep well, exercise and have a positive mental attitude,” he says adding, “my yoga practice has certainly contributed to my mental wellbeing and in turn to my positive attitude,”

Bhattacharyya’s life mantra is corroborated by studies conducted in NIMHANS on the positive effects of yoga on caregivers of patients with mental illnesses.

The first step of the study involved quizzing caregivers on their needs. While managing the patient’s symptoms (may include delusions, paranoia and panic attacks in some psychiatric disorders) was the top need, this was followed by managing socio-occupational concerns (that is, keeping their jobs and managing daily duties), then came physical and mental health followed by managing marital and sexual issues of the patient.

“Health was their third need and as we all know, if we have good health, we can take care of another person’s needs. Many caregivers, maybe because of the stress, did have lifestyle disorders like diabetes and hypertension. But these were managed with medication and were not our focus. Our focus was to take care of their burden, and how to cope with the stress of caring for a mentally ill person,” says Dr Aarti Jagannathan, assistant professor of psychiatric social work at NIMHANS, who led this study conducted by NIMHANS in collaboration with Swami Vivekananda Yoga Anusandhana Samasthana (SVYASA), Bangalore.

A module combining yogasanas, pranayama and cyclic meditation was then created keeping in mind the specific needs of caregivers. Caregiver burden is a collective term for the stress caregivers have while caring for the physically or mentally ill.

In the International Journal of Yoga , Dr Jagannathan writes, “the ultimate aim of the yoga program was to reduce the burden of the caregivers either by addressing their needs or by developing a yoga program which in turn would equip them with the ability and skills to reduce their burden— irrespective of the fulfillment of needs. As not all needs could be theoretically addressed by teaching yoga, we focused on the reduction of burden (aim of the study), irrespective of the expressed needs.”

The module developed was tested on nine caregivers of inpatients at NIMHANS. After a month of practicing yoga, most participants reported improved mental health and a greater ability to cope with burden. While this pilot was conducted only on caregivers of patients with schizophrenia for the sake of standardization, the researchers do believe that the result could be extrapolated to all caregivers of patients with mental illnesses.

As a corollary to this test it was also found that there is a direct correlation between how symptomatic a patient is and the burden felt by the caregiver. “This was tested on what we call the Positive and Negative Symptom Scale (PANSS). If the score is high it means the patient is highly symptomatic. We found that whenever the PANSS score is high, the burden score is high,” says Dr Jagannathan, stressing the need for burden management among caregivers. 

But despite having established the positive effects of yoga on caregivers, the research team did find that attending yoga classes was not always feasible for caregivers. The biggest barrier was time spent away from the patient. They preferred quick fixes to their physical issues and often didn’t think about their mental wellbeing at all.

To work around this problem, Dr Jagannathan recommends that those who are unable to access the Yoga Centre at NIMHANS, Bangalore should definitely practice yoga by joining a class close to them or following video instructions of trusted yoga practitioners. “It is after all well known that if nothing else, practice of yoga is beneficial for one’s mental wellbeing,” she says.

If you would like to know more about yoga programmes for caregivers you can visit the NIMHANS Integrated Yoga Centre http://nimhans.ac.in/advanced-centre-yoga/contact-us