In recent years, yoga has gained immense popularity across the world among the young and old alike. Psychiatrists and psychologists have recognized its potential and are using yoga as part of treatment and rehabilitation of psychiatric disorders. Dr BN Gangadhar, Dean of Behavioural Sciences at NIMHANS spoke to Patrecia Preetham of White Swan Foundation about what research has inferred so far.
What are the therapeutic effects of yoga on mental health?
Yoga has been found to be therapeutically effective for people with depression and anxiety disorders. It has also been fairly well-used and tested as a treatment for schizophrenia. Of course, in schizophrenia, it is not used as the first line of treatment, but as an add-on when the patients get better (after using anti-psychotic drugs), but some problem still remains. We then suggest yoga and this benefits them. In fact, the benefits of yoga for people with schizophrenia has been recognized and hence recommended for use in one of the international guidelines for the treatment of schizophrenia.
Yoga is used to improve many other mental health conditions like Attention Deficit Hyperactivity Disorder (ADHD) and autism. People have used yoga for elderly individuals with cognitive failure, what we call minimal cognitive impairment. Also, in sleep and other psychosomatic conditions that include, for example, body aches caused due to non-physical diseases, yoga has been found to be helpful. So, this is the range of conditions where we have used yoga.
Can you explain how yoga has a positive effect on the brain?
In people who have meditated for several years, compared to those who haven't, it has been found that some brain regions are more preserved than the others. We also did a study among elderly people, who were otherwise physically well, who practiced yoga for six months. A scan was done before and after six months of regular practice. There are some sensitive areas in the brain in the elderly which shrink. On the contrary, in these people, those sensitive areas which work for memory had gained. So, it suggests that yoga has helped protect the brain and enhanced its structure.
Now, there are many other arguments on why the brain's function improves. Yoga reduces cortisol levels, and cortisol if in excess is known to cause some dysfunction in the brain. For example, when people with depression practice yoga, it increases a protein in the blood called as brain derived neurotrophic factor. This could repair and protect the brain from being affected.
On a functional basis, there have been studies on electro-physiology of the brain, EEG, event-related potentials and we have shown that there is an improvement in the brain's functions.
Some of the procedures of yoga, for example, chanting 'Om' has shown that some regions of the brain actually become ‘calm’; their activity becomes less. Why should the activity of the brain become less? These are the areas of the brain which, in an emotionally excited situations function more. So, it seems there is a neuro-physiological correlation of reduced emotionality, which in turn makes the process of brain-repair get better. So, these are the examples of why yoga would help the brain function better and protect it from other possible harmful effects.
There are various forms of yoga such as jnana yoga, karma yoga, bhakthi yoga, and raja yoga. What form of yoga is predominantly used in treating mental disorders?
If you ask me, every psychiatrist is using one or the other form of yoga. I'll give you some examples.
Jnana yoga – We do psycho-education. We improve the individual's understanding of the disease, what he needs to do and what the family needs to do – jnaana. Of course, I don't truly call it the 'jnaana yoga', but in a different form, we use it.
Bhakti yoga – We know that when patients have faith in their doctor, they obtain better benefits. In fact, inducing faith is also establishing better rapport. In psychotherapy, this is one of the important preconditions. When you improve the rapport, the person develops more faith in the doctor's treatment and both of them can work together better. So, that's Bhakti yoga.
Karma yoga is something that you are seeing in the Psychiatric Rehabilitation centre. Patients with psychiatric disorders who have lost their motivation are motivated to engage in useful and constructive activities, get themselves trained. This is very helpful for them. So we are using Karma yoga every day.
Raja yoga is a form of many other things, which include yogasana, meditation, and so on. The patient helps himself (self-help) to recover. We use yogasanas and pranayama, which are very well incorporated as part of Raja yoga. And, of course we have meditation, which we selectively use. We don't use it with all patients. In fact, meditation is one of the key elements of Raja yoga. But, we know psychiatric patients may have difficulty in trying to meditate. So, we probably limit our intervention to yogasanas and pranayama, and in select conditions we do encourage meditation as it helps them get better.
How can we encourage more people to practice yoga for their mental health and wellbeing? What would you like to convey to the audience about yoga and its importance and benefits?
How do you motivate people to do yogasana? Telling them to simply do yogasanas won't work. Getting them to do it together – we walk the talk, we do yogasanas with them, and we let them experience the benefits of yogasanas and hopefully that will continue to motivate them to do yoga. For example, in NIMHANS, one of the ways we thought we should work towards that is by offering all our colleagues. Staff and students partake in a one-month appreciation course on yoga, hoping that they will appreciate the benefits. Those who do, can continue practicing yoga at home. For in-patients, it's a little more challenging. Even if they have all facilities to reach the yoga center, get the guru or yoga teacher at home, etc., their own motivational levels are compromised because of their condition. So, it needs a little more hand-holding and with some easier asanas.
Sermons about yoga's benefits alone, in my personal opinion, are not going to attract people. Nothing like making them practically experience that. And, I'm sure most yoga schools and yoga teachers are aware of this technique. While yoga classes go on, they explain about the so called 'understanding of the benefits of yoga' to help them remain motivated to practice yoga.
What is the significance of international yoga day? Why is it celebrated throughout the world?
Yoga was well-known in our country for thousands of years. The idea of declaring one day for yoga has been initiated by several groups, including India and other countries. Many European countries, including US, kept asking the UN to recognize a day for yoga. About three years back, an international meeting was held in Bangalore, and I had attended that meeting. Apart from many Indian yoga pioneers, a group of people from Europe, who are yoga gurus managing yoga schools and who are spreading this idea decided that 21 June be declared as the International Yoga Day. 21 June is summer solstice, the longest day of the year. Nearly 80 per cent of the population that lives in the northern hemisphere, experience this phenomenon every year. It therefore symbolizes enlightenment, ‘tamasoma jyotirgamaya’.
Yoga, we believe, is the one which will bring us to enlightenment. And what we are all talking of yoga is limited to yogasana, pranayama and meditation. But, yoga in its true spiritual sense is something that transcends us to a state of liberation. And the very description of yoga in a spiritual context is 'my consciousness is to be blended with the cosmic consciousness'. In this path, we experience a lot of good effects of yoga and that is what we are using. In a lighter vein, one of the persons said that it is the side-effects of yoga we are using for the benefits of our patients.
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