Specific yogasanas for mental illness

Yoga as an intervention in psychiatric disorders is not a recent concept, as doctors have been recommending yoga-based interventions for stress-related disorders since a long time. However, there has been a renaissance in the last two decades, in terms of a scientific approach and modern research methods to the study of yoga-based interventions. 

Yoga practice is known to improve a person's physical and mental functioning. In psychiatry, yoga-based interventions have been successfully used both as a standalone and a supportive treatment of disorders such as depression, anxiety, and insomnia. Yoga has also been beneficial as a complementary treatment for psychiatric conditions such as schizophrenia, Attention Deficit Hyperactivity Disorder (ADHD) in children, and cognitive impairment in the elderly.

Yoga practice has led to improved cognitive performance in persons with depression, better emotion recognition abilities in persons with schizophrenia, and improved memory, sleep and quality of life in elderly persons with mild memory impairment.

Regular practice of yoga causes a reduction in the 'stress hormone' cortisol, increase in the ‘cuddle hormone’ oxytocin and increase in markers of brain plasticity such as Brain Derived Neurotrophic Factor (BDNF). It helps prevent degeneration of brain cells, or even an increase of brain volume in areas related to memory (hippocampus), especially in the elderly A neuro-imaging study on healthy persons showed that chanting ‘Om’ reduced brain activation in areas related to emotional control, suggesting that it has the potential to calm emotional disturbances. 

The above references highlight the benefits of yoga-based interventions to treat psychiatric disorders. However, there are several challenges for adapting yoga in clinical practice. One of these is the significant variability in the yoga practices taught and followed by different schools of yoga. In addition, there is difficulty in correlating the benefits of yoga practices as described in traditional yoga literature to specific disorders as defined by modern medical diagnostic systems.

Staunch yoga practitioners and experts define it to be a holistic and spiritual lifestyle and are not in favor of creating specific yoga modules for specific mental health problems. However, evidence-based modern medical science demands ‘scientific proof’ in terms of 'randomized controlled trials' of a specific yoga ‘module’ or ‘package’ for a specific disorder. This mandates cooperative research by clinicians and yoga experts to make the optimum benefits of yoga available to the maximum number of people.

The NIMHANS Integrated Center for Yoga has made several efforts in this direction wherein psychiatrists and neuroscientists have collaborated with yoga experts from Swami Vivekananda Yoga Anusandhana Samsthanam (SVYASA) and Morarji Desai National Institute of Yoga, New Delhi (an institution under the Department of AYUSH, Govt. of India). This has led to the development and validation of some specific yoga modules for disorders such as depression, cognitive impairment in the elderly, and schizophrenia. This is just the beginning of a much-needed intensive program that will integrate different streams of medicine for the benefit of patients suffering from neuropsychiatric disorders.

Dr Shivarama Varambally is a consultant at the NIMHANS Integrated Centre for Yoga, and additional professor of psychiatry at NIMHANS, Bangalore

References:

1- Hariprasad VR, Varambally S, Varambally PT, Thirthalli J, Basavaraddi IV, Gangadhar BN. Designing , validation and feasability of a yoga-based intervention for elderly. Indian J Psychiatry 2013; 55:344-9

2- Naveen GH, Rao MG, Vishal V, Thirthalli J, Varambally S, Gangadhar BN. Development and feasibility of yoga therapy module for out-patients with depression in India. Indian J Psychiatry 2013;55:350-6