Two New Evidence-Based Studies on Yoga for Depression

by Ram

Light Through the Trees by Melina Meza

Major Depressive Disorder (MDD), or simply depression, is a mental disorder characterized by at least two weeks of low mood or a loss of interest or pleasure in daily activities and impaired social, occupational, or educational function. This is often accompanied by significant weight change, change in appetite and sleep, fatigue or loss of energy, feelings of worthlessness, excessive or inappropriate guilt, diminished ability to think or concentrate and suicidal tendencies. Thus, MDD can have a major effect on a person's personal life, at work or school, as well as sleeping, eating, and general health. Between 2–7% of adults with major depression die by suicide and nearly 60% of people who die by suicide may have suffered from depression. 
MDD affects approximately 216 million people worldwide in 2015 with females being affected about twice as often as males. About 40% of the risk appears to be related to genetics. Other risk factors include major life changes, medications, chronic health problems, and drug abuse. No laboratory tests exist for MDD and diagnosis is primarily based on the individual's experiences and a mental status examination. In general, individuals who are confirmed with MDD undergo counseling (cognitive behavioral therapy and interpersonal therapy) and often are put on antidepressants. Unfortunately, most of the individuals who use antidepressants for MDD do not see a complete reversal of their depressive symptoms. While medication appears to be effective especially in the most severely depressed, there are reports to indicate that medication in of itself can trigger suicidal tendencies. Hospitalization is recommended for those who tend to harm themselves. 
But there is some good news! The National Center for Complementary and Integrative Health has been funding several research projects to identify nonpharmacological interventions to reduce the symptoms of MDD and the latest research findings involving yoga, breathing exercise and meditation offer great promise. A recent report Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study. appearing in the Journal of Alternative and Complementary Medicine showed that people with MDD and who participated in yoga and deep (coherent) breathing classes at least twice weekly (plus practicing at home) experienced a significant reduction in their depressive symptoms. The authors had sought to: 

1. Assess the effects of Iyengar yoga and coherent breathing at five breaths per minute. 
2. Determine optimal intervention yoga dosing as part of future studies for individuals with major depressive disorder (MDD). (For those of you interested in carrying out a yoga intervention research trial yourself, I would highly recommend this article.) 

The researchers carried out the study painstakingly and were very clear with their objectives. Thirty two individuals from an initial total of 265 subjects were selected. The individuals whose age ranged from 18–55 years were diagnosed to have MDD. Subjects were randomized to a high-dose group or a low-dose group for 12 weeks. The high-dose group consisted of three 90-minute yoga classes and four 30-minute homework sessions per week. The low-dose group consisted of two 90-minute yoga classes and three 30-minute homework sessions per week. 
The 90-minute yoga classes consisted of approximately 60 minutes of yoga postures, approximately 10 minutes of transition that included Savasana and Ujjayi breathing, followed by 20 minutes of coherent breathing. Subjects were given the option to continue Ujjayi during coherent breathing. During the coherent breathing session, researchers played an audio disc of two chime tones to allow the subjects to synchronize their breath, with inhalations performed on the high tone and exhalations performed on the low tone. The 12-week yoga intervention consisted of the following poses: seated or reclining postures for centering, Sun Salutations, standing poses, twists, transition poses, and inversions, followed by Savasana, Ujjayi and coherent breathing. Each homework assignment consisted of 15 minutes of postures and 15 min of chime tone-paced coherent breathing. Compliance by the sujbexts was monitored by sign-in sheets at each class,and through weekly homework forms.
The researchers noted that irrespective of the high does or low doses, the combination of yoga, Ujjayi and coherent breathing resulted in significant reduction in depressive symptoms in both groups. Both groups showed comparable compliance and clinical improvements, although more subjects in the high dose group exhibited the positive changes. The study results also indicated that twice weekly classes plus home practice (low-dose group) may be less burdensome but is still very effective to get the benefits. 
In a second study Mindfulness yoga during pregnancy for psychiatrically at-risk women: preliminary results from a pilot feasibility study. a group of researchers discovered that pregnant women reported significant reductions in depressive symptoms as well as a stronger bond with their babies in the womb after attending a 10-week mindfulness yoga intervention session. Perinatal MDD impacts 1 in 5 women and may be due to hormonal changes, genetic predisposition, and/or social factors. While antidepressant medications may be effective, many pregnant women are reluctant to take these drugs as it may have effect on the growing infant. To check the effectiveness of yoga and meditation, researchers recruited 20 primiparous (first pregnancy) women with confirmed diagnosis of MDD. These women who were at ≤ 26 weeks of gestation and were not taking any psychotropic medications were invited to participate in a free 10-week prenatal “Mindfulness Yoga” class that was facilitated by two certified instructors. 
Each 90-minute session focused on a variety of poses that were modified for any level of experience or gestational age. Classes were held once weekly, with one class during evening hours and the other during the day. Both classes received the same intervention, taught by the same instructors, and only differed by time of day. Suitable props were also provided. In addition to practicing the yoga asanas, participants engaged in mindfulness techniques, including breathing, guided visualization, and relaxation. A significant aspect of the intervention was being “mindful” of the baby, to sense its unique persona, which in turns facilitates the attachment process. Numerous parameters were tested before, during, and after the study. The researchers found that in all cases the symptoms of depression were significantly reduced and mindfulness and maternal-fetal attachment significantly increased. This first of its kind, this pilot study clearly demonstrated that yoga and mindfulness meditation may be an effective treatment for pregnant women at high risk for psychopathological symptoms, including MDD. 
Both these studies together with other reports clearly show that there seems to be a lot of potential for yoga, meditation, and breath practices as a first-line approach to mental health! 
For our readers here at Yoga for Healthy Aging, Nina has several articles on yoga for depression that you can safely use as a home practice. Of course, you don’t have to be depressed to resort to yoga. All of us who do yoga as part of our daily routine have experienced its benefits at the physical, mental, or emotional level or at all levels. Undoubtedly, you cannot find a better, more effective, and cheaper therapy. 
Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Follow Baxter Bell Yoga on Instagram ° Join this site with Google Friend Connect