In any given year, nearly 7 percent — or about 1 in 14 adults — suffers from an episode of major depression, according to the Substance Abuse and Mental Health Services Administration.
If not treated, episodes last about six to 12 months on average, and often continue for longer, marked by symptoms ranging from a loss of pleasure in activities a person previously found enjoyable to disturbance of sleep as well as characteristic depressed, or low, mood. While some people find relief through conventional treatment, such as therapy and medication, many either avoid treatment — for reasons including perceived stigma related to mental illness and reluctance to seek help or difficulty accessing care — or aren’t able to overcome the disorder through conventional treatment.
Given such difficulties and the popularity of yoga, many are turning to the mind-body discipline to self-treat depression, as well as anxiety disorders, says Dr. Sudha Prathikanti, a clinical professor of psychiatry and an integrative psychiatrist at the University of California–San Francisco. “It’s actually a very common reason for why people take up yoga,” she says.
[See: Am I Just Sad — or Actually Depressed?]
Now research is trying to catch up to the trend to determine whether the mind-body discipline is actually an effective alternative — or adjunct — to traditional treatments for depression like cognitive behavioral therapy and antidepressants.
A recent small pilot study led by Prathikanti evaluated hatha yoga, which emphasizes body postures, breathing and relaxation techniques, as a standalone treatment for mild to moderate depression. Of 38 participants, 20 were randomized to the yoga practice group during the eight-week trial, while 18 were randomized to a control education group where they learned about yoga history but didn’t practice yoga. “At the end of eight weeks both groups had some decrease in depressive symptoms. But [participants] who were actually practicing hatha yoga had a significantly greater decline in their depressive symptoms,” Prathikanti notes. The study’s findings appeared in the open-access journal PLOS One in March.
She emphasized that given the small study size it still amounts to “very preliminary data — encouraging in our case, but certainly not conclusive evidence regarding the effect of yoga on mood.” As a result, the researchers write, “While our study had statistically significant findings and raised the possibility of yoga-specific mood benefits, no reliable conclusions about mood effects of yoga can be drawn from such a small sample.” Larger studies are needed to replicate the results.
What’s more, while researchers reported that rates of retention and adherence to protocol in the yoga practice and control groups were statistically comparable, they noted that six of 18 control group participants dropped out of the study at a very early stage. So the effect of yoga on depression may not be as strong as it first appears, says Dr. Philip Wang, director of research for the American Psychiatric Association. “You’re looking at a real result: Their intervention does look like it’s efficacious. It’s probably just not as strong as you would otherwise think,” he says.
That said, based on research to date, it makes sense that clinicians might suggest yoga as an adjunct, or an addition, to conventional therapy to treat depression, Wang says. If a person with depression had a strong preference for yoga and definitely didn’t want to do evidence-based talk therapy or be prescribed a medication, he believes in that situation it would be worth trying yoga as a standalone therapy for mild to moderate depression.
[See: Coping With Depression at Work.]
But, generally speaking, he advised against using yoga as a standalone treatment especially in patients who have severe or complicated depression. That would include a person who is suicidal or has depression that is treatment-resistant or what’s also called treatment-refractory — not responding to appropriate courses of treatment or getting better. Wang emphasizes that studies have not yet been done comparing yoga as a standalone treatment for depression head-to-head with traditional approaches, like medication.
Still, experts emphasize that where conventional treatments may fall short for many patients, the mind-body activity could provide a boost. “About 40 percent of the people who are put on antidepressants for depression don’t get better,” says Dr. Chris Streeter, an associate professor of psychiatry and neurology at Boston University School of Medicine and a psychiatrist at Boston Medical Center. “They might have a decrease in their symptoms but they still are symptomatic.”
In a small study Streeter led published in March in the Journal of Complementary and Alternative Medicine — seeking to evaluate how much yoga might be helpful for depression — she found a handful of participants who were also on medication responded to doing yoga as well. “In these four people, when we added yoga to their antidepressants, they had a considerable improvement in their symptoms,” she says. In the study, participants did Ivanyar yoga — a form of hatha yoga focused on precision, like holding poses for a long time — followed by a coherent breathing exercise, breathing at a rate of five breaths per minute. The high-dose group did three classes of this a week, while the low-dose group did two classes weekly during the 12-week study. While the researchers note that the study provided evidence the yoga and breathing exercise was associated with a significant reduction in depression symptoms, the dosing study found no significant difference in compliance, rates of response or remission between participants in the low-dose group and the high-dose group.
Experts say, generally speaking, more research — and larger studies — are still needed to better understand how yoga might benefit a person with depression and how it should be prescribed, including how often it needs to be done. Still, integrating yoga with other treatment, and as an option to address mild to moderate depression, shows promise, though mental health professionals stress the importance of first and foremost getting a proper diagnosis of depression before determining how to proceed.
If you don’t like to do yoga, Streeter says it’s worth trying other forms of physical activity as well, such as running or lifting weights. “Exercise in general has also been shown to improve mood,” she says.
[See: How to Find the Best Mental Health Professional for You.]
Taking it all in, experts say it’s always worth the time commitment to incorporate physical activity to improve overall mental and physical health, though particularly for those who are diagnosed with severe depression it’s important to continue on conventional therapies as well. “Going off your antidepressants to do yoga or not getting evaluated when you could be quite ill I think is not advised,” Streeter says.
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Should You Do Yoga to Treat Depression? originally appeared on usnews.com
