Yoga and mental health services.

Abstract

Byline: B. Gangadhar, Kishan. Porandla United Nations and International community recognized our Indian National Wisdom - “Yoga” by declaring “June-21” as “International Day of Yoga.” The word Yoga means “union,” that is, union of one's personal consciousness with the cosmic consciousness. Yoga helps the evolution from “I” to “WE;” that is, from limited individual to global human being.[sup][1] For a psychiatrist, this “union” could also mean, the union of thought and affect as well as mind and body, which could have therapeutic potential. Yoga is a spiritual lifestyle that transcends all religions. Yoga is successfully applied in various psychiatric disorders over the globe with encouraging evidence coming from scientific publications in reputed journals, especially in last three decades. These reports suggest a need to integrate yoga in mental health services. Yoga has been used with success both in severe and less severe mental disorders as an intervention either with other conventional treatments or even solely. Different forms of yoga viz., Sudarashankriya, Sahajyoga, yogasanas, have been investigated with promising results in the treatment of depression.[sup][2],[3] These investigations were prompted by the observation that yoga led to a feeling of well-being and reduced dysphoria in clinically healthy subjects. Studies of varying research results indicate that patients benefited with regards to reduction in depression scores following yoga. In randomized comparisons, yoga fared nearly as well as an antidepressant drug (imipramine).[sup][4] Yogasana-based therapy alone too reduced depression to the level of remissions.[sup][5] In anxiety states too, yoga has proven benefits not only in the nonclinical population but also in clinical populations.[sup][6] Patients with the obsessive compulsive disorder have been treated with Kundalini yoga and the effects have been encouraging.[sup][7] Well-conducted clinical trials have confirmed the benefits of yoga added to ongoing, stabilized antipsychotic therapy in outpatients of schizophrenia. Benefits of Yoga on the negative and cognitive symptoms of the disorder are notable.[sup][8],[9] These two symptoms have been implicated in the functional outcome of schizophrenia patients. These promising findings of yoga in schizophrenia have led to an international guideline to recommend yoga in the treatment of schizophrenia along with medications.[sup][10] The chronic nature of this disease puts demands and on the caregivers, thus subjecting the latter to stress and burden. In a randomized trial, yoga has also shown promise in helping such caregivers of schizophrenia outpatients.[sup][11] Though there is no direct evidence of yoga helping patients of drug/alcohol dependence to remain abstinent, research indicates that depression symptoms during withdrawal in alcohol dependent subjects are reduced better if a yoga practice is added during such acute detoxification program.[sup][12] Isolated reports suggest a role for yoga in other conditions such as attention deficit hyperkinetic disorder and autism.[sup][13],[14] Chronic back pain, a condition for which psychiatric intervention is often sought, has been treated with yoga. A review on this subject supports a role for yoga.[sup][15] Success with yoga in reducing functional pain in somatoform disorders is recently reported.[sup][16] Senior citizens with minimal cognitive impairment (MCI) have experienced improvements in sleep, cognitive function, and quality of life following yoga practice.[sup][17],[18] It is known that MCI is a forerunner of later dementia. Would yoga delay the onset of dementia if applied as a lifestyle package in the elderly? Well-designed longitudinal trials comparing yoga with appropriate control intervention can provide an answer to this question. …