Yoga for Mental Health Disorders: Research and Practice

Depression

A depressive episode is characterized by feeling pervasively sad, having decreased interest in activities, depressive cognitions, death wishes, suicidal thoughts, ideas of guilt, decreased concentration/memory/self-confidence/sleep, and appetite. In some cases, sleep and appetite may also be increased. In the past few years, there has been an increased interest in the use of yoga for the management of depressive disorders. In one of the earliest Randomized Controlled Trials (RCT), Sudarshan Kriya Yoga was found to be comparable to anti-depressant medications as a sole treatment in major depression (Janakiramaiah et al., 2000). In another study, yoga produced clinical improvement in depression comparable to medications, without significant adverse effects (Naveen et al., 2013). Yoga has been found to be effective even when used as a stand-alone treatment for mild to moderate depressive episodes. A recent study using yoga as a mono-therapy for depressed patients found that the effect size in reducing depression was large (Prathikanti et al., 2017). In another recent RCT, Iyengar yoga was tested for its impact on suicidal ideations (SI) in depressed individuals. The preliminary evidence from this study suggests that this intervention may be safe in such patients and may reduce suicidal ideation (Nyer et al., 2018).

A review looking at the efficacy of yoga for depression and anxiety concluded that yoga might be helpful for depression and anxiety, although the most substantial evidence was for unipolar depression (Uebelacker et al., 2016). In a systematic review, 12 RCTs were reviewed of which 3 RCTs had a low risk of bias. There was moderate evidence for yoga's short-term effects compared to usual care concerning the severity of depression. The review concluded that despite methodological drawbacks in the studies, yoga could be considered an add-on treatment option for patients with depressive disorders (Cramer et al., 2013).