Yoga eases depressive symptoms in people with other mental health issues

By Dr. Ananya Mandal, MDMay 18 2020

Researchers have found that the practice of yoga could help those with mental health problems by easing symptoms of depression effectively. Their study titled, "Effects of yoga on depressive symptoms in people with mental disorders: a systematic review and meta-analysis," was published in the latest issue of the British Journal of Sports Medicine. The study was funded by the National Institute for Health Research (NIHR) and Health Education England.

Study: Effects of yoga on depressive symptoms in people with mental disorders: a systematic review and meta-analysis. Image Credit: Rawpixel.com / Shutterstock

What was this study about?

The researchers write that mental health disorders are among the first in terms of global disease burden with it responsible for "for 32.4% of disability-adjusted life years (a year of 'healthy' life lost)". Further depressive disorders affect over 340 million people across the world, and by 2020 it contributes to the second largest "contributor to the global burden of disease."

The authors of the study explain that depressive disorders are often coexistent with other mental health problems, such as psychotic illnesses and anxiety disorders. For example, 25 percent of those who suffer from schizophrenia and 81 percent of those who suffer from generalized anxiety disorders have depressive symptoms, the team explained. Depression is also coexistent with other physical disorders such as type 2 diabetes, metabolic syndrome, obesity, and heart disease. This could be due to a lack of physical activity and more time spent in a sedentary manner, write the researchers. "There is a clear need for interventions which are efficacious in improving both physical activity and depressive symptoms and multi-component lifestyle interventions incorporating a combination of physical activity, exercise, and diet," they added.

Yoga is a form of such "multi-component mind-body practice" which comprises not only physical postures called "asanas" but also combines it with regulated breathing, movement, techniques of relaxation, mindfulness, and meditation. The last two components of yoga are said to be beneficial for alleviating depressive symptoms. The team wrote, "Yoga practice often includes a combination of each and therefore may have additional benefits beyond a single component (e.g., mindfulness, meditation or exercise alone)."

Several studies look at the effects of yoga on depressive symptoms. This study aimed to see the effects of physically active yoga on depressive symptoms compared with persons who had other mental health disorders. Physically active yoga was compared with "waitlist control, treatment as usual and attention control," used among those with mental health disorders.

What was done?

This was a systematic review and meta-analysis based on PRISMA guidelines. Data on the studies were obtained from the noted databases for studies, "MEDLINE, EMBASE, PsychINFO, CENTRAL, EMCARE, PEDro". Studies up to 14^th May 2019 were included in the study. All randomized controlled trials using yoga intervention with more than 50 percent physical activity among those with a recognized diagnosed mental disorder according to DSM-3, 4, or 5 (Diagnostic and statistical manual for mental health disorders), were included in the study.

The team defined yoga intervention as, "Yoga interventions were defined as a structured, formal and premeditated form of physical activity involving the integration of specific body movements (asana) with breathing (pranayama) and/or mindfulness (including meditation), where the movement component (physical activity) made up more than 50% of the total intervention." The types of yoga practiced by the participants included hatha yoga, vinyasa yoga, kundalini yoga, and Kripalu yoga. Each of the weekly sessions lasted between 20 and 20 minutes and was continued for an average period of 2.5 months for the participants.

What was found?

In this study, a total of 19 studies were included for review providing 1,080 participants. A further 13 studies with a total of 632 participants were included for the meta-analysis. They included mental health disorders were anxiety, bipolar disorder, depression, post-traumatic stress disorder, schizophrenia, and alcohol dependence. Results compared yoga with waitlist treatment as usual and attention control. Results were most significant in those with depression, schizophrenia, and alcohol dependence disorders.

The authors wrote, "Greater reductions in depressive symptoms were associated with a higher frequency of yoga sessions per week."

Conclusions and implications

The reviewers concluded that there as a positive impact of physical yoga that was "beyond usual care for reducing depressive symptoms in people with a range of mental disorders." Further, there was a dose-response relationship between the number of sessions of yoga per week and improvements in the depressive symptoms among the participants. They wrote, "Consideration of yoga as an evidence-based exercise modality alongside conventional forms of exercise is warranted, given the positive results of this review. Yoga may provide an additional or alternative strategy to engage people experiencing depression in meaningful physical activity."