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Thursday, September 18, 2014

Is Yoga Good for Depression or Anxiety?

Yes. No. Maybe?

Certain types of exercise have been compared to anti-depressants for treating depression; the great news is that at least one good study has shown that exercise is better at treating depression than anti-depressants. To sum things up: in the first couple months, exercise and meds were equally effective but, over time, exercise significantly outpaced meds. For the group of people taking meds and exercising, they felt over time that the meds actually decreased their ability to benefit from exercise; this may be due to the "numbing effect" that many people experience when taking anti-depressants.

In the few studies done on Yoga, there do seem to be several potential benefits, including:
1. Improved ability to cope with symptoms of stress (anxiety) for people who had difficulty  coping with stress before starting Yoga,
2. Improved ability to cope with pain (e.g., Fibromyalgia),
3. Improved ability to cope with symptom of depression.

Regardless of all the research on exercise in general, or specifically regarding Yoga for depression or anxiety, you'll never know if it will help you unless you try it. Until there are some larger studies (3,000+ people), it's impossible to know how many people will benefit or be harmed by Yoga. Yes, some people will be harmed by Yoga by experiencing increased pain, muscle tears, ligament tears, slipped discs, hernias, or other problems. Most interventions or therapies come with potential benefits as well as potential risks.

If there are benefits from Yoga for depression or anxiety,
it may be due to factors of socializing or self-esteem
much more than the act of exercising.

If there are benefits from Yoga for depression or anxiety, they may be due to social factors or increased self-esteem much more than from the act of doing yoga.

There is always the question of why something works. When someone starts exercising, there  are a lot of other things going on, any one of which could be the primary factor that causes the depression to lift. For example, when women start exercising, they might start socializing more, and it might be the socializing that makes them feel better. That's certainly the case for women who join a church; they benefit from the social connections much more than they benefit from worshiping. Exercising or praying alone probably will not be as emotionally beneficial as when done together with people you like. 

There are also changes in what people think about themselves. When people start doing something that most other people, including their doctor or pastor, see as "good," then they start to believe, "I'm a good person;" this improves  self-esteem and self-esteem impacts people's daily, general mood. No pill is going to change that. The most likely hypothesis is that several factors along with exercise help alleviate depression or anxiety. Other factors, like endorphins, enkephalins (your body's pain killers), improved general health, and improved sleep probably play a role too.

People tend to assume that a treatment will either work or will not work; but, that's not the case - for just about all treatments, even antibiotics. 

For example, statin drugs (e.g., Lipitor) may prevent heart attacks (there is actually no evidence that they prolong life), but only 1 heart attack is prevented out of every 256 people who take statin drugs; yet, one out of every 50 people who take statins will develop diabetes and one in ten will develop muscle damage of some type.

The same is true for anti-depressants. In one NIMH study, one in 50 people who took anti-depressants experienced suicide ideation or suicide behavior caused by the anti-depressant. So, for every 1,000,000 people who take an anti-depressant, 20,000 will experience this problem. However, only one in seven or eight people who take an anti-depressant will benefit. So, for every 1,000,000 people who take an anti-depressant, only about 140,000 will benefit. Who will be harmed and who will benefit cannot be predicted and so, it is your risk to take. The same is true for Aspirin: one out of about every 1,661 people will benefit from it. So, drug therapies are not a sure thing or a cure-all. 
Take anti-depressants for OCD. Nearly all anti-depressants work about the same at reducing OCD symptoms, but most of them only reduce the intensity of symptoms by 15%. So, if you have moderate or severe OCD, taking an anti-depressant will not cure you; you will still have symptoms, possibly even severe symptoms. That is why for severe mental health problems, you probably need more than one treatment at a time for the best results.

If you think exercise might help your depression or anxiety, clear it with your doctor first. They may want to conduct a physical exam prior to your starting a new routine, especially if you are overweight or have any other medical conditions. 

After that, you may want to consult with a certified trainer who has experience with people of your health status (gender, age, weight, general physical health). Exercise is not without risk; just because your trainer doesn't see many injuries doesn't mean that they don't happen. For example, a trainer with high turnover might not be aware that people are not coming back because they are injured and just don't tell the trainer about it.

Depression and anxiety are very common human conditions. It's a popular myth that you "need medications" for these problems. You should also consider psychotherapy after you've tried other things first, like talking with friends, family, priests or pastors, or doing other things such as exercise, improving the quality of your  sleep and so on. Psychotherapy has just as much benefit in the short-term as meds, but like exercise, it's better in the long term, and it comes with few if any potential risks.

Mental Health Advice Disclaimer: The information included in this post and blog are for educational purposes only. It is not intended nor implied to be a substitute for professional mental health treatment or medical advice. The reader should always consult his or her mental health provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a mental health or medical condition or treatment plan. Reading the information on this website does not create a therapist-patient relationship.

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