Mental Health and Yoga (with an example of Yoga Therapy for Depression)
In our training we go into great depth regarding the different aspects of mental health from both a scientific (neuroscience and psychology) and a traditional yoga perspective, as well as what we as Yoga Therapists can do to help.
Here is just a small extract from our IAYT Accredited Yoga Therapy Training manual relating to yoga, mental health and the effect on overall health of different states of mind. With an general description of what we do for Depression
Regarding Mental Health over the years there has been a shift in general medicine to a much more holistic approach that actually emphasises that psychological distress is multifactorial, and that can present itself in many different aspects, and it can have an impact on several areas of a person’s life. The holistic model focuses on the individual user needs focusing on their strengths and non-professional care since problems are often mostly social.
There is a shift to the biopsychosocial approach, synthesizing the disease, the psychodynamic, the cognitive-behavioural and the social model. This completely fits in with the Yoga Therapy approach to mental health.
According to yoga, all diseases/ Vyadhis start with the mind.
The character of the mind is determined by the predominant guna (sattva, rajas, tamas). The mind is impaired by excessive utilisation (rajasic mind), by non-utilisation and by wrong utilisation (tamasic mind). A healthy/balanced (sattva) mind is maintained by engaging in beneficial thoughts and actions and avoiding harmful ones.
The mind is divided in 4 parts, the buddhi, manas, ahankara, and chitta.
Buddhi or the intellect (the decision maker based on memories, senses, etc)
Manas – thoughts based on the sensations coming to the brain from the body.
Ahankara is sometimes translated as ego, it gives a sense of identity.
Chitta is pure intelligence. It does not function out of memory or awareness.
Chitta is always on – whether you are awake or asleep.
The main 9 obstacles/kleshas that agitate the mind, that create mental disturbances and encourage distractions, the 9 tendencies that make people vulnerable to reach the state of yoga, to have a still and clear mind, according to Patanjali sutra 1.30.
Vyadhi – pathology/disease/disconnection
Styana – mental heaviness/dullness
Samsaya – doubts
Pramada – lack of clarity/careless
Alasya – laziness
Avirati – abusing your senses/over-indulgence
Bhrantidarsana – distortion of view due to stubbornness
Alabhabhumikatva – disability to get to another level and achieve your goal, Anantasthitatvani – instability to stay to another level and retain your goal
Cittaviksepah is agitated mind and all of these are antarayah (life obstacles) (Patanjali 1.30).
The mind can be calmed by cultivating (as an object) friendliness, compassion, gladness and disinterest within happiness, suffering, virtue(Patanjali 1.33) and by “focusing, to stabilize the mind”. (Patanjali 1.39).
The causes of any disease/ vyadhi are:
1. The cause of vyadhi (the physical diseases) stems from the Adhi (the disturbed mind), according to the yogicconcept of health and disease.
Mental confusion leads to agitation of prana (life force) and haphazard flow along nadis results in depletion of energy and / or clogging up of these channels of vital energy. This leads to disturbance in the physical body with disturbances of metabolism, excessive appetite and improper functioning of the entire digestive system. This is the reason that the psychosomatic disorders are the most common, according to yoga vashista and yoga sutras of Patanjali.
Psychosomatic disorders/ stress related disorders are due to pancha klesha (psychological afflictions) such as avidya (ignorance of the ultimate reality leading to bodily identification), asmita (a false sense of identification), raga-dwesha (addiction and aversion), abhinivesha (clinging on to life for fear of death).
2. Another major cause of disease is the imbalances of doshas.
3. Also, due to obstructed swara(smooth and regular air flow) in the nostrils. (when it does not adhere to their fixed timings and days), according to Shivaswarodaya, a classical text on Swara Yoga.
4. Last, duality. The perception of ego being separated from the whole is another reason for manifestation of disease.
All diseases, maladies, tensions are manifestations of divisions of what should
be man’s complete nature, the atman or ‘Self’. This ‘Self’ is “ease”. A loss of “ease” creates “dis-ease”. Duality is the first insanity, the first disease, the unreasonable thought that “I am different from the whole, I am unique. I am the only one suffering, I feel alone, (suffering from loneliness).
The main symptoms of Vyadhi (disease) are duhkha (mental or physical pain/suffering), daurmanasya (sadness), angamejayatva (anxiety/tremor) and shvasa prashvasah (respiratory irregularities) as expressions of mental disturbances.
By paying careful attention to personal history, one can recognize patterns of mental and emotional tendencies, lifestyle and diet. Through Yoga we try to lessen the impact of these factors (klesha tanukaranam) and promote the state of integration (samadhi bhavanam). Yoga is promoting balance with pratipaksa bhavanam (the cultivation of the opposite.
The first goal of yoga is the stillness of the mind (cittavrittinirodha), to still perturbations/fluctuations of the mind, the main obstacle of liberation.
In order to facilitate the stillness/the calming of the mind, to have a dharmic life (a life based on moral and ethical principles), toexamine our habitual attitudes and behaviours and their consequences, yoga prescribes moral and practical means -the yamas and the niyamas, as the starting point and foundation for all spiritual disciplines.
Yoga also aims at emptying our minds, removing every conditioning (Satyananda) and find the inner truth and meaning in life.
According to yoga psychology, the most fundamental and recurrent mental problem is the lack of meaning. Most mental problems are caused by the simple fact that people do not add values to their lives. Everything seems superficial, meaningless, and hopelessness resulting in powerful negative emotions that can cause a real breakdown of mental functions (Vivekananda)
An Example of what we do in Yoga Therapy for Depression
We try to find something they like, to provoke some interest/arousal/curiosity in something and this something when there is nothing, can be found in their childhood by asking them what they liked when they were kids.
We try to awaken their passion and the determination by highlighting their ability to influence their condition through their own actions, to encourage them to connect with whatever nourishes their heart and to attend to group activities such as a group yoga class. We also try to stimulate interest in some form of activity, however simple and ideally outdoors.
We enhance faith in something bigger, gratitude for what we have and commitment to do or stop doing something to help themselves. We may even remind them that if they continue to do what they do, they will feel the way they don’t want to.
We motivate and empower people to feel what they need to feel, to believe that they can feel differently, to have hope for change and to make the change they want.
We focus on what can be changed, reframe perspective by enhancing appreciation for what they have, redirect their focus to something positive (also by japa mantra), to what can be learned through the situation by vairagya exercise. We may gradually be able to see which chakra is affected and balance its elements/qualities.
Also accepting some sadness, making space for it as part of life that changes, befriending it, may release some burden of being depressed.
We prefer morning practices and contra-lateral adaptations in asanas to focus the mind.
We focus on breathing based on the breathing assessment and often on increasing inhalation. Especially for a morning practice, and we may incorporate a short retention.
Most of the times, we focus on chest mobilisation and expansion by opening and lifting the hands and back bends ultimately making inhalation equal to exhalation, especially in cases where they are physically sedentary, or energy depleted and mentally depressed (tamasic in body and mind).
When we shouldn’t increase inhalation, we release chest restriction by opening the chest, lifting and opening arms, by side bends and twists.
We may start by bringing awareness to them and progressively to the cosmos and then back to them, to make them feel that the whole world is not full of their problem(s) and that it is tiny in comparison to the whole cosmos.
In general, we prefer a brahmana sequence, starting in supine position, at the energy level or the mood they are found, and with more repetitions than stays we lift the energy levels and hopefully the spirit, too.
We start from supine position with micromovements (finding them where they are energetically) and then come to kneeling and ultimately in standing and big positions, although it may take some sessions, depending on whether they are ready.
We prefer back bends and lateral bends, repetitions than staying in the postures, we proceed to stronger standing asanas, and we may finish in a sitting position instead of lying.
We may incorporate self-touch and empowering mantras during the practice and during the breathing.
We may explore humming or chanting, mentally and at the end verbally from soft to louder. In chanting, the higher volume, pitch and speed has a more brahmana effect and we prefer it for depression while the lower volume, pitch and speed has a more laghana effect and we prefer it for anxiety.
A simple and short meditation in sitting position could be visualising light expanding only in their brain/head or in (in brahmana sequence) light to the perineum, then light expanding to the belly, and light expanding to the heart, with or without retention of inhalation, with or without chanting their mantras in each position for a few repetitions.
When physically agitated and mentally depressed, we may lengthen exhale in combination with short retention of inhalation using a laghana sequence, especially for an evening practice.
