Indian Journal of Health Social Work
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YOGA AS THERAPY FOR MENTAL HEALTH
Justin Raj, P.C1
, Narendra Kumar Singh2, Nishant Goyal3
1Junior Research Fellow, K.S. Mani Centre for Cognitive Neurosciences, Department of Psychiatry,
CIP, Ranchi, 2In-charge and Senior Psychiatric Social Welfare Officer, Department of Psychiatry,
CIP, Ranchi, 3Professor of Psychiatry, In-Charge K.S. Mani Centre for Cognitive Neurosciences,
Department of Psychiatry, CIP, Ranchi.
Correspondence: Justin Raj, P.C, email: justin.raj@yale.edu
Abstract
Yoga is developing as therapy for various disorders in mental health, at same it is used in daily
life for mental health wellness. The aim of this article is to determine development of yoga as
therapy, and where it’s role in mental health as a novel exercise modality. Yoga is developing as
science, in various forms and in different life situations. Mental health is one of the life situations
where yoga is more evidently applicable to maintain wellness as well as improving physical and
psychological health. The research is going on how yoga can be utilized in its full form to minimize
impact of psychiatric disorders, furthermore it’s direct effect has been not yet revealed and yoga
is used as adjunctive therapy modalities in various disorders. Therefore, further research indeed
to understand direct effect of yoga as therapy. This article tries to describe current developments
in yoga as therapy in mental health.
Keywords: Yoga, Mental Health, Social Cognition, Electroencephalography.
INTRODUCTION
Yoga is an ancient system of body and mind
exercises that began during the Indus Valley
Civilization in South Asia. The first written
record of this technique appears in the Yoga
Sutras of Patanjali in the 3rd or 4th century
BC (Singh, 1983). Yoga is conceptualized as
the science of consciousness that deals with
the transformation of the individual self
(Nagendra, 2008). Patanjali defines it as masa
(control), niyamas (observation), asana
(postures), pranayama (control or breathing),
pratya-hara (sensory withdrawal), dharana
(concentration), dhyana (meditation) and
Samadhi (self-realization). Yoga has been
around for centuries in the Indian
REVIEW ARTICLE
subcontinent and is promoted as a lifestyle
and a means to improve overall health. Yoga
has been used to improve health and reduce
pain (Chong et al., 2011). Yoga has been used
as a therapeutic measure in the treatment of
mental illnesses (Posadzki et al., 2010). Yoga
is not used to treat stress, depression, anxiety,
and childhood pain (Cramer et al., 2013; da
Silva et al., 2009; Galantino et al., 2008); and
childhood illness. Treatment of substance
abuse (Posadzki et al., 2010). The course of
drug addiction often escalates with relapse
and withdrawal. Chronic pain treatment leads
to the search for new treatments. As a
complementary therapy, yoga holds the promise of providing an alternative treatment
to substance abuse.
With many changes in lifestyle, the stress of
thinking in daily life is also increasing, and
many relaxation techniques are becoming
popular to reduce this situation. But one of
the most common practices is various types
of yoga and yoga breathing. Sudarshan Kriya
and other practices is a type of yoga that
teaches breathing exercises (Pranayam) in
addition to physical postures (asanas)
(Kjellgren & Anderson, 2015)
WHY YOGA AS THERAPY?
Yoga may be beneficial as a complementary
treatment for individuals with alcohol addiction
and personality disorders. Yoga practices,
such as pranayama (breathing exercises),
asanas (yoga postures), and meditation, have
been shown to reduce symptoms of anxiety
and depression, which are common
comorbidities of alcohol addiction.
Additionally, the mindfulness and selfawareness practices incorporated in yoga may
help individuals with personality disorders and
alcohol addiction to gain insight into their own
thoughts and emotions, which can be
beneficial in therapy. However, it’s important
to seek guidance from a mental health
professional before starting yoga as part of a
treatment plan and to work with a qualified
yoga therapist who is trained to work with
individuals with addiction and personality
disorders.
Self-control, meditation, cleansing (Kriya),
yoga asanas (postures), pranayama
(breathing) and meditation (Dharana and
Dhyan) are some of these (Malhotra, 2017).
Yoga-based interventions are interventions
that include at least one of these activities.
Yoga helps in whole personality development
against many diseases and spiritual uplift.
Many people practice yoga to improve overall
health and prevent disease (Cramer et al.,
2016; Stussman et al., 2012). Conditions such
as anxiety, depression, back pain, asthma,
hypotension, musculoskeletal disorders,
obstructive pulmonary disease (chronic
obstructive pulmonary disease), and cancer
are increasingly considered medical
conditions. Brenes (2018) reviewed all
available evidence on the benefits of yoga for
adults with Alzheimer’s disease and cognitive
impairment. After reviewing six studies
combining cognitive and behavioral changes
in people with cognitive impairment, they
concluded that yoga may be an effective
treatment for people with dementia. Yoga has
been shown to be more effective than no
intervention for mental health, but it is not
more effective than mental activity or physical
activity. No significant effects of yoga have
been shown to be affected in terms of life
satisfaction and relationships (Hedriks et al.,
2017).
USE OF YOGA AS THERAPY IN MAJOR
PSYCHIATRIC DISORDERS
Schizophrenia is characterized by three main
symptoms: positive symptoms, negative
symptoms and cognitive symptoms.
Schizophrenia patients often seek treatment
for positive and negative symptoms. But
cognitive impairment occurs earlier and has
a greater impact on performance.
Schizophrenia is a chronic mental illness which
causes significant distress and dysfunction.
Yoga has been found to be effective as an addon therapy in schizophrenia (Govindaraj et al.,
2016). Schizophrenia has also been described
as ‘citta vikhalathe’ (distortions of the mind).
Yoga practice is defined as “citta vrtti
nirodhah” (controlled mind change). Some
yoga texts, such as Patanjali’s Yoga Sutras,
describe experiences similar to symptoms of
schizophrenia (Iyengar, 2007). Therefore,
yoga is considered an adjunctive treatment
alongside antipsychotics in the treatment of
schizophrenia. These studies have yielded
positive results demonstrating the role of yoga
in schizophrenia (Bhatia et al., 2012;
Duraiswamy et al., 2007; Varambaly et al.,
2012). Studies using yoga modules vary
depending on the experience of the
researcher. However, although many people
use yoga poses as therapy, there is little
evidence that specific yoga poses are
beneficial for psychosis or schizophrenia.
Yoga-based modules developed for
schizophrenia (Table 1) are accepted by most
experts from different schools of yoga. Yoga
has been shown to be beneficial to cognitive
development in healthy adults and older adults
(Gothe & McAuley, 2015). As an adjunctive
treatment, yoga is more effective than physical
exercise in reducing negative symptoms in
person with schizophrenia (Duraiswamy et al.,
2007; Varambaly et al., 2012). It may also
improve the quality of life of people with
schizophrenia (Cramer et al., 2013). Recent
studies have examined the therapeutic effects
of yoga on neurocognition and reported
cognitive gains in schizophrenia patients
(Bhatia et al., 2017).
Anxiety and Depression
These yoga practices are effective and costeffective and can be given to many adults to relieve mental stress and related conditions, which may also help prevent physical and psychological problems (Kjellgren & Anderson, 2015). Because depression is a significant mental health problem after a diagnosis of schizophrenia, and many clinical studies have shown that yoga practice is considered an adjunct to medical treatment, the data in this study and group have always been inconclusive in reducing symptoms of depression. Consider whether meditation is a good treatment for depression. Yoga therapy is often beneficial compared to uncontrolled therapy; however, results were lower when comparing active conditions to inactive controls (Yadav et al., 2022). The quantity and quality of available research data are not sufficient to determine whether studies focusing specifically on yoga postures are better than studies focusing specifically on meditation and pranayama. It is not clear whether lust is a problem for people with depression. Experiments have elucidated the mechanisms behind the anti-anxiety effects of yoga by examining electrophysiological to manage stress, which can lead an individual to healthier lifestyle. There are not enough studies to prove that yoga directly helping individuals with addiction, however, it is incorporate with mindfulness practices to support rehabilitation. NDifferent yoga schools use all or some of the above steps. Kundalini Yoga or Primordial Energy Unification System is a wellestablished yoga school (Mahan, 1981; Maharishi, 1992). Different yoga schools use all or some of the above steps. Kundalini Yoga or Primordial Energy Unification System is a well-established yoga school (Mahan, 1981; Maharishi, 1992). A special feature of this school is the ability to solve problems when trying to cut and cut, starting with seven-step meditation (dhyana), which is especially useful for combating the negative effects of stress and encouraging smoking. Yoga techniques for smoking cessation have been suggested but have not been empirically tested (McIver, O’Halloran, & McGartland, 2004; Sahay & Sahay, 2002). A yoga intervention based on social psychology is more effective than a self-help approach in coping with the effects of smoking (Sahrma & Corbin, 2006).
Anxiety and Depression
These yoga practices are effective and costeffective and can be given to many adults to relieve mental stress and related conditions, which may also help prevent physical and psychological problems (Kjellgren & Anderson, 2015). Because depression is a significant mental health problem after a diagnosis of schizophrenia, and many clinical studies have shown that yoga practice is considered an adjunct to medical treatment, the data in this study and group have always been inconclusive in reducing symptoms of depression. Consider whether meditation is a good treatment for depression. Yoga therapy is often beneficial compared to uncontrolled therapy; however, results were lower when comparing active conditions to inactive controls (Yadav et al., 2022). The quantity and quality of available research data are not sufficient to determine whether studies focusing specifically on yoga postures are better than studies focusing specifically on meditation and pranayama. It is not clear whether lust is a problem for people with depression. Experiments have elucidated the mechanisms behind the anti-anxiety effects of yoga by examining electrophysiological to manage stress, which can lead an individual to healthier lifestyle. There are not enough studies to prove that yoga directly helping individuals with addiction, however, it is incorporate with mindfulness practices to support rehabilitation. NDifferent yoga schools use all or some of the above steps. Kundalini Yoga or Primordial Energy Unification System is a wellestablished yoga school (Mahan, 1981; Maharishi, 1992). Different yoga schools use all or some of the above steps. Kundalini Yoga or Primordial Energy Unification System is a well-established yoga school (Mahan, 1981; Maharishi, 1992). A special feature of this school is the ability to solve problems when trying to cut and cut, starting with seven-step meditation (dhyana), which is especially useful for combating the negative effects of stress and encouraging smoking. Yoga techniques for smoking cessation have been suggested but have not been empirically tested (McIver, O’Halloran, & McGartland, 2004; Sahay & Sahay, 2002). A yoga intervention based on social psychology is more effective than a self-help approach in coping with the effects of smoking (Sahrma & Corbin, 2006).
Yoga in Substance Use Disorder Management.
(Sarkar & Varshney, 2017)
Yoga intervention for addiction psychiatry can
be considered as adjunctive and alternative
treatment. In practical, this intervention is
best combined with other treatments such as
physical therapy or psychotherapy (Sarkar &
Varshney, 2017). Khalsa et al. (2008)
investigated the effects of home-based
Kundalini-based yoga therapy in eight patients
with polydrug addiction (alcohol, opioids, and
barbiturates). These subjects were members
of a home clinic who practiced Kundalini yoga
for ninety days. Compared to baseline, the
intervention group indicated improvements in
self-reported symptoms, problem severity, and
recovery, although perceived stress during the
yoga session did not change. Devi et al. (2014)
randomly divided a group of drug addicts into
a yoga group and a control group; The yoga
group took daily yoga classes for 4 weeks.
Yoga intervention reduced severity of
depressive symptoms in the intervention
group for 4 weeks. The intervention also
improved quality of life, including physical,
mental and health. The above information
shows that yoga is used in the treatment of
many drug addictions, including tobacco,
alcohol, opioids, and others. It is often used
as an adjunctive treatment to complement
other medical treatments for substance abuse
(Sarkar & Varshney, 2017). It can be used in
both outpatient and inpatient settings, with
the admonition that yoga sessions should
rarely be held in outpatient clinics.
Personality Disorders
Personality is something unique that every person thinks, acts, and needs throughout their life. According to Allport (1961), personality is a dynamic organization in the psychophysiological system that determines the characteristics of a person’s behavior and thoughts. According to Cattell (1950), attitude is something that predicts how a person will behave in any given situation. A negative attitude is a persistent pattern of behavior and internal experiences that are significantly affected by one’s leadership expectations, influence, and change. Yes, it begins early in old age, stabilizes over time, and causes damage or stress. They are divided into three groups according to similar explanations. Yoga has been shown to be beneficial as a complementary treatment for individuals with personality problems. Yoga practices, such as pranayama (breathing exercises), asanas (yoga postures), and meditation, have been shown to reduce symptoms of anxiety and depression, which are common comorbidities of personality disorders. Additionally, the mindfulness and self-awareness practices incorporated in yoga may help individuals with alcohol addiction with personality to gain insight into their own thoughts and emotions, which can be beneficial in therapy. Research has shown that individuals with personality disorders who suffer from alcohol addiction may have additional benefit from practicing yoga. Yoga has been found to help individuals with personality disorders improve emotional regulation, stress management, and selfawareness, which can be particularly beneficial for individuals who struggle with impulsivity and emotional regulation. Additionally, Yoga may also help to reduce symptoms of anxiety and depression associated with alcohol addiction and personality disorders. It is important to note that while yoga may be helpful as a complementary treatment for individuals with personality disorders and alcohol addiction, it should not be used as a replacement for conventional therapy or medication.
YOGA AND SOCIAL COGNITION
Humans are better able to understand and evaluate social situation by understanding other people’s minds, facial expression, prosody of speech, body posture, emotions, and intentions (Uekermann & Daum, 2008). All together such processes are incorporated under the umbrella of term Social Cognition. Social cognition is defined as psychological functionality in social relationships (Brothers, 1990). The most common cognitive skills in schizophrenia are Mind Thinking (ToM), Thinking (EP), Perception (SP), Intelligence, and Intelligence (AS) (Couture et al., 2006; Penn et al., 2008). Apart from positive symptoms, there is no effective treatment for negative symptoms and cognitive symptoms (including social cognition) (Buckley and Stahl, 2007). Additionally, current treatments are not without side effects. Some cause extrapyramidal side effects and some cause metabolic effects (Abbott, 2010). Psychological interventions can target some or most social cognition, with or without neurocognitive training. But many of these [such as Clinical Cognitive Training (CET), Social Cognitive Training (SCIT)] are effective products and the question is whether they work well in all countries. These are also designed for Western patients, and their cultural impact on other cultures is questionable. Additionally, the magnitude of benefits provided by these interventions varies (size 0.30–1.29) (Kurtz et al., 2016), and the extent to which they improve work is not a good measure. The uniqueness of yoga among complementary therapies is that, unlike other therapies, it is a treatment for the body, breath and mind. Yoga has been shown to be beneficial for cognitive development in healthy adults and older adults (Gothe & McAuley, 2015). Yoga has been shown to have a positive effect on social cognition, which includes aspects of mental functioning such as perception, attention, memory, and decision-making related to social interactions. Studies have found that practicing yoga can improve empathy, emotional regulation, and theory of mind, which are all important components of social cognition. Additionally, yoga may also improve attention and memory, which can be beneficial for social interactions and communication. Overall, yoga has the potential to positively impact an individual’s social cognition, making it easier to navigate social interactions and relationships.
YOGA AND ELECTROENCEPHALOGRAPHY (EEG) /EVENT RELATED POTENTIALS (ERP) In a study using emotional intelligence, EEG showed increased emotion-related gamma activity (Lutz et al., 2004). A study found that after doing yoga, alpha, beta, delta and theta wave energy in the frontal and occipital regions of the right brain was better than that of the left brain. For this reason, the right side of the brain shows more power than the left side (Kochupillai, 2015). Additionally, after doing yoga in 2016, an increase in alpha power and a significant difference in gamma, alpha, and theta2 rhythms were observed. After doing yoga, the amplitude of mismatch negativity (MMN) increases and therefore the interest and prioritization of ERP studies increases (Srinivasan & Baijal, 2007). Also in 2011, this study showed a decline in ERP; as a result, hope and emotional control are better after yoga (Gootjes et al., 2011). The P300 ERP is a neural response that occurs about 300 milliseconds after the presentation of an infrequent or unexpected stimulus, such as a target in a visual or auditory oddball task. The P300 is thought to reflect cognitive processes such as attention allocation and decisionmaking and is often used as a measure of cognitive function. Facial emotional recognition is the ability to identify and understand the emotions being expressed by another person’s face. It involves the neural processing of facial cues such as eye gaze, facial expressions, and other nonverbal cues. Research has shown that the P300 is related to facial emotional recognition. Studies have found that the amplitude and latency of the P300 is modulated by the valence (positive or negative) and the intensity of the facial expression. Moreover, individuals with higher P300 amplitude and shorter latency tend to score higher in facial emotional recognition tests. The P300 is a neural response that occurs in response to infrequent or unexpected stimuli, and it is related to cognitive processes such as attention allocation and decision-making (Chandra et al., 2016). Research has shown that the P300 is also related to facial emotional recognition, with studies suggesting that the amplitude and latency of the P300 is modulated by the valence and intensity of the facial expression, and individuals with higher P300 amplitude and shorter latency tend to score higher in facial emotional recognition tests.
CONCLUSION
Yoga is a developing science as therapy, and there is not much evidence to prove direct effect of Yoga Therapy in mental health, while it is used as adjunctive with traditional treatment. Yoga can utilize positively for better mental health by reducing stress, improving mood, enhancing emotional regulation, promoting better sleep, increasing resilience, boosting self-esteem, fostering social connection, and improving focus and concentration. While it offers valuable mental health benefits, it should be seen as a complement to, not a replacement for, traditional treatment. Overall, it can incorporate into individuals’ mental well-being and overall health. Further studies are needed to find out the effect of various Yoga practices in mental health.
Personality Disorders
Personality is something unique that every person thinks, acts, and needs throughout their life. According to Allport (1961), personality is a dynamic organization in the psychophysiological system that determines the characteristics of a person’s behavior and thoughts. According to Cattell (1950), attitude is something that predicts how a person will behave in any given situation. A negative attitude is a persistent pattern of behavior and internal experiences that are significantly affected by one’s leadership expectations, influence, and change. Yes, it begins early in old age, stabilizes over time, and causes damage or stress. They are divided into three groups according to similar explanations. Yoga has been shown to be beneficial as a complementary treatment for individuals with personality problems. Yoga practices, such as pranayama (breathing exercises), asanas (yoga postures), and meditation, have been shown to reduce symptoms of anxiety and depression, which are common comorbidities of personality disorders. Additionally, the mindfulness and self-awareness practices incorporated in yoga may help individuals with alcohol addiction with personality to gain insight into their own thoughts and emotions, which can be beneficial in therapy. Research has shown that individuals with personality disorders who suffer from alcohol addiction may have additional benefit from practicing yoga. Yoga has been found to help individuals with personality disorders improve emotional regulation, stress management, and selfawareness, which can be particularly beneficial for individuals who struggle with impulsivity and emotional regulation. Additionally, Yoga may also help to reduce symptoms of anxiety and depression associated with alcohol addiction and personality disorders. It is important to note that while yoga may be helpful as a complementary treatment for individuals with personality disorders and alcohol addiction, it should not be used as a replacement for conventional therapy or medication.
YOGA AND SOCIAL COGNITION
Humans are better able to understand and evaluate social situation by understanding other people’s minds, facial expression, prosody of speech, body posture, emotions, and intentions (Uekermann & Daum, 2008). All together such processes are incorporated under the umbrella of term Social Cognition. Social cognition is defined as psychological functionality in social relationships (Brothers, 1990). The most common cognitive skills in schizophrenia are Mind Thinking (ToM), Thinking (EP), Perception (SP), Intelligence, and Intelligence (AS) (Couture et al., 2006; Penn et al., 2008). Apart from positive symptoms, there is no effective treatment for negative symptoms and cognitive symptoms (including social cognition) (Buckley and Stahl, 2007). Additionally, current treatments are not without side effects. Some cause extrapyramidal side effects and some cause metabolic effects (Abbott, 2010). Psychological interventions can target some or most social cognition, with or without neurocognitive training. But many of these [such as Clinical Cognitive Training (CET), Social Cognitive Training (SCIT)] are effective products and the question is whether they work well in all countries. These are also designed for Western patients, and their cultural impact on other cultures is questionable. Additionally, the magnitude of benefits provided by these interventions varies (size 0.30–1.29) (Kurtz et al., 2016), and the extent to which they improve work is not a good measure. The uniqueness of yoga among complementary therapies is that, unlike other therapies, it is a treatment for the body, breath and mind. Yoga has been shown to be beneficial for cognitive development in healthy adults and older adults (Gothe & McAuley, 2015). Yoga has been shown to have a positive effect on social cognition, which includes aspects of mental functioning such as perception, attention, memory, and decision-making related to social interactions. Studies have found that practicing yoga can improve empathy, emotional regulation, and theory of mind, which are all important components of social cognition. Additionally, yoga may also improve attention and memory, which can be beneficial for social interactions and communication. Overall, yoga has the potential to positively impact an individual’s social cognition, making it easier to navigate social interactions and relationships.
YOGA AND ELECTROENCEPHALOGRAPHY (EEG) /EVENT RELATED POTENTIALS (ERP) In a study using emotional intelligence, EEG showed increased emotion-related gamma activity (Lutz et al., 2004). A study found that after doing yoga, alpha, beta, delta and theta wave energy in the frontal and occipital regions of the right brain was better than that of the left brain. For this reason, the right side of the brain shows more power than the left side (Kochupillai, 2015). Additionally, after doing yoga in 2016, an increase in alpha power and a significant difference in gamma, alpha, and theta2 rhythms were observed. After doing yoga, the amplitude of mismatch negativity (MMN) increases and therefore the interest and prioritization of ERP studies increases (Srinivasan & Baijal, 2007). Also in 2011, this study showed a decline in ERP; as a result, hope and emotional control are better after yoga (Gootjes et al., 2011). The P300 ERP is a neural response that occurs about 300 milliseconds after the presentation of an infrequent or unexpected stimulus, such as a target in a visual or auditory oddball task. The P300 is thought to reflect cognitive processes such as attention allocation and decisionmaking and is often used as a measure of cognitive function. Facial emotional recognition is the ability to identify and understand the emotions being expressed by another person’s face. It involves the neural processing of facial cues such as eye gaze, facial expressions, and other nonverbal cues. Research has shown that the P300 is related to facial emotional recognition. Studies have found that the amplitude and latency of the P300 is modulated by the valence (positive or negative) and the intensity of the facial expression. Moreover, individuals with higher P300 amplitude and shorter latency tend to score higher in facial emotional recognition tests. The P300 is a neural response that occurs in response to infrequent or unexpected stimuli, and it is related to cognitive processes such as attention allocation and decision-making (Chandra et al., 2016). Research has shown that the P300 is also related to facial emotional recognition, with studies suggesting that the amplitude and latency of the P300 is modulated by the valence and intensity of the facial expression, and individuals with higher P300 amplitude and shorter latency tend to score higher in facial emotional recognition tests.
CONCLUSION
Yoga is a developing science as therapy, and there is not much evidence to prove direct effect of Yoga Therapy in mental health, while it is used as adjunctive with traditional treatment. Yoga can utilize positively for better mental health by reducing stress, improving mood, enhancing emotional regulation, promoting better sleep, increasing resilience, boosting self-esteem, fostering social connection, and improving focus and concentration. While it offers valuable mental health benefits, it should be seen as a complement to, not a replacement for, traditional treatment. Overall, it can incorporate into individuals’ mental well-being and overall health. Further studies are needed to find out the effect of various Yoga practices in mental health.
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Conflict of interest: None Role of funding source: None
Conflict of interest: None Role of funding source: None
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