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Yoga Is Not a Standalone Treatment for Psychological Disorders
Recently, I was contacted by a well-intentioned, experienced yoga teacher who was hoping to learn some effective stress management techniques in the hope that she could teach them to a friend who was suspected of being suicidal.
This line of thinking, while well-meaning, is potentially dangerous if not deadly. But unfortunately, in my work as a psychologist and yoga therapist, I come across it all too often.
Yoga seems to be a natural fit for treating psychological disorders given its focus on mind, body and spirit, and in some respects it is. With the practice of yoga proliferating, it is no surprise that it is the latest form of complementary medicine to gain appeal in the search to combat mental illness. Unfortunately, there is still too little research available to substantiate the effectiveness of yoga as a treatment for psychological disorders.
The reason we know so little is a combination of poor research design, the difficulty of standardizing studies, and just the sheer recency of the arrival on yoga as a potential adjunct treatment for psychological disorders.
In a recent review, a team of researchers in the United States and India conducted a systematic examination of the scientific literature to assess the benefits of yoga for depression, schizophrenia, ADHD, sleep complaints, as well as cognitive and eating disorders. Of a total of 124 studies in which yoga was used as therapy for the disorders listed above, only 16 studies, or 12.9%, were considered to be of sufficient quality to be considered in the final evaluation.
That is an important statistic. It indicates that the overwhelming majority of studies regarding the effects of yoga for mental illness are of such poor quality that it would be ill advised to draw any conclusions from their results.
Yoga May Offer Help in Cases of Mild Depression
This carefully conducted systematic review provided some evidence linking yoga practice to reduced symptoms of depression. It is important to note that the participants in these studies were categorized predominantly as having mild depressive symptoms. None of the studies indicated that participants had been formally diagnosed with a depressive disorder, had moderate to severe symptoms, or were experiencing any suicidal tendencies. In addition, these studies found short-term, positive changes but did not assess long-term outcomes. So the effectiveness of yoga for chronic symptoms or pervasive depressive disorders is not known.
Of the 16 studies selected, 4 examined the use of yoga for depression, 3 for schizophrenia, 2 for ADHD, 3 for sleep complaints, 2 for cognitive disorders, and 2 for eating disorders. And while the studies were of sufficient quality to be included in the review, they were still rated as low quality by the authors.
The findings for the remaining disorders were either minimal, inconclusive, or suggested that yoga may present some benefit as an adjunct to pharmacotherapy. The authors cautiously concluded that there is “emerging evidence from randomized trials to support popular beliefs about yoga for depression, sleep disorders, and as an augmentation therapy”. They go on to state that more rigorous studies are needed to “fully translate the promise of yoga for enhancing mental health.”
East Meets West – Well Not Quite Yet
The practice of yoga is beneficial on many levels, and there are a plethora of anecdotal reports of students experiencing significant and sustained relief from physical and emotional symptoms. However, while personally relevant, this does not support the use of yoga as a standalone therapy for psychological disorders. With the growing popularity of yoga, it’s important for well-meaning individuals, such as the yoga teacher in the opening to this article, to keep in mind that we still know very little about the usefulness of yoga in the treatment of psychological issues. For now, all we can say is that at best, yoga may serve as an adjunctive treatment to existing forms of psychotherapy and pharmacotherapy.
While there are many claims that yoga can help people with symptoms of mental illness, it is not a treatment in and of itself, and it is not a cure. At best there is evidence for symptom reduction for individuals with mild forms of depression and anxiety, and data to suggest that it can improve people’s experience of stress, and perceptions regarding quality of life.
It is critically important that yoga therapists, teachers and practitioners respect the limitations of the practice and the ethical scope of services that we can provide. Far too often people in the yoga community overestimate the power of the practice based on personal experience. This overzealous attitude is, frankly, irresponsible and dangerous.
Yoga is most definitely not a standalone treatment for psychological illness, particularly moderate to severe depression, anxiety, trauma/PTSD, schizophrenia, obsessive compulsive disorder, panic disorder, psychosis, psychotic disorders, or any other severe psychiatric illness. To treat it as such puts individuals at risk for harm or, in the worst case, death. This is an unpopular opinion, but there are no convincing data based on empirically rigorous research to support its use as anything but an adjunctive therapy under specific conditions. Yoga does not replace the need to seek appropriate care from a well-trained, qualified mental health professional. Period.
This is not to say that there aren’t some excellent programs out there. This is only to provide a reality check for the overzealous yoga enthusiasts who believe that yoga is a cure all for mental illness. It is not.
B Grace Bullock, PhD, E-RYT 500, is the Founding Director of the International Science & Education Alliance, a firm that provides strategic planning, research consultation and assessment design to support the empirically rigorous evaluation and sustainable implementation of programs in education, leadership, health and human services. Grace is an intervention scientist, psychologist, yoga educator and author who has worked extensively in integrated behavioral health settings. Her research, clinical practice, teaching and writing emphasize the incorporation of empirically supported psychotherapy with yoga therapy and mindfulness practices to relieve the symptoms of stress, trauma, anxiety, depression and other psychological illnesses, and to promote healthy relationships. She is Faculty at the Integrated Health Yoga Therapy therapist training program, and Professor of Yoga & Neuroscience at the Taksha University School of Integrative Medicine. Grace is the former Editor in Chief of the International Journal of Yoga Therapy and recipient of a Francisco J. Varela Research Award from the Mind & Life Institute. For more information contact Grace at firstname.lastname@example.org or see http://isaeaorg.wix.com/isaea and http://www.mind-bodytherapy.com.