ANXIETY AND YOGA

What is anxiety disorder

Several clinical conditions are included in this term:-
Panic disorder; extreme fear and dread accompanied by physical symptoms such as shortness of breath, chest pain, choking sensations. People can eventually become constantly afraid of an impending attack, thus increasing their fears. Panic attacks and agoraphobia, (or “avoidant personality disorder”) are the most prevalent manifestations of anxiety disorders. There are different subtypes of panic disorder, mainly divided into cued (caused by a particular situation) and spontaneous (occurring without outside stimulus).

Examples of the latter:-

• Obsessive–compulsive disorder; intrusive thoughts, and rituals performed out of a feeling of great need.
• Post-traumatic stress disorder; a reaction to a terrifying event which keeps returning through memories.
• Phobia; a fear of a specific object or situation.
• Generalised anxiety disorder; exaggerated worry and tension over everyday events and decisions.

General Benefits of Yoga classes for anxious students

According to research presented to the annual meeting of the Endocrine Society in 2003, Yoga practice significantly reduces

cortisol, a hormone linked to stress reactions. However, other research questions the involvement of cortisol in all anxiety states. NIMH (National Institute for Mental Health in USA) factsheet says that many of the current medications for anxiety disorders affect the neurotransmitter serotonin and new treatments are being investigated which affect other neurotransmitters.

Research at the Boston University School of Medicine suggest that the practice of yoga be explored as a possible treatment for depression and anxiety, disorders associated with low GABA levels. Yoga practitioners showed a 27% increase in GABA levels with no change produced in a comparison group who had read for one hour.

Selene Vega, in “The Psychospiritual Clinicians Handbook” mentions benefits of Yoga found by one of her clients, which included a feeling of connection with the body leading to increased vitality. The client also found that anxious thoughts reduced during the class, that this continued throughout the day, and that practicing in a group of people who were focusing intently on their own agenda meant that he felt less exposed to possible judgment from others.

Reducing reactivity

Fear is an evolutionary necessity for the survival of the species, and is a result of complex brain operations designed to alert us to danger and prepare us for appropriate action. The process starts with sensory information and moves to evaluation followed by preparation. In anxiety, however, this process has long ago stopped at the “alert” stage. Also, we tend to become so accustomed to our own patterns of tension so that we no longer notice them.

In the practice of asana (the physical postures of yoga), a useful habit is to notice where there are obstacles to moving fully into a posture, and evaluating how much of this is a “given” and how much is caused by unhelpful unconscious contraction. See asana section elsewhere on this site for some suggested poses. Yoga is a very ancient art with generations of teachers. Therefore, one posture may have different names, or one name may refer to different postures. The stick men used in these articles are intended as a guide to what posture I am describing. I would suggest that you consult a yoga book, teacher, or a site with more detailed illustrations before attempting a pose.

Some researchers have found progressive muscle relaxation helpful in reducing prevalent anxiety states. As well as producing immediate relaxation of muscular tension, it is a training in awareness of contraction habits. This can lead to a recognition of the changes in muscular tension and disturbed breathing during asana practice, a skill which can hopefully be transferred to recognition of the start of the anxiety reaction in everyday life.

One precaution though:- our tensions may have come about as a way of coping with distress. When we dismantle defences, we should be aware that the mental and emotional patterns which caused us to erect them may resurface. We may need other strategies in place for dealing with our fears. On the other hand, the fear which caused the holding pattern may have long since vanished, and we can let go of the tension with an amazed smile and an enjoyable deep breath.

Increasing tolerance of environmental challenge

It has been found that fear, which has evolved to protect us from danger, causes an immediate response before any conscious thought. The amygdala, deep inside the brain, rapidly receives signals which set the fight or flight reaction in motion. The heart starts to pound and the body is flooded with stress hormones and glucose in preparation for immediate action. The immune system and pain response are suppressed and the learned fear response is indelibly etched on the amygdala. Another set of signals travels more slowly to the cerebral cortex, the cognitive part of the brain. As studies suggest that memories stored in the amygdala are relatively indelible, research is continuing into therapies which increase cognitive control of the amygdala response. This should lead to the ability to interrupt the cascading fight or flight reaction when it is appropriate to do so.

Behavioural therapy tries to change rapid fear response by such techniques as diaphragmatic breathing. Increased cognitive control may help to interrupt a habitual “act now, think later” response.

One way to facilitate the cognitive control through yoga is to increase the challenge in asana as appropriate, noting any automatic fear responses however slight. Even the Tree posture - Vrkasana [image 1] can be challenging for some, especially as balance is often affected by medication. The support of the wall or a chair can be useful in this case as well as resting the lifted foot on the opposite ankle. Eventually students might feel encouraged to attempt other balances such as Boat - Navasana [image 4 ], Warrior Virabhadrasana [image 2] or Dancers pose Natarajasana [image 5 ] Another way is through the practice of meditation techniques in which the states of mind and body are merely observed, without judgment, as they arise and pass away. Meditation in a yoga context will be dealt with elsewhere on this site, but of course this mindful attitude can be applied throughout the practice of asana and pranayama (yogic breathing techniques.)

REFERENCES

VEGA, Selene. The Psychospiritual Physicians Handbook