Yoga in Reducing the Symptoms of Depression - Essay Example

Yoga for Depression Institution Date Introduction Many scholarly articles report a link between Yoga and a decrease in the psychological outcomes of patients suffering from a range of conditions (Kirkwood, Rampes, Tuffrey, Richardson, and Pilkington, 2005; Pilkington, Kirkwood, Rampes and Richardson, 2005). This study aims to investigate whether Yoga is effective is reducing the symptoms of depressions among middle-aged patients. This study follows findings that indicate that Yoga could significantly decreases the symptoms of depression such as ruminations (Lopez, Driscoll and Kistner, 2009). The present study will search for evidence of the effectiveness of Yoga from several Randomized Controlled Trials conducted on the use of Yoga as an intervention for reducingsymptoms of depression. According to Park (2013), Yoga is a mind-body modality that comprises of physical exercise, breathing and relaxation practices which focus on improving the overall health of the individual. One of the greatest advantages of Yoga as an intervention for fighting depression is that it can be self-administered and adapted to ones mood. Yoga is also easily acceptable by many patients and provides a cheap intervention that can help enhance the mental health of middle-aged individuals suffering from depression (Park, 2013). Depression is one of the conditions that reduce the quality of life for middle-aged individuals as it affects their daily functioning. Search Strategy A systematic review for Randomized controlled trials using Yoga interventions was conducted in 2 electronic databases (Scopus and Cochrane). The key terms used in the search included (yoga, depression, middle-age, midlife, adult, mature, Depression reduction. The search in the two databases yielded 253 articles. The first inclusion criteria were studies published in English in peer-reviewed academic journal (If the study included a range of ages 45-65, however studies were included if they included a range of ages starting from 18 but did not exceed 65 years. Thirdly, the study had to bea Randomized Controlled Trials (RCT). In addition, Yoga had to be the chief or part of the main component of the intervention. In addition, selected studies had to have a measures for psychological outcomes. Finally, the study included were available in full-text online. A further inclusion criterion was applied where articles which measured the outcomes of well-being, depressive symptom and depression were included. An exclusion criterion was applied to exclude articles that did not use an explicit measure of depression such as Hospital Anxiety and Depression Scale, Beck Depression Inventory and the Depression Anxiety Stress Scale. In addition, Studies were excluded from the review if they did report enough data for computing the effect of the intervention within the study (Single case studies were not included as they do not allow for computation of standard deviation). Non-RCT studies were also excluded as the review sought primary evidence to support the conclusion. All the studies in the review include Yoga as an intervention and provide empirical evidence regarding its effectiveness in reducing depression symptoms. To be included, a study must have reported Yoga as” a mind-body modality that comprises of physical exercise, breathing and relaxation practices which focus on improving the overall health of the individual”( Park, 2013). Results and Discussion Kinser, Bourguignon, Whaley, Hauenstein and Taylor (2013), conducted a study that sought to investigate the effectiveness of Gentle Hatha Yoga on the depression symptoms of women suffering from Major Depression disorder (MDD). The study involved a randomized controlled trial employing mixed-methods in a community setting. The study sample consisted of 27 women diagnosed with MDD and an attention control group. The study group were offered a 8-week yoga intervention (Kinser et al, 2013). The study reported that participants exhibited a reduction of depression symptoms including decreased ruminations, gaining of coping strategies and increased connectedness. In addition, the study reported that Yoga was acceptable and feasible for reducing the symptom of depression among women suffering from MDD. Further support, for the efficacy of Yoga is found in Tekur, Nagarathnaa, Chametchaa, Hankeya and Nagendrab (2012) who conducted a seven day randomized control study in Bangalore, India. The study conducted in a HolisticHealth Centre sought to find the effect of yoga on anxiety, pain, depression and spinal mobility of 80 patients (43 male, 37 female) suffering from Chronic Low back pain (CLBP) (Tekur et al, 2012). The yoga interventions used in the study included meditation, asanas and pranayamas for back pain, lectures on yoga philosophy and yogic counseling. The study reported that the Yoga program was more effective in reducing pain, depression and anxiety symptoms and resulted in increased mobility in patients suffering from CLBP. The researchers asserted that Yoga is useful in reducing the psychological impact of CLBP which usually spirals to depression if effective interventions are not used. Field, Diego, Hernandez-Reif, Medina, Delgadoa and Hernandez (2012) sought to provide evidence that Yoga can reduced the depression symptoms among prenatally depressed women. The randomized controlled trial involved 84 women suffering from prenatal depression. It used Yoga and massage therapy as the primary interventions (Field et all, 2012). The intervention comprised of two sessions per week of 20 minutes of massage or Yoga therapy lasting for 12 weeks. The study results show that the therapy group had a greater increase on the relationship scale than the control group. Serpa, Taylor and Tillisch (2014), conducted a RCT at an urban Veterans Health Administration medical centre on the effectiveness of MBSR on the anxiety, pain, depression and suicidal ideation of 79 veterans. The study used an MBSR intervention that included gentle yoga, discussion of pain, depression, anxiety. The intervention had 9 weekly sessions involving all the MBSR activities. The researchers reported that the MBSR course resulted in significant reduction in depression, anxiety and suicidal ideation score (Serpa, Taylor and Tillisch, 2014). This study illustrates that Yoga and other psychosocial intervention can help reduce the symptoms of depression among middle-aged veteran; a group with high mental disorder incidence rates. Lavretsky, Epel, Siddarth, Nazarian, Cyr, Khalsa, Lin, Blackburn and Irwin (2013) investigated the effect of yogic meditation on the mental health outcomes of family dementia caregivers diagnosed with mild depressive symptoms. The average age of the care giver was 63 years old meaning they fell within the middle age group that is the interest of this study. The yoga interventions used were either the practice of Kirtankriya or listening to yogic relaxations music for periods of 12 minutes per day during the 8 weeks trial (Lavretsky et al, 2013). The study assessed the severity of mental and depressive symptoms at baseline and at follow-up. The reported similar findings to the other included in this review. According to Lavrestsky et al (2013), the caregivers involved in meditation during the 8 weeks had significantly lower levels of depression than the relaxation group. 65.2 per cent of participants exhibited a 50 per cent improvement in the Hamilton depression Rating Scale. The study shows that daily meditation can significantly reduce depression symptoms among middle-aged dementia caregivevers, Wu¨rtzen, Dalton, Peter Elsass, Sumbundu, Steding-Jensen, ValbjørnKarlsen, Andersen, Flyger, Pedersen and Johansen (2013) investigated the effectiveness of mindfulness-based stress reduction intervention (MBSR) in reducing the levels of self-reported anxiety and depression among 336 Danish women who had undergone treatment for stage I-III breast cancer. The study involved women aged between the ages of 18 and 75 and who had undergone a breast cancer surgical operation in the last 3-18 months. The randomized controlled trial compared the efficacy of MBSR+usual care versus usual care in the absence of MBSR. The MBSR intervention involved eight weekly 2-h group session of guided meditation, psycho-education on stress reaction and reduction and yoga. Participants were also provided with a yoga mat, training log and assignment to use at home and during the course sessions. The 8-week MBSR intervention resulted in a significant impact on the reduction of depression symptoms at 12 months follow-up. Chan, Maarten, Immink and Hillier (2012) investigated whether yoga and exercise is effective on reducing the symptoms of depression and anxiety among patients suffering from post stroke disability. The randomized controlled trial involving 14 participants involved a 6-week standardized program compromising of weekly yoga and exercise sessions and a control group which participated in exercise only (Chan, 2012). Using the Geriatric depression scale, the study assessed depression symptoms at baseline and after the end of the intervention program. The study reported that both the control and intervention group reported significant improvements in depression and anxiety outcomes for both the intervention and control group. However, the group engaged in both yoga and exercise recorded greater improvements. The researchers noted that the yoga program was characterized by high retention rates and adherence to the yoga program. Lakkireddy, Atkins, JayasreePillarisetti, Kay Ryschon, Bommana, Drisko, Vanga and Dawn (2013) investigated the impact of yoga on the Atrial fibrillation (AF) burden, anxiety, depression and quality of life of cardiovascular patients. The study recruited 90 patients with symptomatic paroxysmal AF (Lakkireddy et al, 2013). The study method was unique as the patients were observed for an initial 3-months period before being enrolled in the intervention. The intervention applied was 60 minutes of Yoga training, two times a week for three months. Lakkireddy et al (2013), reported that the intervention resulted in a significant decrease in depression symptoms among the study participants. Butler, Waelde, Hastings, Chen, Symons, Marshall, Kaufman, Nagy, Blasey, Siebert and Spiegel (2008) conducted randomized pilot study to compare the impact of group therapy with hypnosis, yoga and psycho education on long-term depression symptoms. The trial involved 46 participants diagnosed with long-term depressive disorders. Three patients in the control group and eight in the hypnosis group experienced remission while no patient in the yoga group and group-therapy group experienced remission (Butler, 2008). The research indicates that yoga can be used as an intervention for treating long-term depressive disorders. Chandwani, Perkins, Nagendra, Raghuram, Spelman, Nagarathna an Kirschbaum (2014) investigated whether yoga has an impact on the quality of life of breast cancer patient undergoing radiotherapy. The research involved 109 participants randomly assigned into a yoga and stretching intervention groups. The patients in either group participated in the Yoga or stretching exercise three times a week for 6 weeks (Chandwani, 2014). The research assessed self-reported measures of quality of life, depression, and sleep quality at baseline and at the end of the treatment. The study reported no significant differences between the stretching and yoga group in terms of reduction of depression symptoms measured using the Centers for Epidemiological Studies-Depression (CES-D) measure. As seen in these primary studies, depression is a major condition that accompanies many diseases that affect middle-aged individuals. Yoga is a form of therapy that can be used alone or alongside other medication to reduce the symptoms of depression among middle-aged patients suffering from various ailments (Edelman, Mandle and Kudzma, 2013). In Kinser et al (2013), a link between yoga and a reduction of depression symptoms among middle-aged women suffering from depression was established. Yoga was also shown to help people suffering from CLBP, breast cancer, prenatal depression, post-stroke disability and cardiovascular disorders to cope (Tekura et al 2012; Field et al, 2012, Wu¨rtzen et al, 2013). Interestingly, yoga was found to reduce depression symptoms among veterans and dementia care givers (Serpa et al , 2014; Lavretsky et al, 2013) In addition, yoga could be used for the treatment of long-term depressive disorders. Therefore, yoga can be concluded to be a useful and effective intervention to fight depression symptoms common among middle-aged individuals. Implications and Limitation These randomized controlled trials strongly support the use of yoga as an adjutant to usual treatment options for a range of conditions that affect middle aged individuals. Healthcare providers should move with speed to include yoga interventions as part of the treatment for conditions such as CLBP, breast cancer, prenatal depression, post-stroke disability and cardiovascular disorders. Such an approach will greatly enhance the holistic health of middle-aged individuals being treated for various physical and mental conditions. However, many of these studies have limitations that place doubts on the applicability of their recommendations on yoga interventions. Many of these studies have small sample sizes below 100 participants that make the generalization on the results difficult. However, this shortcoming can be overcome by selecting larger sample sizes for participation in research investigating the impact of yoga on the reduction of depression symptoms (Kinser et al, 2013). References Butler, L. D., Waelde, L. C., Hastings, T. A., Chen, X. H., Symons, B., Marshall, J., & Spiegel, D. (2008). 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Tekur, P., Nagarathna, R., Chametcha, S., Hankey, A., &Nagendra, H. R. (2012). A comprehensive yoga programs improves pain, anxiety and depression in chronic low back pain patients more than exercise: an RCT. Complementary therapies in medicine, 20(3), 107-118. Würtzen, H., Dalton, S. O., Elsass, P., Sumbundu, A. D., Steding-Jensen, M., Karlsen, R. V., ... & Johansen, C. (2013). Mindfulness significantly reduces self-reported levels of anxiety and depression: results of a randomised controlled trial among 336 Danish women treated for stage I–III breast cancer. European Journal of Cancer,49(6), 1365-1373. Read More