Like anxiety disorders, depression is a complex and challenging mental illness and may require a myriad of treatment protocols. According to the World Health Organization, more than 264 million people worldwide suffer from depression. It is the leading cause of disability globally. The Anxiety & Depression Association of America states that it is also common for people with depression to suffer from anxiety disorders and vice versa. According to the ADAA, more than 16.1 million adults suffer from Major Depressive Disorder, and it is the most commonly diagnosed form of depression. So many of us suffer from these mental health challenges and they often go hand-in-hand.
Yoga Therapy can be used effectively to manage depression in conjunction with other treatment protocols including psychotherapy and/or psychiatry and other approaches provided by medically trained professionals. It also works well with other alternative therapies. Yoga Therapy would be applied to help alleviate the symptoms associated with depression.
Below I have outlined some approaches that we might use in Yoga Therapy for a client suffering from depression. There is never a cookie cutter approach and each practice is customized and tweaked over time to suit the individual in need. However these are some good starting point practices we might use.
The goals of these practices are to provide opportunities to gently increase energy, facilitate breath and pranic flow and create body awareness. We might also use heart opening postures and practices encouraging connectedness to self and to others. The goal regardless of approach is to make slow and steady progress over time. As is the case with most conditions, we look for consistency and simplicity of practice over anything fancy or overly complex.
1 - Breathwork focusing on moving energy/ prana up with affirmation - With depression, it is helpful to try and move stagnant energy upwards. Prana is defined as ‘life force energy’. We can move prana using breathwork. This can help with the lethargy, lack of motivation and sadness that is commonly experienced with depression. A breathwork technique that can be helpful is gentle kapalbhati (skull shining) breathing. This technique uses vigorous exhales rapidly pulling the belly in, and passive inhales. The exhale should occur about every second (this can be adjusted to comfort level). Kapalbhati is good for generating heat in the abdominal region and moving it upwards towards the heart center which is what we want to accomplish in this case. A couple of rounds is usually sufficient with a break in between to feel the heat dissipate. We can also add the gentle engagement of mula bandha (the root lock, or perineum area around the underside of the pelvis) during the breathing. This can help with groundedness and create a ‘seal’ at the root of the body so most of the prana we are generating moves upwards. After the breathwork is finished, an affirmation can be used, either out loud a few times or to oneself. A few examples are, “May I be open hearted and steady”, “I am strong and resilient” or “I deserve love, joy and happiness.”
2 - Steady, comfortable yoga postures, focusing on heart openers - We use moving postures to help lengthen inhale and exhale and facilitate blood flow. We also use static holds to help build strength and endurance. We want the body moving with a slight challenge to increase stamina without fatiguing or overwhelming. We use “sun breaths” or half sun salutes, low lunges, and warrior poses which all work well. Seated postures might be staff pose (focusing on open heart with breathing moving upwards), as well as twists to open the chest area. An example sequence of poses is below. Here we are moving from standing, to floor postures. Again, we can move in and out of these postures and then hold each (except for sun salutes) for 5-12 breaths.
3 - “Metta” or loving kindness meditation - This type of meditation focuses on wishing oneself happiness and wellbeing and extending it to others in our life as well. We may use:
May I (you) be filled with loving-kindness
May I (you) be well
May I (you) be peaceful and at east
May I (you) be happy
The traditional method is to start this meditation by saying the above words and wishing oneself well. Then we move to those we love, to friends and acquaintances. We can end it by trying to extend these well wishes to those we may be having difficulties with in life and ultimately to all beings on earth. This type of meditation is helpful in reestablishing a connection to oneself and others which can be therapeutic for depression.
4 - Guided body scan or a yoga nidra - We could do a full yoga nidra (“yogic sleep” more on this HERE), or a shorter (5ish minutes) guided body scan. This would simply be a recording asking the listener to notice each body part, one at a time without judgement. The goal of this practice is to provide some mind/body integration and drop into the body for observation and connection.
5 - Seated rest (rest without lying down)- We would sit in a comfortable seat for 3-5 minutes with eyes closed or a soft gaze on one point. The goal is to relax the mind and notice the sense of well-being created from the practice while staying upright and alert. We can come back to the affirmation used at the beginning of the practice to finish if desired.
This is one example of a practice that can be used to help alleviate the symptoms caused by depression. These can be done individually, a couple at a time, or strung together for one session. The approach used depends on individual time, preference, and extent of symptoms.
There are a number of other factors that we might also consider off the mat, as it relates to depression as well. They are: diet (focus on whole, unprocessed foods), time spent with others (attending a yoga class in this situation could be beneficial if possible), time spent in nature, and time spent doing other hobbies or activities that are enjoyable. These are areas that may be important to address in conjunction with yoga therapy - and of course in consultation with other related professionals.
I hope this helps. As always, if you have any questions about these practices or yoga therapy in general, please reach out to me!