Review of Scientific Research on Iyengar Yoga for the Treatment of Depression
The writings and teaching of B. K. S. Iyengar have fostered the development and promotion of Iyengar Yoga as a therapy for physical and behavioral disorders and scientific research on its effectiveness. An important role in making yoga accessible to the West was played by B. K. S. Iyengar, and the Iyengar Yoga methods make it well suited to biomedical research. Its standardization supports the reproducibility of the method which suits the need for replication of the findings of research studies. The instructions given by Iyengar Yoga (IY) teachers are detailed and continuous during classes, with a focus on awareness of the activity of muscles and joints in conjunction with appropriate breathing patterns to achieve the ideal performance of each asana. An important feature of participation is sustained attention and concentration.
Iyengar theory and practice specifies asanas and sequences of asanas for different conditions and states. For example, backbend asanas were found to enhance mood in healthy participants (Shapiro & Cline, 2004). The purpose of this overview is to summarize the findings of several studies of Iyengar Yoga for depression. The studies were designed by researchers in conjunction with senior IY teachers who consulted with Iyengar. The main IY teachers were Marla Apt, Beth Sternlieb, and Karen Cline. Additional teachers were Paul Cabanis, James Benvenuto, Sherry Gould, and Morna Watson.
In a study of healthy people (Woolery et al., 2004) with mild levels of depression, the classes emphasized yoga postures thought to alleviate depression, back bends, standing poses, and inversions. The participants showed significant decreases in self-reported symptoms of depression and trait anxiety. These effects emerged by the middle of the yoga course and were maintained by the end. Changes also were observed in acute mood, with subjects reporting decreased levels of negative mood and fatigue following yoga classes. These findings provide evidence of the utility of IY asanas in improving mood.
In a study of individuals with diagnosed Major Depressive Disorder on anti-depression medication but only in partial remission (Shapiro et al., 2007), significant reductions were shown for depression, anger, anxiety, and neurotic symptoms in the 17 completers. Eleven of these completers achieved remission levels post-intervention. The three types of yoga asanas were designed by Marla Apt: inversions, backbends, restorative. The sessions were led by Marla Apt, James Benvenuto, and Paul Cabanis.
In a study by Streeter et al. (2010), a 12-week IY intervention was associated with greater improvements in mood and anxiety than a metabolically matched walking exercise. This study demonstrated that increased thalamic GABA levels are associated with improved mood and decreased anxiety. It is also the first time that a behavioral intervention (i.e., yoga postures) has been associated with a positive correlation between acute increases in thalamic GABA levels and improvements in mood and anxiety scales. Given that pharmacologic agents that increase the activity of the GABA system are prescribed to improve mood and decrease anxiety, the reported
correlations are in the expected direction. The possible role of GABA in mediating the beneficial effects of yoga on mood and anxiety warrants further study.
Given the widespread occurrence of depression and especially the role it plays in the etiology of heart disease and its association with the occurrence of heart attack in patients with heart disease, the evidence on the benefits shown in these studies merits integration of these treatment methods in the health care system.
Shapiro, D., & Cline, K. (2004). Mood changes associated with Iyengar yoga practices. International Journal of Yoga Therapy, 14, 35-44.
Shapiro, D., Cook,. I.A., Davydov, D.M., Ottaviani, C., Leuchter, A.F., & Abrams, M. (2007). Yoga as a complementary treatment of depression: Effects of traits and moods on treatment outcome. Evidence Based Complementary and Alternative Medicine. 4, 493-502.
Streeter, C. C., Whitfield, T. H., Owen, L., Rein, T., Karri, S. K., Yakhkind, A., Perlmutter, R., Prescot, A., Renshaw, P. F., Ciraulo, D. A., & Jensen, J. E. (2010). Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. The Journal of Alternative and Complementary Medicine, 16, 1145-1152.
Woolery, A., Myers, H., Sternlieb, B., & Zeltzer, L. (2004). A yoga intervention for young aduts with elevated symptoms of depression. Alternative Therapies. 10, 60-63.
David Shapiro, PhD is Professor Emeritus, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles