Depression and Yoga A Review

Yoga is a system of physical and mental self-improvement and final liberation that people have been using for thousands of years. Yoga is a science which is common to all and whole humanity in its true nature of efficacy, results and applications. Yoga is a centuries-old guide to healthy living developed by ancient Indian sages. With its unique blend of physical exercises, psychological insight, and philosophy, it can help you to bring your body, mind, and spirit into better balance. Yoga takes a holistic approach to life, enabling you to experience complete equilibrium inside and out. Depression is one of the most common mental illnesses in the world. It is estimated that there are 350 million people worldwide who have some form of depression. Indians are among the worlds most depressed, according to a (WHO) World Health Organization-sponsored study. So to addressing such type of huge problem in present scenario we have to take help of yoga and mind relaxing technique. Present study intended to review research work has been performed on using yoga to alleviate depression. This review will focus on how yoga is being useful to treat depression. Findings from this review will be used to determine areas of further study and implications for clinical social work practice. KeywordsYoga, Depression, mental illness, WHO

Depression is one of the most common mental illnesses in the world. It is estimated that there are 350 million people worldwide who have some form of depression. Indians are among the worlds most depressed, according to a (WHO) World Health Organization-sponsored study. So to addressing such type of huge problem in present scenario we have to take help of yoga and mind relaxing technique. Present study intended to review research work has been performed on using yoga to alleviate depression. This review will focus on how yoga is being useful to treat depression. Findings from this review will be used to determine areas of further study and implications for clinical social work practice.

Introductions:
Depression is prevalent among all age groups, in almost all walks of life. Indians are among the world's most depressed.

Introduction:
Depression is a state of low mood and aversion to activity. It can affect a person's thoughts, behavior, motivation, feelings, and sense of wellbeing. It may feature sadness, difficulty in thinking and concentration and a significant increase or decrease in appetite and time spent sleeping. People experiencing depression may have feelings of dejection, hopelessness and, sometimes, suicidal thoughts. It can be either short term or long term. [1] Depressed mood is a symptom of some mood disorders such as major depressive disorder or dysthymia; it is a normal temporary reaction to life events, such as the loss of a loved one; and it is also a symptom of some physical diseases and a side effect of some drugs and medical treatments. Depression is one of the most common mental illnesses in the world. It is estimated that there are 350 million people worldwide who have some form of depression. [2] Depression is prevalent among all age groups, in almost all walks of life.
Indians are among the worlds most depressed. According to a World Health Organization-sponsored study, while around 9% of people in India reported having an extended period of depression within their lifetime, nearly 36% suffered from what is called Major Depressive Episode (MDE).MDE is characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy and poor concentration, besides feeling depressed. Lowest prevalence of MDE was in China (12%). The average age of depression in India is 31.9 years compared to 18.8 years in China, and 22.7 years in the US. The female: male ratio was about 2:1."WHO ranks depression as the fourth leading cause of disability worldwide and projects that by 2020, it will be the second leading cause. According to the National Institute of Mental Health, depression occurs due to a combination of genetic, biological, environmental, and psychological factors. [3] Depression is a disorder of major public health importance, in terms of its prevalence and the suffering, dysfunction, morbidity, and economic burden. Depression is more common in women than men. The report on Global Burden of Disease estimates the point prevalence of unipolar depressive episodes to be 1.9% for men and 3.2% for women, and the one-year prevalence has been estimated to be 5.8% for men and 9.5% for women. It is estimated that by the year 2020 if current trends for demographic and epidemiological transition continue, the burden of depression will increase to 5.7% of the total burden of disease and it would be the second leading cause of disabilityadjusted life years (DALYs), second only to ischemic heart disease. [4] Treatment for depression consists of participation in psychotherapy, taking antidepressants, or a combination of both. However, many individuals do not participate in psychotherapy or antidepressants due to factors such as unmet needs, side effects, lack of access/resource, and personal choice. Some of the more common negative effects that many patients experience with antidepressants include dizziness, fatigue, blurred vision, sexual side effects, weight gain, constipation, insomnia, dry mouth, nausea, feeling numb, and anxiety. [5] Sometimes there may be Serotonin Syndrome.
Symptoms of serotonin syndrome include confusion, agitation, muscle twitching, sweating, shivering, and diarrhea. In addition, severe cases may include symptoms such as a very high fever, seizures, irregular heartbeat, and unconsciousness. There may be suicidal tendency in patients with antidepressant medication.
Studies indicate that this may be especially true for people younger than age 25. [6] In people who are susceptible to bipolar disorder, medications like antidepressants can potentially trigger an episode of mania. [7] so considering these types of side effect and other problems in treatment of depression, we can use Yoga as an Alternative and complementary treatment for depression.

Yoga
Yoga is an ancient Indian science which helps to improve physical, mental, social and spiritual health. Yoga is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India. Yoga is one of the six Āstika (orthodox) schools of Hindu philosophical traditions.
Yoga has been found useful for mental disorders like depression. The application of yoga as a therapeutic intervention, which began early in the twentieth century, takes advantage of the various psychophysiological benefits of the component practices. The physical exercises (asanas) may increase patient's physical flexibility, coordination, and strength, while the breathing practices and meditation may calm and focus the mind to develop greater awareness and diminish anxiety [8] and thus result in higher quality of life. Other beneficial effects might involve a reduction of distress, blood pressure, and improvements in resilience, mood, and metabolic regulation. [9] The practice of Yoga incorporates elements of physical movement and exercise while cultivating mindfulness meditation, encouraging selfacceptance and love, and providing opportunity for relaxation. Many emerging research evidence suggests that the practice of Yoga is an effective antidepressant intervention, including at least five randomized-controlled research studies. [10,11] There is a body of research supporting the use of yoga to reduce depression or depressive symptoms.
Yoga is known for its ability to ease stress and promote relaxation. Multiple studies have shown that it can decreases the secretion of cortisol the primary stress hormone. [12,13] yoga significantly lowers level of cortisol and level of stress, anxiety, fatigue and depression. [14] Yoga commonly used as an adjunct therapy to improve quality of life for many individuals. Studies of 135 seniors were assigned to either six months of yoga, walking or a control group. Practicing yoga significantly improved quality of life, as well as mood and fatigue. Compared to the other groups. [15] Some studies have found that yoga may help improve sleep quality, enhance spiritual wellbeing, improve social function and reduce symptoms of anxiety and depression in patients with cancer. [16,17] Some studies show that yoga may have an anti-depressant effect and could help to decrease symptoms of depression. This may be because yoga is able to decrease levels of cortisol, a stress hormone that influences levels of serotonin, the neurotransmitter often associated with depression. [18] In another study participants in an alcohol dependence program practiced sudarshan kriya, a specific type of yoga that focus on rhythmic breathing shows fewer symptoms of depression and lower level of cortisol. They also had lower levels of ACTH, a hormone responsible for stimulating the release of cortisol. [19] Other studies have had similar results, showing an association between practicing yoga and decreased symptoms of depression. [20,21]

Discussion:
Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder. Many mental-health conditions or developmental disabilities are associated with depression as well. Individuals with anxiety, attention deficit hyperactivity disorder (ADHD), substance abuse, and developmental disabilities may be more vulnerable to developing depression. Depression is sometimes described as the "common cold" of psychiatry, it is certainly common, and it is also present most commonly in mild forms. Physical illness increases the risk of developing severe depressive illness.
According to extensive literature view there are so many research papers available that suggest yoga can help to improve depressive condition of mind as well as it also help to maintain physical health at normal stage. As per yoga sutras of Patanjali, yama (ethical rules),niyama(principles for personal/social well being), asan (yoga posture), pranayama (breathing techniques), pratyahara (control of sense organs), dharana (continued attention to object), dhyan (mediatation), and samadhi (super-consciousness) are stages of the gradual withdrawal of consciousness from outward contact and a simultaneous rising into wider and wider dimensions of itself, culminating in infinitude which is its quintessential essence. [22] Yama and niyam are ethical practices provide the power and courage needed to face all obstacles. Ahimsa (nonviolence), satya (truth), asteya (non stealing),brahmacharya(celibacy), and aparigraha (not desiring for other"s things) are five yama. [23] While niyama consists of Saucha (purity internally and externally), santosh (satisfaction), tapas (penance), svadhyaya(sacred study), and ishvarapranidhana (surrender of oneself to God). [24] Yama and niyama teaches, how to satisfy with achievements and prevent the loss caused by over expectations, ultimately decrease the desire, stress and depression consequently. Asanas and pranayama relaxes the mind [25] , [26] and tone up the nervous system, endocrine system and the activity of internal organs. By practicing these, one can develop mental equilibrium, balance, endurance, and great vitality. The deep relaxation during Savasana (Corpse pose) provides relief from any kind of physical and mental stress in few minutes and has regenerative effect on the mind and the body. Practicing different physical postures of yoga has been shown to increase levels of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain that can have anti-depressant and anxiolytic effect. Pranayama breathing help to relax shattered brain cells and stressed out nerves by calming the various electrical activity going on in the stressed anxious brain, shutting down unwanted activity, and regulating the normal flow of impulses in the neurons in the brain.
In depression the production of our own endorphins are reduced and these are increased by doing exercise, yoga, Pranayama breathing. That is why modern medicine now recommends exercise as essential tool to lift depression, reduce anxiety and stress, as well as maintaining healthy heart and circulation.
Pranayama enhances one's ability to hold on to thoughts by reducing the number of breaths per minute. This brings calmness to the mind. During Bhramari pranayama sound is produced like the large black bee, [27] which vibrate cerebral cortex, and send impulse to the sympathetic and parasympathetic nervous systems (PNS). PNS is associated with a relaxed and calm state of mind and body. Under the relaxing effects of PNS, autonomic nervous system facilitates to decrease the stressing effects of sympathetic nervous system and channels it towards more relaxed PNS. Depression may result from dysfunctional activity or asymmetry of activity between the left frontal lobe (causing decreased positive affect) and the right frontal lobe (causing emotional lability, difficulty with emotional information processing and decreased arousal). Yoga practices effective in such neurobiological conditions by influencing functions and interaction between these structures and decreasing depression and anxiety symptoms. The slow breathing patterns in Pranayama stimulate the vagus nerve and increases levels of prolactin, dopamine and serotonin and maintaining the chemical equilibrium in the brain.
Pratyahara is the withdrawal of the powers of the senses from their respective objects. [28] Pratyahara means abstraction or bringing back. It should also go side by side with Vichara or a careful investigation of every psychological condition; due to this the sense organs are under the complete control of mind. Pratyahara establishes peace with the mind and changes thinking of person from depression to pleasure. Dharana, Dhyana, and Samadhi these are meditative practices and acts as a powerful mental as well as nerve tonic. Considerable changes take place in the mind, brain and the nervous system by the practice of meditation. The whole mind and nervous system are remodeled. Person will develop a new view of mind, new sensations, new feeling, new mode of thinking, acting and a view of the universe. Meditation with and without Om (AUM) chanting is now unequivocally accepted as effective in helping us stabilize our mind and emotions, widely practiced and accepted not only as a self-help therapy in stress, anxiety and depression but also in daily life. Psychological problems like Regression and Guilt can be lowered by the practice of Yoga Nidra.

Conclusion:
Practice of Yoga stops the uncontrolled and uninterrupted thoughts. Lack of social support is an important factor in the development of depression. Thus a factor in the effectiveness of yoga for depression may be the social support provided during group classes that could enhance coping in some individual. For some stressful individuals, the yoga practices could become a self-reinforcing behavior with a personal and group effect on mood. These behavioral modulations from yoga assist the individual to have a healthier physical and psychological response to stress and depression. So in consideration with these effects of yoga and mind relaxation techniques we should emphasize regular use of yoga and pranayama in Depressive and also in other mental disease patients with regular medications.