"
"
Abdominal Breathing
Abdominal breathing, also called diaphragmatic breathing or
belly breathing, is a core activity of meditation and yoga
practices and an important therapeutic technique in its own
right. Various Eastern religious and philosophical traditions cite
the breath as a bridge connecting mind-body-emotions-spirit
(Brown 2009). The breath can indicate the level of peace and
contentment of a client. Anxious or depressed individuals
breathe only from the upper chest, in a shallow fashion, whereas
individuals who have an integrated mind-body system breathe
deeply, from the diaphragm. Therefore, for clients with anxiety
disorders or depression, it follows that breath training can serve
as an empowering adjunctive treatment for these mental health
challenges (Weil 2006). In fact, according to Philippott et al, cited
by Brown and Gerbarg, changing breath patterns therapeutically
“can account for at least 40% in feelings of anger, fear, joy and
sadness” (Brown 2009).
Abdominal breathing, also called diaphragmatic breathing or
belly breathing, is a core activity of meditation and yoga
practices and an important therapeutic technique in its own
right. Various Eastern religious and philosophical traditions cite
the breath as a bridge connecting mind-body-emotions-spirit
(Brown 2009). The breath can indicate the level of peace and
contentment of a client. Anxious or depressed individuals
breathe only from the upper chest, in a shallow fashion, whereas
individuals who have an integrated mind-body system breathe
deeply, from the diaphragm. Therefore, for clients with anxiety
disorders or depression, it follows that breath training can serve
as an empowering adjunctive treatment for these mental health
challenges (Weil 2006). In fact, according to Philippott et al, cited
by Brown and Gerbarg, changing breath patterns therapeutically
“can account for at least 40% in feelings of anger, fear, joy and
sadness” (Brown 2009).
Physical Effects of Breathing Practices
Diaphragmatic breathing decreases an excessively active
parasympathetic nervous system. When practiced, it
appropriately energizes the sympathetic nervous system on the
inhale, and the exhale appropriately engages the
parasympathetic system (Brown 2009). Proper breathing
manages energy, breath volume, and adjusts other biological
systems such as the endocrine, digestive, circulatory and
neurochemical. Deep breathing stops the cycle of stress so
prevalent in current society. Regulation of breath regulates
heart function through the vagus nerve (Edwards 2008).
The Impact of Breathing on Anxiety and
Depression
While Americans often think of yoga as a series of meditative
postures, the system of yoga includes an emphasis on various
breathing techniques which induce a variety of desired states.
Brown and Gerbarg conducted an intensive study of Sudarshan
Kriya yogic breathing (SKY). They found decreases in a variety of
mood states such as depression, anxiety, stress and PTSD (posttraumatic
stress disorder—severe anxiety symptoms that linger
after traumatic events). They were especially curious about the
mechanisms of change from this form of breathing. They found
that SKY increased parasympathetic nervous system activity,
relaxation of the stress response, hormonal release and thalamic
response. In addition, they found that SKY breathing was
effective as an early intervention with survivors of natural
disasters, and they cite experience with 9/11 and the December
2004 tsunami. The authors emphasize the importance that
healthcare providers comprehend the research and clinical
evidence of these therapeutic benefits. SKY breathing has much
to offer—at no cost—as an adjunctive treatment to conventional
methods (Brown 2005).
SKY has been taught by the Art of Living Foundation
(www.artofliving.org/us-en) for many years and has reached 6
Diaphragmatic breathing decreases an excessively active
parasympathetic nervous system. When practiced, it
appropriately energizes the sympathetic nervous system on the
inhale, and the exhale appropriately engages the
parasympathetic system (Brown 2009). Proper breathing
manages energy, breath volume, and adjusts other biological
systems such as the endocrine, digestive, circulatory and
neurochemical. Deep breathing stops the cycle of stress so
prevalent in current society. Regulation of breath regulates
heart function through the vagus nerve (Edwards 2008).
The Impact of Breathing on Anxiety and
Depression
While Americans often think of yoga as a series of meditative
postures, the system of yoga includes an emphasis on various
breathing techniques which induce a variety of desired states.
Brown and Gerbarg conducted an intensive study of Sudarshan
Kriya yogic breathing (SKY). They found decreases in a variety of
mood states such as depression, anxiety, stress and PTSD (posttraumatic
stress disorder—severe anxiety symptoms that linger
after traumatic events). They were especially curious about the
mechanisms of change from this form of breathing. They found
that SKY increased parasympathetic nervous system activity,
relaxation of the stress response, hormonal release and thalamic
response. In addition, they found that SKY breathing was
effective as an early intervention with survivors of natural
disasters, and they cite experience with 9/11 and the December
2004 tsunami. The authors emphasize the importance that
healthcare providers comprehend the research and clinical
evidence of these therapeutic benefits. SKY breathing has much
to offer—at no cost—as an adjunctive treatment to conventional
methods (Brown 2005).
SKY has been taught by the Art of Living Foundation
(www.artofliving.org/us-en) for many years and has reached 6
million people in 150 countries. It consists of 4 parts: 3-stage
slow resistance breathing (Ujjayi), bellows breath, om chanting,
and cyclical breathing. Ujjayi has been shown to increase
parasympathetic activity through vagal afferent inputs to the
brain and improves heart rate variability. In addition, it
improves low respiratory sinus arrhythmia, which has been
associated with depression, anxiety, panic and obesity. Brown
and Gerbarg also found evidence suggesting that yogic breathing
has powerful physiological and psychological effects which may
contribute to longevity (Brown 2009).
Various breathing training programs have reduced both
anxiety and depression. A breathing training style called the
Papworth Method, used to treat asthma and its accompanying
anxiety, produced significantly less anxiety and depression in a
treatment group as compared to a control group after five
sessions and at a one-year follow-up (Holloway 2007).
Meuret et al investigated whether breathing training for the
treatment of panic disorder was effective or merely placebo
effect. Although the nine studies they examined had
methodological challenges, the authors concluded that
breathing training had something to offer panic disorder
treatment (Meuret 2003).
Mindfulness
Mindfulness, the simple act of being in the present moment, has
been knows for centuries to be therapeutic. Mindfulness permits
the individual to move out of the mind’s “noise,” thus reducing
negative mental influences. Various techniques have been
developed to assist individuals in focusing on the present,
including outdoor activities, meditation, putting attention on
the breath, and putting attention on a chant or sound. Myriad
forms of meditation have been studied and practiced for
thousands of years. The two forms most studied are mindfulness
meditation (MM) and transcendental meditation (TM).
slow resistance breathing (Ujjayi), bellows breath, om chanting,
and cyclical breathing. Ujjayi has been shown to increase
parasympathetic activity through vagal afferent inputs to the
brain and improves heart rate variability. In addition, it
improves low respiratory sinus arrhythmia, which has been
associated with depression, anxiety, panic and obesity. Brown
and Gerbarg also found evidence suggesting that yogic breathing
has powerful physiological and psychological effects which may
contribute to longevity (Brown 2009).
Various breathing training programs have reduced both
anxiety and depression. A breathing training style called the
Papworth Method, used to treat asthma and its accompanying
anxiety, produced significantly less anxiety and depression in a
treatment group as compared to a control group after five
sessions and at a one-year follow-up (Holloway 2007).
Meuret et al investigated whether breathing training for the
treatment of panic disorder was effective or merely placebo
effect. Although the nine studies they examined had
methodological challenges, the authors concluded that
breathing training had something to offer panic disorder
treatment (Meuret 2003).
Mindfulness
Mindfulness, the simple act of being in the present moment, has
been knows for centuries to be therapeutic. Mindfulness permits
the individual to move out of the mind’s “noise,” thus reducing
negative mental influences. Various techniques have been
developed to assist individuals in focusing on the present,
including outdoor activities, meditation, putting attention on
the breath, and putting attention on a chant or sound. Myriad
forms of meditation have been studied and practiced for
thousands of years. The two forms most studied are mindfulness
meditation (MM) and transcendental meditation (TM).
Mindfulness Meditation
Kabat-Zinn defines mindfulness as “the awareness that emerges
through paying attention on purpose, in the present moment,
and nonjudgmentally in the unfolding of experience moment by
moment” (p. 145). Kabat-Zinn also emphasizes the factor of nonattachment
to outcome as unique in clinical applications (Kabat-
Zinn 2003). In addition, Baer conducted a theoretical summary
and analysis of mindfulness as an intervention. She cites that
Kabat-Zinn has hypothesized how meditation helps with anxiety,
that “sustained, nonjudgmental observation of anxiety-related
sensations, without attempts to escape or avoid them, may lead
to reductions in the emotional reactivity typically elicited by
anxiety symptoms” (p. 128). She lists the elements of
mindfulness that contribute to its effectiveness: exposure,
cognitive change, self-management, relaxation and acceptance.
In addition, she conducted a meta-analysis of mindfulness as an
intervention and found effect sizes ranging from 0.15 (weak) to
1.65 (exceptionally strong). At follow-up, effect sizes ranged
from 0.08 to 1.35. Baer also noted that patient satisfaction with
mindfulness was high (Baer 2003).
Practitioner interest in mindfulness launched a study of many
techniques that use mindfulness components such as
Mindfulness-Based Cognitive Therapy (MBCT), which has been
successfully applied to preventing depressive episodes (Segal
2005) (Teasdale 2000). Mindfulness appears to function as a
means of creating psychic distance between an individual and
depressogenic thinking which then results in empowerment to
utilize mindfulness to stop relapses into depression before they
occur. Chiesa and Serretti conducted a meta-analysis of MBCT
and found that it was significantly better than usual care alone
for depression in individuals with at least 3 depressive episodes.
MBCT was also shown to reduce anxiety (Chiesa 2011). In
addition, MBCT has been shown to reduce panic and may be an
effective adjunctive treatment (Kim 2010).
Kabat-Zinn defines mindfulness as “the awareness that emerges
through paying attention on purpose, in the present moment,
and nonjudgmentally in the unfolding of experience moment by
moment” (p. 145). Kabat-Zinn also emphasizes the factor of nonattachment
to outcome as unique in clinical applications (Kabat-
Zinn 2003). In addition, Baer conducted a theoretical summary
and analysis of mindfulness as an intervention. She cites that
Kabat-Zinn has hypothesized how meditation helps with anxiety,
that “sustained, nonjudgmental observation of anxiety-related
sensations, without attempts to escape or avoid them, may lead
to reductions in the emotional reactivity typically elicited by
anxiety symptoms” (p. 128). She lists the elements of
mindfulness that contribute to its effectiveness: exposure,
cognitive change, self-management, relaxation and acceptance.
In addition, she conducted a meta-analysis of mindfulness as an
intervention and found effect sizes ranging from 0.15 (weak) to
1.65 (exceptionally strong). At follow-up, effect sizes ranged
from 0.08 to 1.35. Baer also noted that patient satisfaction with
mindfulness was high (Baer 2003).
Practitioner interest in mindfulness launched a study of many
techniques that use mindfulness components such as
Mindfulness-Based Cognitive Therapy (MBCT), which has been
successfully applied to preventing depressive episodes (Segal
2005) (Teasdale 2000). Mindfulness appears to function as a
means of creating psychic distance between an individual and
depressogenic thinking which then results in empowerment to
utilize mindfulness to stop relapses into depression before they
occur. Chiesa and Serretti conducted a meta-analysis of MBCT
and found that it was significantly better than usual care alone
for depression in individuals with at least 3 depressive episodes.
MBCT was also shown to reduce anxiety (Chiesa 2011). In
addition, MBCT has been shown to reduce panic and may be an
effective adjunctive treatment (Kim 2010).
Mindfulness Meditation and Anxiety Disorders
Numerous randomized controlled trials have examined the
impact of mindfulness meditation on various anxiety disorders
and depression (Saeed 2010). The most common treatment is
Mindfulness Based Stress Reduction (MBSR) developed by Kabat-
Zinn. Over 240 hospitals and clinics in the US and abroad have
MBSR programs (Salmon 1998). Reibel et al looked at the MBSR
program and found a 44% decrease in anxiety. They also found
that this program enhanced functioning and well-being (Reibel
2001). A meta-analysis was conducted to examine effect sizes of
MBSR on many health issues including depression and anxiety,
and robust evidence was found for its effectiveness. The report
stated that 20 studies revealed moderately strong effect sizes
(0.5, p< 0.0001). The authors conclude that MBSR helps both
clinical and nonclinical populations with mood issues and that
MBCT helps reduce depression in 3+ episodes (Grossman 2004).
Vipassana meditation seems to reduce alcohol and substance
abuse in prisoners (Chiesa 2010).
Lee et al found that, compared to an anxiety disorders
education group, a meditation-based stress management
program demonstrated significant improvement on all anxiety
scales (Lee 2007). According to van der Kolk, the nature of
trauma requires that the treatment include a way to bring
individuals back to their body and into the present through
interoceptive exposure. He advocates both mindfulness and yoga
as adjunct treatments for PTSD and has conducted many studies
to support this claim (van der Kolk 2006).
Arias et al conducted a meta-analysis of meditation on a variety
of medical ailments and found evidence that meditation helps
mood disorders such as anxiety and depression (Arias 2006).
Transcendental Meditation
Transcendental meditation has been studied in research
facilities since 1963 and much of the research is generated
through the Maharishi University of Management in Iowa
Numerous randomized controlled trials have examined the
impact of mindfulness meditation on various anxiety disorders
and depression (Saeed 2010). The most common treatment is
Mindfulness Based Stress Reduction (MBSR) developed by Kabat-
Zinn. Over 240 hospitals and clinics in the US and abroad have
MBSR programs (Salmon 1998). Reibel et al looked at the MBSR
program and found a 44% decrease in anxiety. They also found
that this program enhanced functioning and well-being (Reibel
2001). A meta-analysis was conducted to examine effect sizes of
MBSR on many health issues including depression and anxiety,
and robust evidence was found for its effectiveness. The report
stated that 20 studies revealed moderately strong effect sizes
(0.5, p< 0.0001). The authors conclude that MBSR helps both
clinical and nonclinical populations with mood issues and that
MBCT helps reduce depression in 3+ episodes (Grossman 2004).
Vipassana meditation seems to reduce alcohol and substance
abuse in prisoners (Chiesa 2010).
Lee et al found that, compared to an anxiety disorders
education group, a meditation-based stress management
program demonstrated significant improvement on all anxiety
scales (Lee 2007). According to van der Kolk, the nature of
trauma requires that the treatment include a way to bring
individuals back to their body and into the present through
interoceptive exposure. He advocates both mindfulness and yoga
as adjunct treatments for PTSD and has conducted many studies
to support this claim (van der Kolk 2006).
Arias et al conducted a meta-analysis of meditation on a variety
of medical ailments and found evidence that meditation helps
mood disorders such as anxiety and depression (Arias 2006).
Transcendental Meditation
Transcendental meditation has been studied in research
facilities since 1963 and much of the research is generated
through the Maharishi University of Management in Iowa
(www.mum.edu) (Brown 2009). Brief, frequent meditation seems
to produce significant changes in anxiety and depression using a
mantram (concentrative TM) technique (Lane 2007). Yunesian et
al conducted a pre-post study on an adult Muslim population,
and results indicated that somatization and anxiety were
decreased after 12 weeks of TM (Yunesian 2008). Also, Bormann
et al conducted a random controlled trial and found that the
treatment group among an HIV population had decreased traitanger
and increased spiritual connection when practicing TM
(Bormann 2006).
Physical Effects of Meditation
Davidson et al conducted a randomized controlled trial and
found there was more activity in the left-side anterior section of
the brain which links to positive mood in people who meditate.
In addition the authors found greater antibodies, which assisted
in immune function (Davidson 2003). EEG studies have revealed
significant increase in both alpha and theta brain wave activity
during meditation. It activates the prefrontal cortex and
anterior cingulated cortex, and EEGs show that long-term
meditation is related to enhanced attention (Chiesa 2010).
Yoga
“Yoga” is a Sanskrit word originating in India. It means to yoke
or to bind. The primary function of yoga is an integration of
mind-body-spirit and emotions (Bhusan 1994). Yoga primarily
consists of three components: asanas (postures), pranayama
(breathing exercises) and dhyana (meditation) (Pilkington 2005).
Yoga has ancient roots but it has been enthusiastically embraced
by the West for physical and spiritual reasons in the past thirty
years. It seems that yoga has far-reaching effects on a variety of
ailments, but especially as an adjunctive treatment for mental
disorders.
to produce significant changes in anxiety and depression using a
mantram (concentrative TM) technique (Lane 2007). Yunesian et
al conducted a pre-post study on an adult Muslim population,
and results indicated that somatization and anxiety were
decreased after 12 weeks of TM (Yunesian 2008). Also, Bormann
et al conducted a random controlled trial and found that the
treatment group among an HIV population had decreased traitanger
and increased spiritual connection when practicing TM
(Bormann 2006).
Physical Effects of Meditation
Davidson et al conducted a randomized controlled trial and
found there was more activity in the left-side anterior section of
the brain which links to positive mood in people who meditate.
In addition the authors found greater antibodies, which assisted
in immune function (Davidson 2003). EEG studies have revealed
significant increase in both alpha and theta brain wave activity
during meditation. It activates the prefrontal cortex and
anterior cingulated cortex, and EEGs show that long-term
meditation is related to enhanced attention (Chiesa 2010).
Yoga
“Yoga” is a Sanskrit word originating in India. It means to yoke
or to bind. The primary function of yoga is an integration of
mind-body-spirit and emotions (Bhusan 1994). Yoga primarily
consists of three components: asanas (postures), pranayama
(breathing exercises) and dhyana (meditation) (Pilkington 2005).
Yoga has ancient roots but it has been enthusiastically embraced
by the West for physical and spiritual reasons in the past thirty
years. It seems that yoga has far-reaching effects on a variety of
ailments, but especially as an adjunctive treatment for mental
disorders.
Physical Effects of Yoga
Yoga has been shown to reduce muscle tension, blood pressure,
and autonomic sympathetic over-activation (Emerson 2009). It
has also been shown to improve neuroendocrine and other
hormonal activity. Yoga has also been demonstrated to help
asthma, cardiac problems, cholesterol, irritable bowel syndrome,
cancer, insomnia and fibromyalgia. It reduces sympathetic and
increases parasympathetic nervous system operations. Cardiac
vagal (parasympathetic) tone has been connected to the
regulations of emotions and development of empathy (Brown
2009).
In recent years, yoga has been introduced into a variety of
inpatient and outpatient psychiatric programs. One such
program conducted a study to better understand the effects of
yoga on mood. The authors found that one session of yoga in an
inpatient program resulted in significant improvements in
anxiety, depression, anger, fatigue and confusion (Lavey 2005).
In addition, yoga has begun to be explored as an adjunct
treatment for schizophrenia (Visceglia 2007). The author is a
psychiatrist and yoga instructor who taught yoga to
schizophrenic patients and found that yoga resulted in many
benefits for this population, chief among them a sense of
groundedness and empowerment about the body, which is
unusual in this population. Also, since the primary treatment is
medication, which is generally prescribed and managed outside
their control, yoga allows the patients to feel a sense of control
and empowerment over this chronic illness.
Yoga and Anxiety Disorders
Kirkwood et al (Kirkwood 2005) conducted a meta-analysis on
the effect of yoga on anxiety disorders and found eight studies
that provided important information. All had some data that
favored yoga as a means to reduce anxiety. Within the analysis
the most prominent study was a randomized controlled trial that
Yoga has been shown to reduce muscle tension, blood pressure,
and autonomic sympathetic over-activation (Emerson 2009). It
has also been shown to improve neuroendocrine and other
hormonal activity. Yoga has also been demonstrated to help
asthma, cardiac problems, cholesterol, irritable bowel syndrome,
cancer, insomnia and fibromyalgia. It reduces sympathetic and
increases parasympathetic nervous system operations. Cardiac
vagal (parasympathetic) tone has been connected to the
regulations of emotions and development of empathy (Brown
2009).
In recent years, yoga has been introduced into a variety of
inpatient and outpatient psychiatric programs. One such
program conducted a study to better understand the effects of
yoga on mood. The authors found that one session of yoga in an
inpatient program resulted in significant improvements in
anxiety, depression, anger, fatigue and confusion (Lavey 2005).
In addition, yoga has begun to be explored as an adjunct
treatment for schizophrenia (Visceglia 2007). The author is a
psychiatrist and yoga instructor who taught yoga to
schizophrenic patients and found that yoga resulted in many
benefits for this population, chief among them a sense of
groundedness and empowerment about the body, which is
unusual in this population. Also, since the primary treatment is
medication, which is generally prescribed and managed outside
their control, yoga allows the patients to feel a sense of control
and empowerment over this chronic illness.
Yoga and Anxiety Disorders
Kirkwood et al (Kirkwood 2005) conducted a meta-analysis on
the effect of yoga on anxiety disorders and found eight studies
that provided important information. All had some data that
favored yoga as a means to reduce anxiety. Within the analysis
the most prominent study was a randomized controlled trial that
found Kundalini yoga significantly effective for obsessivecompulsive
disorder (Shannahoff-Khalsa 1999).
Post-Traumatic Stress Disorder
The Justice Resource Institute, founded and run by renowned
trauma specialist Bessel van der Kolk, conducted a study looking
at the effects of yoga on various trauma survivors: rape
survivors, war veterans, and survivors of childhood physical and
sexual abuse, among others. Initial studies have revealed that
yoga is an effective intervention. Trauma survivors have
inherently “left their bodies” as a result of the trauma, and yoga
and other meditative therapies gently bring the survivors back
into embodied whole experience (Emerson 2009).
Yoga and Depression
Pilkington et al (Pilkington 2005) conducted a meta-analysis on
yoga as a treatment for depression in the UK. The authors found
5 random controlled trials which used a variety of yoga methods
for psychiatric symptoms ranging from mild to severe
depression. Overall, they found that yoga was effective.
disorder (Shannahoff-Khalsa 1999).
Post-Traumatic Stress Disorder
The Justice Resource Institute, founded and run by renowned
trauma specialist Bessel van der Kolk, conducted a study looking
at the effects of yoga on various trauma survivors: rape
survivors, war veterans, and survivors of childhood physical and
sexual abuse, among others. Initial studies have revealed that
yoga is an effective intervention. Trauma survivors have
inherently “left their bodies” as a result of the trauma, and yoga
and other meditative therapies gently bring the survivors back
into embodied whole experience (Emerson 2009).
Yoga and Depression
Pilkington et al (Pilkington 2005) conducted a meta-analysis on
yoga as a treatment for depression in the UK. The authors found
5 random controlled trials which used a variety of yoga methods
for psychiatric symptoms ranging from mild to severe
depression. Overall, they found that yoga was effective.
ليست هناك تعليقات:
إرسال تعليق