Yoga shown to improve anxiety

August 12, 2020

Science Daily/NYU Langone Health / NYU School of Medicine

Yoga improves symptoms of generalized anxiety disorder, a condition with chronic nervousness and worry, suggesting the popular practice may be helpful in treating anxiety in some people.

Led by researchers at NYU Grossman School of Medicine, a new study found that yoga was significantly more effective for generalized anxiety disorder than standard education on stress management, but not effective as cognitive behavioral therapy (CBT), the gold standard form of structured talk therapy that helps patients identify negative thinking for better responses to challenges.

"Generalized anxiety disorder is a very common condition, yet many are not willing or able to access evidence-based treatments," says lead study author Naomi M. Simon, MD, a professor in the Department of Psychiatry at NYU Langone Health. "Our findings demonstrate that yoga, which is safe and widely available, can improve symptoms for some people with this disorder and could be a valuable tool in an overall treatment plan."

For the study, publishing online Aug. 12 in JAMA Psychiatry, 226 men and women with generalized anxiety disorder were randomly assigned to three groups -- either CBT, Kundalini yoga, or stress-management education, a standardized control technique.

After three months, both CBT and yoga were found to be significantly more effective for anxiety than stress management. Specifically, 54 percent of those who practiced yoga met response criteria for meaningfully improved symptoms compared to 33 percent in the stress-education group. Of those treated with CBT, 71 percent met these symptom improvement criteria.

However, after six months of follow-up, the CBT response remained significantly better than stress education (the control therapy), while yoga was no longer significantly better, suggesting CBT may have more robust, longer-lasting anxiety-reducing effects.

Study Details

The study involved an evidence-based protocol for CBT treatment of generalized anxiety disorder, including psychoeducation, cognitive interventions (focused on identifying and adapting maladaptive thoughts and worrying), and muscle relaxation techniques.

Kundalini yoga included physical postures, breathing techniques, relaxation exercises, yoga theory, and meditation/mindfulness practice.

The stress-management education control group received lectures about the physiological, psychological and medical effects of stress, as well as the antianxiety effects of lifestyle behaviors, such as reducing alcohol and smoking, and the importance of exercise and a healthy diet. Homework consisted of listening to educational material about stress, nutrition, and lifestyle.

Each treatment was administered in groups of three to six participants, over weekly two-hour sessions for 12 weeks with 20 minutes of daily homework assigned.

Can Yoga Help Treat Anxiety?

According to researchers, generalized anxiety disorder is a common, impairing, and undertreated condition, currently affecting an estimated 6.8 million Americans. While most people feel anxious from time to time, it is considered a disorder when worrying becomes excessive and interferes with day-to-day life. CBT is considered the gold standard first-line treatment. Medications, including antidepressants and sometimes benzodiazepines, may also be used. Yet, not everyone is willing to take medication which can have adverse side effects and there are challenges with accessing CBT for many, including lack of access to trained therapists and long waitlists.

"Many people already seek complementary and alternative interventions, including yoga, to treat anxiety," says Dr. Simon. "This study suggests that at least short-term there is significant value for people with generalized anxiety disorder to give yoga a try to see if it works for them. Yoga is well-tolerated, easily accessible, and has a number of health benefits."

According to Dr. Simon, future research should aim to understand who is most likely to benefit from yoga for generalized anxiety disorder to help providers better personalize treatment recommendations.

"We need more options to treat anxiety because different people will respond to different interventions, and having more options can help overcome barriers to care," she says. "Having a range of effective treatments can increase the likelihood people with anxiety will be willing to engage in evidence-based care."

https://www.sciencedaily.com/releases/2020/08/200812144124.htm

Experts review evidence yoga is good for the brain

December 12, 2019

Science Daily/University of Illinois at Urbana-Champaign, News Bureau

Scientists have known for decades that aerobic exercise strengthens the brain and contributes to the growth of new neurons, but few studies have examined how yoga affects the brain. A review of the science finds evidence that yoga enhances many of the same brain structures and functions that benefit from aerobic exercise.

The review, published in the journal Brain Plasticity, focused on 11 studies of the relationship between yoga practice and brain health. Five of the studies engaged individuals with no background in yoga practice in one or more yoga sessions per week over a period of 10-24 weeks, comparing brain health at the beginning and end of the intervention. The other studies measured brain differences between individuals who regularly practice yoga and those who don't.

Each of the studies used brain-imaging techniques such as MRI, functional MRI or single-photon emission computerized tomography. All involved Hatha yoga, which includes body movements, meditation and breathing exercises.

"From these 11 studies, we identified some brain regions that consistently come up, and they are surprisingly not very different from what we see with exercise research," said University of Illinois kinesiology and community health professor Neha Gothe, who led the research with Wayne State University psychology professor Jessica Damoiseaux.

"For example, we see increases in the volume of the hippocampus with yoga practice," Gothe said. Many studies looking at the brain effects of aerobic exercise have shown a similar increase in hippocampus size over time, she said.

The hippocampus is involved in memory processing and is known to shrink with age, Gothe said. "It is also the structure that is first affected in dementia and Alzheimer's disease."

Though many of the studies are exploratory and not conclusive, the research points to other important brain changes associated with regular yoga practice, Damoiseaux said. The amygdala, a brain structure that contributes to emotional regulation, tends to be larger in yoga practitioners than in their peers who do not practice yoga. The prefrontal cortex, cingulate cortex and brain networks such as the default mode network also tend to be larger or more efficient in those who regularly practice yoga.

"The prefrontal cortex, a brain region just behind the forehead, is essential to planning, decision-making, multitasking, thinking about your options and picking the right option," Damoiseaux said. "The default mode network is a set of brain regions involved in thinking about the self, planning and memory."

Like the amygdala, the cingulate cortex is part of the limbic system, a circuit of structures that plays a key role in emotional regulation, learning and memory, she said.

The studies also find that the brain changes seen in individuals practicing yoga are associated with better performance on cognitive tests or measures of emotional regulation.

The discovery that yoga may have similar effects on the brain to aerobic exercise is intriguing and warrants more study, Gothe said.

"Yoga is not aerobic in nature, so there must be other mechanisms leading to these brain changes," she said. "So far, we don't have the evidence to identify what those mechanisms are."

She suspects that enhancing emotional regulation is a key to yoga's positive effects on the brain. Studies link stress in humans and animals to shrinkage of the hippocampus and poorer performance on tests of memory, for example, she said.

"In one of my previous studies, we were looking at how yoga changes the cortisol stress response," Gothe said. "We found that those who had done yoga for eight weeks had an attenuated cortisol response to stress that was associated with better performance on tests of decision-making, task-switching and attention."

Yoga helps people with or without anxiety disorders manage their stress, Gothe said.

"The practice of yoga helps improve emotional regulation to reduce stress, anxiety and depression," she said. "And that seems to improve brain functioning."

The researchers say there is a need for more -- and more rigorous -- research into yoga's effects on the brain. They recommend large intervention studies that engage participants in yoga for months, match yoga groups with active control groups, and measure changes in the brain and performance on cognitive tests using standard approaches that allow for easy comparisons with other types of exercise.

"The science is pointing to yoga being beneficial for healthy brain function, but we need more rigorous and well-controlled intervention studies to confirm these initial findings," Damoiseaux said.

https://www.sciencedaily.com/releases/2019/12/191212105851.htm