Yoga for Depression, Part II Yoga Journal Teach By Timothy McCall, M.D. | Aug 28, 2007 share onFacebook get ourNewsletters share onTwitter share onGoogle Plus In Yoga for Depression, Part I I discussed the two major types of depression, rajasic and tamasic, as conceptualized by my teacher Patricia Walden (and her teacher B.K.S. Iyengar), whose work has heavily influenced my own. That article described asana practices that can help lift students out of depression. Now let’s review other useful yoga practices. Pranayama Practices for Depression For students with tamasic depression, pranayama practices that emphasize inhalation may be useful. Of course, getting your students to focus on engaging their abdominal muscles to help squeeze additional air out of the lungs on the exhalation facilitates an easier, deeper inhalation on the subsequent breath. Such breathing practices as three-part inhalation, and Ujjayi on the inhalation with normal exhalation, are examples of practices that increase the length of the inhalation relative to the exhalation. Students with more rajasic depression may benefit from practices that bring attention to and lengthen the exhalation. Examples include three-part exhalations and 1:2 breathing, where, for example, you inhale for three seconds and exhale for six. Strong breathing practices such as Kapalabhati (Skull Shining Breath, sometimes called Breath of Fire) and Bhastrika (Bellows Breath), which tend to activate the sympathetic nervous system, may sometimes be too agitating for those who are already restless and fidgety. Let direct observation of the student be your guide, since finding the appropriate practice is ultimately a matter of trial and error. Furthermore, since a student’s condition may change day to day, what’s appropriate may also vary. Other Practices for Depression Chanting and other bhakti (devotional) practices can be useful for depression. Walden says that these practices bypass the brain and go directly to the emotions. Not all students respond to bhakti yoga, but in those who do, it can be powerful. Chanting tends to keep the brain occupied, and it’s a natural way to extend the exhalation without thinking about it. You’d therefore expect it to be particularly useful for students with busy, rajasic minds. Meditation can be a powerful tool over the long-term to facilitate greater levels of happiness. Dr. Richard Davidson at the University of Wisconsin has done research that shows that meditation tends to increase the activity of the left prefrontal cortex of the brain. Left-sided activation has been associated with greater levels of calm and happiness and well as more emotional resiliency, rendering practitioners better able to withstand the inevitable ups and downs of life. Students who are severely depressed may not be able to meditate, even if they keep their eyes open. If that’s the case, try to initiate meditative practices when they are out of the depths of depression to help insulate them against recurrences. Yoga philosophy can also be of help. Yoga teaches that the more you do or think something, the more likely you are to do it or think it again. Any habit—what yoga calls a samskara—tends to get deeper with repetition. Thus a negative and self-flagellating inner dialogue may not just be a symptom of depression, it may help fuel it. One practice that Walden suggests is to consciously cultivate gratitude. “Count your blessings every day,” she tells her students. It can be useful to get out a pad of paper and try to list all you have to be grateful for. When you think about all the things that had to happen even for you to be born, it’s a miracle you are here. Then there are all the people who’ve loved you, fed you, cared for you, and educated you throughout your life. It’s also helpful to be thankful for the practice of yoga, which has been passed to us from masters who lived thousands of years ago, and the line of teachers extending from them to the present day. Such an exercise is an example of what Patanjali called “cultivating the opposite.” The more you practice this—even if it’s torturous at first—the deeper your “gratitude samskara” will become, and the more it can contribute to your well-being in the long run. Taking a Step, No Matter How Small Your students’ journey out of depression begins with a single step from wherever they are right now. If they are severely depressed, it may be a struggle for them to practice at all. In that case, could you get them to commit to doing a single Sun Salutation, or even a single Down Dog Pose, every day? (Of course, once they get on their mats, they may find themselves doing more.) Or perhaps you could encourage them to study their interior dialogues to understand how recurrent thoughts may be sabotaging recovery. In severe cases, especially if suicide seems like a possibility, don’t hesitate to refer your students to a doctor or psychotherapist. Even if such professional help is necessary, yoga can play a complementary role, likely rendering any psychotherapy or medication more effective. Better still, even though yoga tends to help reverse depression slowly, its ultimate aim is much higher than achieving the “everyday discontent” that Freud viewed as the goal of psychoanalysis. Yoga, in contrast, teaches that life can be peaceful, full of purpose, happy, and even joyful, and that the source of that joy and contentment is found deep inside in each of us. Various yoga practices are simply tools to help get us there. Dr. Timothy McCall is a board-certified internist, Yoga Journal’s Medical Editor, and the author of Yoga as Medicine: The Yogic Prescription for Health and Healing.