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Yoga plus deep breathing to alleviate depression

During a 12-week intervention of yoga and deep breathing, depressive symptoms declined significantly in patients with major depressive disorder, found a small Boston University study.

People who suffer from depression should participate in yoga and deep (coherent) breathing classes at least twice weekly plus practice at home to receive a significant reduction in their symptoms. Study findings provide preliminary support for the use of yoga-based interventions as an alternative or supplement to pharmacologic treatments for depression.

Major depressive disorder (MDD) is common, recurrent, chronic and disabling. Due in part to its prevalence, depression is globally responsible for more years lost to disability than any other disease. Up to 40% of individuals treated with antidepressant medications for MDD do not achieve full remission. This study used iyengar yoga that has an emphasis on detail, precision and alignment in the performance of posture and breath control.

Individuals with MDD were randomised to the high dose group, three 90-minute classes a week along with home practice, or the low dose group, two 90-minute classes a week, plus home practice. Both groups had significant decreases in their depressive symptoms and no significant differences in compliance. Although a greater number of subjects in the high dose group had less depressive symptoms, the researchers believe attending twice weekly classes (plus home practice) may constitute a less burdensome but still effective way to gain the mood benefits from the intervention.

"This study supports the use of a yoga and coherent breathing intervention in major depressive disorder in people who are not on antidepressants and in those who have been on a stable dose of antidepressants and have not achieved a resolution of their symptoms," explained corresponding author Dr Chris Streeter, associate professor of psychiatry and neurology at Boston University School of Medicine and a psychiatrist at Boston Medical Centre.

According to Streeter compared with mood altering medications, this intervention has the advantages of avoiding additional drug side effects and drug interactions. "While most pharmacologic treatment for depression target monoamine systems, such as serotonin, dopamine and norepinephrine, this intervention targets the parasympathetic and gamma aminobutyric acid system and provides a new avenue for treatment."

Abstract
Objectives: The aims of this study were to assess the effects of an intervention of Iyengar yoga and coherent breathing at five breaths per minute on depressive symptoms and to determine optimal intervention yoga dosing for future studies in individuals with major depressive disorder (MDD).
Methods: Subjects were randomized to the high-dose group (HDG) or low-dose group (LDG) for a 12-week intervention of three or two intervention classes per week, respectively. Eligible subjects were 18–64 years old with MDD, had baseline Beck Depression Inventory-II (BDI-II) scores ≥14, and were either on no antidepressant medications or on a stable dose of antidepressants for ≥3 months. The intervention included 90-min classes plus homework. Outcome measures were BDI-II scores and intervention compliance.
Results: Fifteen HDG (Mage = 38.4 ± 15.1 years) and 15 LDG (Mage = 34.7 ± 10.4 years) subjects completed the intervention. BDI-II scores at screening and compliance did not differ between groups (p = 0.26). BDI-II scores declined significantly from screening (24.6 ± 1.7) to week 12 (6.0 ± 3.8) for the HDG (–18.6 ± 6.6; p < 0.001), and from screening (27.7 ± 2.1) to week 12 (10.1 ± 7.9) in the LDG (–17.7 ± 9.3; p < 0.001). There were no significant differences between groups, based on response (i.e., >50% decrease in BDI-II scores; p = 0.65) for the HDG (13/15 subjects) and LDG (11/15 subjects) or remission (i.e., number of subjects with BDI-II scores <14; p = 1.00) for the HDG (14/15 subjects) and LDG (13/15 subjects) after the 12-week intervention, although a greater number of subjects in the HDG had 12-week BDI-II scores ≤10 (p = 0.04).
Conclusion: During this 12-week intervention of yoga plus coherent breathing, depressive symptoms declined significantly in patients with MDD in both the HDG and LDG. Both groups showed comparable compliance and clinical improvements, with more subjects in the HDG exhibiting BDI-II scores ≤10 at week 12.

Authors
Chris C Streeter, Patricia L Gerbarg, Theodore H Whitfield, Liz Owen, Jennifer Johnston, Marisa M Silveri, Marysia Gensler, Carol L Faulkner, Cathy Mann, Mary Wixted, Anne Marie Hernon, Maren B Nyer, E Richard P Brown, John E Jensen

[link url="https://www.sciencedaily.com/releases/2017/03/170303131017.htm"]Boston University Medical Centre material[/link]
[link url="http://online.liebertpub.com/doi/10.1089/acm.2016.0140"]Journal of Alternative and Complementary Medicine abstract[/link]

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