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Over the last few weeks, we have been mostly discussing premenstrual dysphoric disorder (PMDD). You might have been wondering, "so where does yoga fit into all of this?" Well, now is the time for us to discuss what yoga is and why yoga is the perfect practice for mental health, especially for those with chronic illnesses like PMDD. In this post, I'll answer questions about what yoga is, how it changes the brain, and how it can help to transform lives.
So, What is Yoga All About?
Yoga is an ancient practice that comes from Eastern traditions. The word yoga means "to yolk together" or "to unite". Most practitioners believe this is in reference to uniting the mind, body, and spirit, but this can also be understood as to uniting oneself with their community, with nature, and the wonder of life itself.
The Yoga Sutras of Patanjali is a written document that outlines the basis of yogic philosophy. The very first yoga sutra is "yogas chitta vritti nirodha " which translates to: "yoga is the the calming of the fluctuations of the mind". So from the outset, we understand that yoga is really about mental health. It is about becoming less identified with the "mind stuff" and connecting with what is happening in the present moment. It's about uniting mind and body (and spirit, but I find that this third part is very subjective to the practitioner).
Many people are first introduced to yoga as a fitness activity and tend to believe that it is simply repeating a series of poses to improve flexibility.
It's not so much about physical flexibility as it is about mental flexibility. It's not about self-improvement, it's about self-acceptance. It's less about feeling out of control or fighting against your circumstances, and more about going with the flow and accepting what is. Conversely, It is not about exercising power over your mind and body, but discovering the power you have in working with them.
I know this sounds a bit out-there at first, but these ideas are the basis of yoga, and once you begin to practice more regularly and learn about yoga philosophy, the more these types of things begin to make sense.
Okay, let's go back to the common idea that yoga is about the physical body. While it is true that yoga does include physical postures, this is just one small part of a greater whole. The "Eight Limbs" of ashtanga yoga are said to be different branches of one tree. These include:
Yamas (guidance regarding our relationship with ourselves)
Niyamas (guidance regarding our interactions with the outer world)
Asana (the physical practice of yoga postures)
Pranayama (the practice of the breath and energy)
Pratyahara (turning the senses inward)
Dharana (practicing focus & concentration)
Dhyana (surrendering and letting go through meditation)
Samadhi (experiencing a state of bliss/harmony)
The only one that directly relates to the physical body is asana. The purpose of practicing asana is to unite the body with the mind, and to keep the body healthy so that we are able to focus the mind. As you can see, only one of the eight limbs relates to the physical body, one relates to the breath, two relate to our choices or behaviors, and the other four are all about meditation.
Another ancient yogic text, the Bhagavad Gita, states that "yoga is journey of the Self, through the Self, to the Self". By accepting your mind and body as it is (and actively working to heal it through practice) you can begin to full understand that you are more than your physical body, and that life is much bigger than your mind or body, yet you are an integral part of this much bigger picture.
Why Is Yoga Good For Mental Health?
So now that you know what yoga is all about, let's talk about why people might choose to practice yoga for mental health benefits. We'll discuss the more subtle aspects of why yoga and meditation are helpful for mental health, and then we will talk about the neuroscience regarding the impact of yoga on the brain. Scroll down for some amazing statistics!
First of all, I'm in no way saying that yoga should be used treat mental health conditions (at least, I'm not purporting to do so myself). Personally, I believe that yoga can be very beneficial in helping someone cope with stress and symptoms, but I don't like to use the word 'treatment', at least in my own work. I believe yoga and meditation should be just one part of a person's overall wellness plan.
We all know about the placebo effect - the expectation that a drug is helping you can actually cause physiological changes in the body, even if you're receiving a drug that does nothing. Usually these effects wear off after time passes.
Expectations need to managed here. If you see yoga as something that is meant to 'fix' you, you're likely to be disappointed. However, if you see yoga as an opportunity to connect with yourself, your emotions, and your body, as it already is, you're more likely to notice and appreciate any benefits that happen to come from this practice.
Practicing mindfulness, meditation, breathwork, and asana can help you develop a lot of life skills that are vital for mental health. You learn to feel discomfort and manage your emotions and physical sensations through that discomfort. At the same time, you also learn to recognize your limits and prioritize wellbeing. You learn the importance of balance and cultivating resilience. You learn that it takes time to build strength, and that it comes with practice.
The great thing about yoga is that it can be modified for all ages and abilities, and has very few negative side effects. It doesn't need to be a sweaty hour of high-intensity in-person guided class. It can simply be 20-30 seconds of quiet mindfulness, or 5 minutes of breathwork. The hardest part is simply showing up. And when it comes down to it, that's all you really have to do. Just make a conscious effort to be aware of the present moment and to be willing to meet yourself wherever you're at.
Practicing yoga is generally low cost, low risk, and actually enjoyable compared to other interventions for mental health - so why not at least give it a try?
If I haven't convinced you yet, wait until you read the stats!
How Does Yoga Impact The Brain?
Strap yourself in, because we're about to get nerdy! Although Eastern practitioners of yoga have known for centuries that yoga has mental health benefits, Western science has only recently began to quantify (in scientific terms) why this is. We now have proof that practicing yoga regularly changes brain activity, neurochemistry, and structure.
The relationship between the physical and chemical structure of the brain and what we know as "the mind" is complex. The mind, otherwise known as our mental and emotional states, seem to be governed by activity in the different regions of the brain, the levels of neurochemicals and how they are metabolized, and the frequencies of electrical pulses sent between neurons. Therefore our mental health and wellbeing is closely related to what's going on in the brain.
Brain Structure & Bloodflow
Science tells us that the size, bloodflow, and general activity of certain areas of the brain can cause variations in cognitive ability and even mood.
The prefrontal cortex is responsible for things like organization, logic, reasoning, and socialization. People with attention deficit hyperactivity disorder (ADHD) and depression tend to have reduced activity in this region. Studies show that regular practitioners of yoga and meditation have increased grey matter and activity in the prefrontal cortex.
The limbic areas of the brain, including the hippocampus and amygdala are responsible for fear, emotion, and memory storage. These areas of the brain have been shown to be overactive in people with anxiety, panic disorder, and post-traumatic stress disorder (PTSD). Researchers believe that practicing yoga and mediation reduces brain activity in the amygdala.
It seems that regular yoga and meditation may be able to help people become less reactive to stressful situations by helping them to divert brain activity away from the amydgala (the emotional mind) and towards the prefrontal cortex (the thinking mind).
Neurotransmitters
Neurotransmitters are chemical compounds in the brain that greatly influence our cognition, mood, and behavior, as well as our "unconscious" body systems such as digestion and heart rate. Neurotransmitters include serotonin, gamma-aminobutyric acid (GABA), and dopamine, among others. Each of these neurotransmitters has a specific distribution and function in the brain. People with depression tend to have less serotonin; people with anxiety have less GABA; People with ADHD tend to have less dopamine.
GABA
We have already discussed that practicing yoga and meditation can increase activity in the prefrontal cortex. Studies show that meditation increases bloodflow in this region, which in turn increases levels of GABA, a neurotransmitter than is shown to have lower than average levels in people with anxiety and/or depression. Another study showed that a 60 minute yoga class increased GABA levels by 27%! This is very compelling evidence to show the benefits of yoga and meditation practice for those with low GABA.
Serotonin
In another study, the baseline levels of serotonin in the urine of meditators was higher than in those who did not meditate; the level of serotonin in the urine increased even further immediately after meditation. This indicates that due to this increase in serotonin, meditation may also be helpful for those who suffer from depression.
Dopamine
And finally, an additional study showed that dopamine levels are increased during Yoga Nidra, a specific type of meditation. In this study, a session of Yoga Nidra increased dopamine levels by 65% indicating that Yoga Nidra could be highly beneficial for low dopamine conditions such as ADHD and/or depression.
Brainwave States
The neurons of the brain communicate by sending electrical pulses between them. These pulses can be measured and are known as brainwaves.
Gamma, 35Hz (associated with concentration and problem solving)
Beta, 12-35Hz (associated with active thinking)
Alpha, 8-12 Hz (associated with thoughtful reflection and rest)
Theta, 4-8Hz (associated with relaxation or drowsiness)
Delta, 0.5-4Hz (associated with dreaming or deep sleep)
Meditation and breathwork practices can induce some of the more restful states associated with these brainwaves. Combining meditation and breathwork with asana, as is common in many Hatha Yoga classes, can help compound this effect. Yoga Nidra, in particular, when practiced regularly, can help to prioritize alpha brainwaves as the dominant state.
Why Is Yoga Beneficial For PMDD, Specifically?
Premenstrual Dysphoric Disorder (PMDD) has symptoms that are physical and symptoms that are mental/emotional. We know that our physical and mental health are related, and that the neurotransmitters in the brain greatly influence how we feel and behave in the world. Yoga is a mind-body practice that seeks to bring the two together. So it clearly makes sense that we would use a mind-body practice to cope with a mind-body disorder.
On a subtle level, PMDD does so much damage to the self. You feel out of control, suffer from self-depreciating thoughts, and can be pushed to self-harm or self-destruction. Yoga is ultimately a practice of working with this self. Forgiving, accepting, caring for, and loving oneself. This work is certainly not easy, especially when you have PMDD. But I believe that yoga has a place in helping you to do this work and improve your relatonship to yourself.
As for the research, there are not a lot of studies specifically looking at yoga and PMDD. Although exercise and lifestyle modifications are listed as first line treatments for PMDD, unfortunately there are no evidence-based guidelines for what this means specifically.
We have all heard "you should try yoga!" from well-meaning individuals, but it is frustrating to hear when there are no specifications as to what type of yoga, how often to practice, and why or how it works.
However, I have found a few studies on the impact of yoga and meditation on premenstrual symptoms in women with menstrual disorders and/or depression and anxiety.
In a study of women with PMS and PMDD, undertaking 12-week yoga program was significantly correlated with decreased physical symptoms, including bloating, cramping, breast tenderness, and cold sweats. Menstrual pain was improved, which in turn improved physical function, social function, energy levels, and mental health. A literature review looked at 18 other studies and found that yoga intervention generally resulted in a reduction in severity of symptoms associated with menstrual disorders.
A study specifically looking at teens with menstrual disorders showed improvements in pain levels as well as the added effect of regulating overall cycle length, the length of the menstrual phase, and the amount of blood loss.
Other research has shown that regular yoga practice has show to reduce the severity of menstrual pain and improve overall quality of life.
Yoga nidra, a specific type of meditation, has been shown to improve symptoms of deprssion and anxiety in women with menstrual disorders. In a study of women experiencing depression and anxiety, those who completed 12 session of hatha yoga over 4 weeks showed a reduction in symptoms of stress, anxiety, and depression. Other studies have shown similar results.
In terms of the science of PMDD, specifically, studies show that the amygdala is overactive during the luteal phase of the menstrual cycle. We also know that PMDD is at least partially related to the modulation of neurotransmitters, especially serotonin and GABA.
Given the studies on brain health that we have discussed, we know that practicing yoga and meditation can affect activity in the amygdala and increase the levels of serotonin and GABA in the brain, which might explain why these practices are so beneficial for people who have PMDD.
So there you have it! Science tells us that yoga is great for mental health! I only hope that there will be more studies specifically related to PMDD and yoga.
Do you find that yoga is beneficial for your mental health? Did any of this research surprise you? Let me know in the comments!