The Bray of the Heart: Yogic Breathing for the Symptoms of Depression.
By Nicole Schnackenberg
“I took a deep breath and listened to the old bray of my heart: I am, I am, I am”.
Sylvia Plath
Depression is one of the most commonly diagnosed mental health conditions in Western society today. In the Diagnostic and Statistical Manual for Mental Disorders (DSM-V), depression is currently divided up into several diagnostic categories. Clinical depression, sometimes referred to as major depressive disorder, describes acute feelings of sadness, loss of interest in activities, sleep and appetite changes, guilt and hopelessness, fatigue or restlessness, difficulty with concentration, and suicidal ideation that persists for most of the day, almost every day, for at least two weeks. Depression often goes hand-in-hand with anxiety, which is described as a feeling of unease, such as worry or fear, that can be mild, severe, or anything in-between.
Yoga has been found by numerous researchers to decrease symptoms of depression (Berger & Owen, 1992; Lee, Mancuso & Charlson, 2004; Mishra & Sinha, 2001; Roth, 1997) and anxiety (Calajoe, 1987; Derezotes, 2000; Lee, Mancuso & Charlson, 2004; Mishra & Sinha, 2001). Wonderfully, Lavey and colleagues (2005) found that people who participated in yoga demonstrated significant improvements on all five of the so-termed ‘negative’ emotion factors, namely tension-anxiety, depression-dejection, anger-hostility, fatigue-inertia, and confusion-bewilderment.
Heart rate variability (HRV) is an important element of this relationship between yoga and depression and anxiety. HRV refers to the natural fluctuation in heart rate occurring with each breath, which is faster on the inhalation and slower on the exhalation. Teaching people to maximise this fluctuation has developed into a clinical procedure on account of its apparent links to autonomic balance: the sympathetic (fight, flight or freeze) and parasympathetic (rest and digest) branches alternate their control of the heart rate in line with the phases of the breath cycle. In 2002, Yeragani and colleagues obtained results of diminished HRV in participants diagnosed with depression compared to controls, while Borkovec and Costello (1993) found that slow-paced meditation with diaphragm breathing had a major impact on depression scores and anxiety scores. Yogic breathing has also been shown repeatedly to be a valuable resource for people suffering from stress, which is in no small part due to the fact that it reduces the resting respiratory rate, thus stimulating the parasympathetic nervous system.
So…what does this all mean in practical terms? Essentially, long, deep breathing stimulates the activity of the parasympathetic (rest and digest) nervous system and can have significant benefits to those experiencing anxiety in particular. For those experiencing symptoms of depression such as acutely low mood and flailing energy levels, rapid breathing will stimulate the sympathetic (fight, flight or freeze) nervous system and thus help to increase energy and drive in the body and mind. In yogic terms, long, deep breathing can bring a person from a rajasic (stimulated and high-energy) state into a sattvic (balanced and peaceful) state, whilst rapid breathing can bring a person from a tamasic (heavy and low-energy) state into a sattvic state.
Breathing Practices to Stimulate the Parasympathetic Nervous System (for soothing anxiety and anxious mood states of depression).
Long, deep breathing: Place one hand above your navel, and one hand below it. Breath in deeply, feeling your hands rise on the inhalation. Fill your diaphragm as fully as you can with air. Notice the pause before the exhalation begins. As you exhale, notice your hands sinking downwards. Empty your lungs completely. Place your attention on the pause between the end of the exhalation and the beginning of the next inhalation. Repeat these rounds of mindful inhalations and exhalations, placing your awareness on the breath and on the rise and fall of your hands. To stimulate parasympathetic nervous system activity more fully, make your exhalation longer than your inhalation (perhaps breathing in for the count of six and out for the count of nine).
Alternate Nostril Breathing: First, block your right nostril with your right index finger and take a long, slow inhale through your left nostril. Then block your left nostril with your left index finger and exhale slowly through your right nostril. Now breathe in from your right nostril, block and breathe out from your left. Continue inhaling and exhaling from alternate nostrils, remembering to breathe in from the same nostril from which you just exhaled. You can also take a particular hand gesture, or mudra, such as Vishnu mudra, to facilitate the passage of air through the nostrils. For Vishnu mudra, bend the first two fingers of the right hand into the palm, using the thumb to control the passage of breath through the right nostril and the ring (third) finger to control the passage of air through the left nostril. As you become more experienced, it is also possible to practise the breath without the use of your fingers, simply blocking off alternate nostrils at will.
Breathing Practices to Stimulate the Sympathetic Nervous System (for increasing energy in low-mood states of depression).
Elongation of the inhalation: To stimulate sympathetic nervous system activity, make your inhalation longer than your exhalation. Perhaps breathe in for the count of six and out for the count of three.
Kapalabhati: This is a rapid, rhythmic, and continuous breath which can be excellent for lifting mood and energy levels. It is equal on the inhale and exhale with no pause in between, practised solely through the nostrils with the mouth closed. Begin on an exhale, expelling the breath powerfully through the nose by pressing the naval point back towards the spine. To inhale, the upper abdomen muscles relax, the diaphragm extends down and the breath will come in naturally. This breath should ideally contain around 2–3 cycles per second.
We hope you find these breathing techniques beneficial for soothing some of the symptoms associated with anxiety and depression. Of course, these techniques only form part of the picture for addressment of these struggles. The importance of exploring and embracing difficult emotions, of finding a way to share your suffering in conversation and connection with others, and of seeking professional help if needed cannot be underestimated.
References
Berger, B. G. & Owen, D. R. (1992). Mood alteration with yoga and swimming: Aerobic exercise may not be necessary. Perceptual and Motor Skills, 75, 1331–1343.
Borkovec, T., & Costello, E. (1993). Efficacy of applied relaxation and cognitive behavioural therapy in the treatment of generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 61(4): 611–619.
Calajoe, A. (1987). Yoga as a therapeutic component in treating chemical dependency. Alcoholism Treatment Quarterly, 3, 33–46.
Derezotes, D. (2000). Evaluation of yoga and meditation training with adolescent sex offenders. Child and Adolescent Social Work Journal, 17, 97–113.
Lavey, R., Sherman, T., Mueser, K. T., Osborne, D D., Currier, M., & Wolfe, R. (2005). The effects of yoga on mood in psychiatric inpatients. Psychiatric Rehabilitation Journal, 28, 399–402
Lee, S. W., Mancuso, C. A., & Charlson, M. E. (2004). Prospective study of new participants
in a community-based mind-body training program. Journal of General Internal Medicine, 19, 760–765.
Mishra, M., & Sinha, R. K. (2001). Effects of yogic practices on depression and anxiety. Journal of Projective Psychology & Mental Health, 8, 23–27.
Roth, B. (1997). Mindfulness-based stress reduction in the inner city. The Journal of Mind-Body Health, 13, 50–59.
Yeragani, V., Rao, K., Smitha, M., Pohl, R., Balon, R., & Srinivasan, K. (2002). Diminished chaos of heart rate time series in patients with major depression. Biological Psychiatry, 51(9): 733–744.