Is Yoga effective in depression? Depress Anxiety. Nov.2013

14.11.2013

Yoga is a mind body intervention (aiming unification of mind, body, and ‘spirit’) that has been a part of traditional Indian spiritual practice for around 5000 years.There are multiple forms of Yoga, but all  involves  focusing the  mind on the body postures with inner awareness and a meditative focus .Some evidence suggest that Yoga can increase 1. Endogenous  striatal dopamine release  2.  Thalamic GABA levels 3. Plasma serotonin.It can also reduce the HPA dysregulation. Psychological processes ( attention training, rumination control, mindfulness etc)  are also key to benefits of Yoga.Benefits of yoga in general wellbeing is widely appreciated. Is Yoga really effective as a treatment for depression?

Holger Cramer, Romy Lauche, Jost Langhorst and Gustav Dobos report the results of a metanalaysis of all  RCTs for adult depression. MBSR ( mindfulness based stress reduction) and MBCT ( Mindfulness based CT) were not included as Yoga interventions.

Results

Twelve studies with a total of 619 patients were included in the qualitative analysis. Of this 12 studies included, 6 were from Asia. Different yoga techniques were used in these studies (e.g.:  Inner Resources program, laughter yoga,  Broota Relaxation Technique, Iyengar yoga, complex yoga,Kirtan Kriya ,Sudarshan Kriya ,Sahaj yoga meditation and Shavasana yoga).Nine studies with 452 patients were included in the meta-analysis.

There is limited to moderate evidence for short-term effects of yoga compared to usual care on severity of depression. (Standardised Mean Difference = −0.69; 95% CI −0.99 to −0.39; P < .001) .Only two RCTs reported longer-term effects and no significant  benefits were found. Mediation based yoga did better than exercise based yoga ( against comparators).

Limitations: Heterogeneity is high, methodological quality of the included RCTs was low. Subgroup analysis limited by small number of studies.

Conclusion: Yoga, (meditation based yoga in particular),  could be beneficial in depression.

Comment: It would be worthwhile to directly compare different yoga forms to understand which elements are useful.

Summary of the article :

Yoga for depression: a systematic review and meta-analysis. Cramer H, Lauche R, Langhorst J, Dobos G.Depress Anxiety. 2013 Nov;30(11):1068-83

 

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