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YOGA and STRESS MANAGEMENT - A Scientific Perspective*

Sat Bir Singh Khalsa**

Yoga is widely respected as a practice that is capable of improving  our ability to cope with stress.

The word “stress” has gained a good deal of notoriety in recent times. Although a stressor can be a physical  challenge that requires us to either withstand or manage  it (e.g. hypothermia or dehydration), we more commonly think about stress in its psychological version, as in a heavy workload at our job, or family relationship problems.   
When unwanted stress occurs over a relatively short period of time, we are usually capable of a full recovery from its  effects. But when we are faced with multiple back-to-back instances of stress or a sustained level of stress that prevents us  from appropriate recovery, we may start to experience negative physical and psychological consequences. This happens  when the systems in our bodies which mediate stress responses go into overdrive, producing chronic high levels of stress hormones. This, in turn, can lead to a wide variety of medical consequences including depression, anxiety, high blood pressure, and insomnia.

Managing Stress
Fortunately, there are a number of ways to manage chronic stress. One obvious approach is to limit stress by reducing it at its source and/or by more efficiently managing it. However, in circumstances such as family relationship problems this approach is not necessarily helpful. Psychological approaches that address our perception of stress – including strategies such as resetting our internal goals and expectations and modifying our thoughts with respect to stressors – can be applied. However, even this tactic may not be all that beneficial for some circumstances, such as in the case of a low-income single parent. A strategy that is more universally useful for all chronic stress circumstances would be to increase our capacity to cope with stress using mind/body techniques, of which yoga is a particularly suitable candidate. Fortunately, these techniques can modify our internal psychological management of stress as well as our physical responses to stress.

Yoga is widely respected as a practice that is capable of improving our ability to cope with stress. In fact, multiple research studies have shown that yoga practices using postures, breath regulation and meditation, either alone or in combination, can lower the levels of stress hormones, reduce tension and anxiety, and improve overall mental well-being. Among research evidence is the example of a study examining effects on perceived stress before and after 90 minute classes of hatha yoga and biology in a school setting. Participants in the  yoga class showed significant reductions in perceived stress, whereas participants in the biology class did not.

Benefits from Yoga over Time

A good example of evidence of the sustained benefit of yoga practice for stress over a longer time course is an older Indian  study showing that normal healthy subjects involved in a 6 month yoga practice showed reductions in stress hormones that were greater than those of subjects practicing an exercise program. However, in order to demonstrate that yoga is also capable of improving stress coping in chronic stress, studies showing that yoga can improve both physical and psychological components of chronic stress in populations of people actually under chronic stress are more appropriate. A number of such studies have been reported.

A recent study in Sweden evaluated a 10 session, 4 month long Kundalini Yoga intervention for 18 people from a large  financial company with self-reported stress-related problems. In addition to the group practice sessions, subjects also practiced at home. At the end of the study, the yoga program participants  experienced statistically significant improvements in perceived stress, stress behavior and exhaustion as assessed from specific questionnaires designed to measure these outcomes.  Although similar improvements were observed in a control group, which underwent a cognitive behavioral therapy program for stress, the yoga group also showed significant reductions in the stress hormone noradrenalin, whereas the cognitive behavior therapy group did not. This study was important in that it suggested that a Kundalini Yoga intervention  alone could be as effective as a well-established technique for stress-reduction.

In another European study, women research volunteers under high levels of distress participated in a controlled study of a 12-week yoga program consisting of two classes per week and in practice at home. At the end of the program, subjects who underwent the yoga program had significant improvements in scores of questionnaires designed to measure perceived stress, anxiety, depression, well-being, vigor, and fatigue as compared with a group of  subjects who did not practice the yoga techniques. These self-perceived changes were further supported by objective measures of the stress hormone cortisol, which was shown to be reduced after the yoga practice sessions. As is common with mind-body treatments such as yoga, not only did subjects not experience any negative side effects, but in fact showed substantial improvements on a number of other symptoms, such as headache and back pain.

Evaluating Stress Techniques
An ideal population useful for evaluating stress interventions is that of caregivers for relatives with chronic medical or psychiatric conditions, whose life circumstances incorporate many of the components characteristic of chronic stress. A small study of caregivers of dementia patients was conducted to evaluate the benefits of a 6-week stress management program incorporating hatha yoga, meditation, and mantra1 repetition in both formal yoga sessions and in at-home practice. Most of the subjects reported feeling better after the intervention and 90% or more of them found the practices to be moderately, quite a bit, or extremely useful for them. Questionnaires assessing anxiety and depression showed significant improvements.

These studies, described above, as well as many similar studies, provide good evidence that yoga is indeed an effective  stress coping technique capable of improving subjectively perceived stress, symptoms and consequences of chronic stress  (e.g. anxiety and depression), and stress hormone levels. However, as with all scientific research, more work needs to be done  in this area by multiple investigators in different settings and in a variety of subject populations before yoga will begin to be accepted by the healthcare and education systems as a stress management intervention worthy of universal implementation. Preventive studies to show that yoga techniques can improve stress resilience are also needed to demonstrate that people can avoid the negative consequences of chronic stress.

Given the significant impact of chronic unmanaged stress in both generating and exacerbating a variety of mental and physical medical conditions, the ultimate widespread implementation of yoga practices in our education and health-care systems will go a long way to improving the overall health of the population.

* To familiarize the SEVAMED readers with Scientific perspective of Yoga in Stress Management, we are reproducing the article entitled ‘YOGA and Stress Management’ by Dr. Sat Bir Singh Khalsa published in Aquarian Times (July-Aug, 2007). We gratefully thank the author and Editor, Aquarian Times for giving us persmission.

- Ed.   

** Assistant Professor of Medicine, Harvard Medical School & Director of Research for the Kundalini Research Institute (KRI), Boston, USA