Balancing Your Emotions with Your Breath

by Nina

Close-Up of the Falls by Melina Meza

As I wrote in Your Breath: The Key to Your Nervous System, while you cannot tell your nervous system directly to slow your heart beat, digest your food more quickly or to start relaxing right this minute, you can control your breath. And because your heart rate tends to speed up on your inhalation and your heart rate tends to slow on your exhalation, this enables you to consciously access your nervous system. By intentionally taking in more air (either by speeding up your breath or by lengthening your inhalation) you can stimulate your nervous system. And by taking in less air (by slowing your breath or lengthening your exhalation), you can calm yourself down.

Last week, I wrote about emotional counter-poses that you can use to balance your emotions. You can use various yogic breath practices in the same way. You can use breath practices when nothing serious is wrong but you’re just feeling slightly hyper (see anxiety or stress) or slightly down (see clinical depression). And you can also use them as a supplement to other treatments if you are suffering from anxiety, agitated depression, clinical depression or chronic stress.

(Note that yogic breath practices have evolved over thousands of years as yogis experimented on themselves and passed on discoveries their students. And while some schools of yoga teach yogic breath practices (pranayama) to beginners, the type of yoga that I’m trained in, Iyengar style, considers breath practices to be so powerful that pranayama is introduced very gradually. So if you start experimenting with breath practices to balance your emotional condition, do take it easy.)

Anxiety and agitated depression. Because anxiety and agitated depression—which is anxiety based—are so often related to an overactive sympathetic nervous system, for these two conditions it’s best to focus on your exhalation. You can simply work on exhaling completely or lengthen your exhalation a beat or two (by pausing after your exhalation is complete). Or, you can try a more formal practice that focuses on lengthening the exhalation, such as Viloma with interrupted exhalation, where you actually pause twice during your exhalation and once at the end. This is the practice that Iyengar himself recommends in Light on Life in his “Asanas for Emotional Stability” practice.

If manipulating your exhalation causes you to feel any agitation whatsoever, stop the practice. In addition, practices that lengthen your inhalation or even that bring your awareness to the inhalation (which can cause you to unintentionally lengthen or deepen your inhalation) may aggravate your condition, so you may want to avoid them.

If you’ve noticed that you are a chest breather—a type of breathing that seems to be associated with anxiety—and it doesn’t make you feel more anxious to work with your inhalation as well as your exhalation, you could practice abdominal breathing. In abdominal breathing, you focus on slowly inhaling into and exhaling from your belly rather than your chest, as you intentionally keep your abdominal area relaxed. You could lie on your back, and place a block or other light weight, such as a 1 pound bag of rice, on your belly to bring awareness to your abdomen, and keep your abdomen relaxed as you slowly inhale and exhale. Or, if lying on your back makes you anxious, you could lie in Crocodile pose (on your belly with your arms out to the sides, elbows bent, and forehead resting on stacked hands) so you can feel your abdomen moving toward and away from the floor as you slowly inhale and exhale.

You can also use any of these techniques if you're just feeling mildly hyper and want to calm down.

Clinical depression. For clinical depression, which tends to make people feel heavy and lifeless, focusing on your inhalation or breathing more quickly can stimulate your nervous system and bring you out of your lethargy. This is one reason why an active vinyasa practice, such as the Ashtanga series or Sun Salutations, can be helpful to those with clinical depression because when you move with your breath, you tend to breathe more quickly and take in more oxygen. So for you, it may be helpful to focus on your inhalation. You can simply work with inhaling more completely or lengthen your inhalation by holding it for a beat or two. Or, you can try a more formal practice that focuses on lengthening the inhalation, such as Viloma with interrupted inhalation, where you actually pause twice during your inhalation and once after. In Yoga As Medicine, Timothy McCall recommends Ujjayi breathing, which tends to lengthen both the inhalation and exhalation, as well as the version of Viloma with interrupted inhalation

Some people who are depressed tend to have a slumped posture, with a collapsed chest, so focusing on opening your chest and inhaling into that area can be beneficial. In Yoga As Medicine, Timothy quotes Patricia Walden, who herself has suffered from clinical depression, saying:

“When you start focusing on your breath, and taking the breath into your chest and breathing deeply, you begin to feel the presence of your breath. What comes with that is a feeling of life returning, a feeling of warm that percolates throughout your chest at the beginning, but then throughout your entire body.”

You can also use any of these techniques if you're just feeling mildly depressed or blue.

Because stress is often a trigger for clinical depression, it’s possible that working with your exhalation as described for anxiety rather than your inhalation, could be helpful for you. So don’t hesitate to give it a try if you feel so inclined. As I said in my post Anxiety, Yoga and the Front Body, when it comes to emotional balance, anything that makes you feel better is working.

Stress. Because chronic stress is the result of an overactive sympathetic nervous system, it makes sense to focus on pacifying your nervous system by working with your exhalation as I described for anxiety. However, from my observations of people doing pranayama, some people find any kind of pranayama relaxing (I, myself, do not, by the way). If you do find all breath work relaxing, go ahead and do whichever breath practice quiets your mind and relaxes you. Simply slowing your breath in general, with long, slow inhalations as well as exhalations, could be helpful in reducing stress. Practices where you speed up your breath will no doubt stimulate your nervous system. So if you are doing an active vinyasa practice to burn off your excess energy, end your yoga practice with a calming breath practice or an emotional counter-pose (see Balancing Your Emotional Body With Counter-Poses) that triggers the relaxation response.

Balancing Your Emotional Body With Counter-Poses

by Nina

Last week in my posts about anxiety Anxiety, Yoga and the Front Body and Soothing Yourself With Supported Forward Bends, I discussed yoga poses to rely on when you’re feeling anxious (supported inversions and forward bends) and yoga poses to avoid when you’re in that state (backbends, twists, and Sun Salutations).

It makes sense if you’re in a crisis period to practice the poses that calm you down and avoid stimulating poses that might exacerbate your condition. However, if you’re in a state of chronic anxiety, avoiding backbends, twists, and many of the active poses for a long period of time will move your body toward imbalance. The same is true if your practice is focused on any emotion-based condition, such as agitated depression, clinical depression, or even just chronic stress.

In this case, I feel it is better to return to a more well-rounded yoga practice (see A Week of Yoga Practice) but consider how you end your practices. By choosing an appropriate counter-pose to end your practice, you can counteract any negative emotional effects of your practice without negating the beneficial physical ones. That way, you can move on to the rest of your day with your nervous system and emotions more in balance. Some people with anxiety or agitated depression even find that beginning with a very active practice can help burn off excess energy, which makes the soothing or relaxing counter-poses at the end of the sequence more effective (or even possible, as it can be hard to stay still when you’re feeling very anxious).

My post Yoga and Your Emotions describes the emotional effects different types of poses have on most people. So if you’re interested in practicing for balancing your emotions, take a look at that and consider how a given practice (standing pose, Sun Salutation, twist, backbend, forward bend, restorative) might affect your current emotional state. Then choose one or more counter-poses—especially passive poses that can be held for long periods of time—that you can add on to the end of your practice to counteract the poses that were the main focus of the practice. For example, if you’re already feeling anxious or hyper yet need to practice backbends for the health of your body, you can end your backbend sequence with a long supported inversion, such as a Chair Shoulderstand or Legs Up the Wall pose, to calm yourself down. 

Anxiety and Agitated Depression. We’ve already said that supported inverted poses and supported forward bends are the best poses to counteract anxiety. These may also be helpful for agitated depression as that is anxiety based. So at the end of a more active sequence, try resting in Supported Child’s pose for a few minutes and then practice Legs Up the Wall pose (Viparita Karani) for 10 minutes or more. If Child’s pose is uncomfortable for you or you can’t kneel for some reason, try a Supported Seated Forward Bend with a chair (see Soothing Yourself With Supported Forward Bends), with a straight back. If Legs Up the Wall pose doesn’t work well for you, try Easy Inverted Pose (Featured Pose: Easy Inverted Pose). If having your front body exposed makes you feel vulnerable, try covering yourself with a blanket. 

Clinical Depression. On the other hand, for people who are suffering from clinical depression, forward bends, with their inward turning quality, can cause you to brood. For you, therefore, a couple of mild, active backbends, such as Purvottanasana (Reverse Plank pose) or Bridge pose, would be good counter poses after practicing a forward bend sequence. Generally speaking, an active practice is best for those with clinical depression, especially one that includes backbends, because that helps counteract feelings of lethargy. But if you are tired and want to practice restorative poses, focus on passive backbends rather than forward bending poses, and be sure to end your sequence with a backbending position, rather than a forward bending one. Rather than doing Savasana flat on your back, try doing it with your torso supported by a bolster or stack of blankets, so your chest is open and your back is in a slight backbend. Or, maybe even reverse the typical pattern of a practice, begin your sequence with resting poses and moving slowly onto more active ones so you are left feeling a bit energized. Often I'll end a restorative sequence by standing in Mountain pose and inhaling as I raise my arms overhead into a slight backbend and exhaling as I return my arms to my sides. 

Stress. For people who are suffering from chronic stress, standing poses, Sun Salutations, backbends, and twists can be over stimulating. So try to end a sequence that is focused on any of those types of poses with any long supported inversion, such as Legs Up the Wall pose or Easy Inverted pose, or any restorative pose that you enjoy.

Even a long Savasana of 10 minutes or more, with a mental focus, such as your breath, would be helpful as an emotional counter-pose (see Savasana Variations) or any form of yoga nidra (see Audio Tracks tab above). Stressed out people tend to skip these ending poses because they think they don’t have time and that restorative poses are not “productive.” However, when you’re suffering from chronic stress, the most beneficial practice for you is some type of conscious relaxation (see The Relaxation Response and Yoga). As with anxiety, you may need to first burn off excess energy with a more active practice, but always leave time for conscious relaxation at the end of your sequence.

 I, myself, have been practicing like this for many years, with focused, nervous-system pacifying sequences during particularly challenging times, and balanced sequences with emotional counter-poses the rest of the time. But what if you, like many other people, do not practice often at home and do most of your yoga practice in classes or with videos? In this case, there is no reason why you can’t do just the counter-pose after the class or video. For example, if an evening backbend practice has left you feeling agitated or even just hyper (I can’t tell you how many people have told me that backbends at night cause insomnia), there’s no reason why you can’t just practice a supported inverted pose or conscious relaxation on your own before bed. This will help pacify your nervous system and may even lead to better sleep.

Supported Forward Bends: Peaceful Poses for Stress, Anxiety, Neck Pain and Headache Prevention

by Nina

We finally took some new photographs, and now I’ve got a portfolio of my favorite poses for stress management and anxiety! So I thought that today I’d introduce you to some of favorite quieting poses: supported forward bends. A supported forward bend is one where you use a prop, such as a bolster, stack of blankets or a chair seat to support your head and arms as you stay in the pose. Relaxing onto the support helps remove straining from the pose and enhances the quieting quality of the forward bend. These are gentle, inward-turning poses that both calming and nurturing.

You can do supported forward bends in two forms: standing and seated. Standing supported forward bends are particularly good for stress as they are partial inversions. See Just in Time for the Holidays: Inverted Poses for information about why inverted poses, including partial inversions, are so beneficial for stress management.

Because the supported seated forward bends are less active than the standing versions, they are more quieting. And because you’re resting the weight of your head and relaxing your neck, these poses may also help with neck pain and headache prevention. I love supported seated forward bends, especially when I’m feeling anxious, however, some people do not enjoy supported seated forward bends, finding them rather too quieting, in other words, sort of deadening. And they’re probably not the right poses for people suffering from depression. So you’ll have to try for yourself and see what you think.

In general, when setting up for these poses, it’s important to be honest with yourself about how many props you need to be truly comfortable. The aim here isn’t to feel a stretch, much less any pain, but to use the pose to quiet yourself physically and emotionally.

As you come into the pose, bend from your hip joints and keep your back straight. This will help prevent back strain that comes from rounding your back. If you need to sit on a folded blanket to encourage the bend from your hips—most of us do—then add that prop as well (see photo).

When you bring your head onto the prop, do not force your head down. If your head doesn’t reach easily, you need a higher prop. For the Standing Forward Bend, you can stack two blocks, with one on the lowest height and the second on the highest. Stacking two blocks end on end, however, is unstable, so be honest with yourself and get your chair! (Besides, if you compare, most chair seats are lower than two blocks end on end, anyway—check it out and see.)

If you want to sequence these poses, I recommend starting with the standing versions first—they are better for warming up your legs and hips, and are more active—and then moving onto the seated ones. Of course, any of these can be done alone, or as part of any restorative or stress management sequence (we’ll have some of those coming in the near future). And there’s no reason at all why you can’t end an active practice with a supported seated forward bend of your choice, followed by Savasana.

1. Standing Forward Bend (Uttanasana), with your head on a block or chair
2. Widespread Standing Forward Bend (Prasarita Padottanasana), with your head on the floor or on a block or chair
3. Wide Angle Pose (Upavista Konasana) or Seated Crossed Legs, with your head on a bolster or chair
4. Seated Forward Bend (Paschimottanasana), with your head on a bolster or chair

I hope these poses bring you peace.

Update: Wondering where those photos are? It turns out, they're not quite ready yet. We took them, but I don't have access to them this afternoon. I'll add them to this post as soon as I get them, so check back again.

Preventing Migraines (and Other Headaches), Part 1

by Nina

Supported Child's Pose

A dear friend of mine, with whom I’ve stayed on many vacations and have traveled with, suffers from terrible migraines; the kind where all you can do is curl up on the fetal position for 24 hours in a dark room. So even though I don’t have migraines myself, I’ve witnessed first hand how awful they can be. Baxter had some good suggestions yesterday (see Yoga for Migraine Headaches) for how to use yoga to get through a migraine headache. But wouldn’t it be nice if you didn’t have to get a migraine in the first place?

Unfortunately, since there are many different triggers for migraines, including different types of food,  it is impossible for us to give you any guaranteed solutions. However, we do have some recommendations for yoga practices you can try. Suffering from a migraine is such a miserable experience and these yoga practices will benefit you in many other ways, so it really seems worth giving them a shot. And everything we’re going to suggest here applies to ordinary tension headaches as well as to migraines, so listen up, everyone!

In his book Yoga As Medicine, Timothy McCall identifies two possible triggers for migraines and other headaches that we can address with yoga: stress and muscle tension in the head, neck and back areas. Today I’m going to talk stress and tomorrow I’ll post something about muscle tension (see Preventing Migraines and Other Headaches, Part 2).

Okay, now to address stress. In his book, Timothy says, “Since stress is a major factor in both tension headaches and in migraines, yoga can certainly play a role in prevention.” And he goes on to say that “There is scientific evidence that relaxation techniques and biofeedback can be effective for both tension and migraine headaches, lessening the duration as well as the frequency of attacks.” That sounds pretty promising to me!

I’ve been ranting about the subject of chronic stress and the importance of stress management since we started the blog (see Chronic Stress: An Introduction  and The Relaxation Response and Yoga), but as a reminder, I’ll simply reiterate that yoga provides a huge selection of possibilities for stress management and you can pick and choose from amongst them according to your experience level, temperament, schedule, and/or personal preference. All of the following yoga techniques reduce your stress levels by switching your nervous system from stress mode (Flight or Fight) to relaxation mode (Rest and Digest). This type of relaxation is something you cannot achieve with a nap or even a full-night’s sleep (see Conscious Relaxation vs. Sleep).

•    Meditation. See How to Meditate for information on how to meditate.

•    Breath practices (pranayama). See Your Key to Your Nervous System for information your nervous system and your breath. For stress reduction and headache prevention, be sure to avoid stimulating and/or overly complex breath practices and focus on simple, calming practices.

•    Restorative poses with a focus for the mind (such as your breath or the relaxation of your muscles).

•    Inverted poses. Studies by Dr. Roger Cole proved that inverted and semi-inverted poses, where your heart is higher than your head, trigger the relaxation response through the mechanisms that control your blood pressure. This is why supported inversions, such Legs Up the Wall pose and Easy Inverted Pose (legs on a chair), are so effective for stress management (See Just in Time for the Holidays: Inverted Poses).

•    Corpse pose (Savasana) with a focus for your mind (such as your breath, the relaxation of your muscles, or peaceful imagery). See Savasana for information.

•    Yoga nidra (yogic sleep), a long, structured form of Savasana. See What is Yoga Nidra? for information about yoga nidra and the Audio Tracks tab at the top of the page for a mini version of yoga nidra that you can stream or download.
 
If you find it difficult to settle in and relax because you’re too restless or anxious when you lie down, first try any active asana practice to burn off steam (although you might want to be careful with backbends—I’ll address that tomorrow) and then move on to relaxation practices.

If you are interested in practicing a combination of inverted and restorative poses, you might like to check the headache sequence in Yoga As Medicine, which includes the following poses:

1. Legs Up the Wall pose
2. Supported Reclined Cobbler’s pose
3. Chair Shoulderstand
4. Half Plow Pose (with chair)
5. One-Legged Forward Bend with head support
6. Full Seated Forward Bend with head support
7. Breath Awareness

Note that this sequence was designed for an experienced practitioner, and if you aren’t familiar yet with or can’t get comfortable in Chair Shoulderstand and Half Plow pose, you may want to skip over those two poses. An easier alternative to those two poses would be to do a Supported Straight Leg Bridge pose (must photograph that for our blog one of these days!). The teacher who designed this sequence also recommended his student use a head wrap (a large bandage that is wrapped around the head to relax the eyes) while practicing, so that may be something you could experiment with. Start wrapping the bandage clockwise at your forehead, go down to your eyes, and then come back up again. Tuck the loose end to secure the bandage.

If the sequence from Yoga As Medicine is too long or complicated for you, any simple restorative sequence could be very effective. Try our Mini Restorative Sequence, which includes three classic restorative poses that almost everyone can enjoy.

So how often should you do these stress reduction practices? I think that if you are chronically stressed out and suffering from debilitating headaches, you should practice six or seven days a week for at least 15 minutes (keep in mind that could be 15 minutes of meditation or 15 minutes in Legs Up the Wall pose). I realize that sounds like a lot. It will take some work—if you can call relaxing “work”—to bring your overall stress levels down. Keep in mind that the payoffs could be huge, as stress management can result in many additional health benefits besides reduced headaches, such as lower blood pressure and a stronger immune system, as well as quality of life benefits, such as increased equanimity and maybe even happiness. And if any of you take up this headache reduction challenge, I’d love to hear back from you about the results.

Check back tomorrow for tips about how to use yoga poses to release neck, shoulder and back tension that can trigger headaches.

Yoga to Reduce Suffering

by Nina 

II.16 Suffering that has yet to manifest is to be avoided. —Yoga Sutras, trans. by Edwin Byrant

Melitta's post Aging, Diabetes and Yoga  and Shari’s post Ruminations on Health reminded us that although yoga can be helpful for many conditions, it is far from a cure all. Melitta’s life is sustained through western medicine (that is, insulin), without which she would have died. And as Shari said:

My own personal pet peeve is the often unspoken allegation within alternative healthcare communities of “healthy living” that if you lived a more “pure and holistic life,” this illness or health problem wouldn’t be happening to you. Too many women I have known with breast cancer have felt the twinge of anxiety that they were the cause of their own cancers. But how much do we owe to our own genetic predispositions rather than to emotional and environmental stresses?

On the other hand, I think all three of us believe that yoga has something important to offer to people suffering from chronic and even terminal diseases or conditions: the reduction of suffering.

This message came home to me in a very powerful way when I attended a therapeutic workshop on yoga for cancer, taught by Bonnie Maeda, RN. As a nurse, Bonnie has a clear-eyed understanding that yoga cannot cure cancer and, indeed, that even western medicine cannot always do the job. So what she has been offering her students, along with a chance to move and regain strength, is the reduction of suffering. This was especially evident when she led us through a sequence that she had designed specifically for this particular set of yoga practitioners. The sequence—which was unlike any I’d ever seen before—was a gentle Vinyasa series that used the wall for support. Bonnie explained that she felt this particular group needed to engage their minds by moving mindfully from one pose to another as they followed their breath, but, because they were often weak from illness or treatments, the wall was necessary for support and safety. To be honest, I thought the sequence was brilliant! It was providing gentle exercise for people who needed to build up their strength, while at same time functioning as a mindfulness practice to help focus minds on the present and distract from worries about the future.

After the movement came supported poses and relaxation. Stress management is also invaluable for people with chronic illnesses as it can help reduce both physical and emotional pain, as well as supporting healing. As we’ve mentioned before on this blog, yoga provides such a wide range of stress management tools (meditation, breath awareness, pranayama, conscious relaxation practices, restorative poses, supported inverted poses, and active practice to release physical tension) that there is something suitable for almost everyone.

For those of us who are teachers, it is important for us to remind ourselves both of the limitations of what we can offer and of the simple but powerful solutions that we can provide. Both mindful movement and stress management techniques are safe practices that can help reduce the suffering of people enduring great challenges.

And as human beings, it is heartening to remember that there are powerful practices we can rely on when difficulty arises.

Healthy Eating, Stress and Self Control

by Nina

One of the most important things you can do to support healthy eating is to practice stress management. Thought the reasons for this weren’t immediately obvious to me, the more I’ve looked into this topic, the more compelling those reasons become. Recently I wrote a post Yoga, Stress and Weight Management about how chronic stress causes weight gain by stimulating your appetite. As if increased hunger isn’t bad enough, it turns out that being stressed out can pose an even bigger challenge to your commitment to eating right: it weakens your willpower and causes you to be more impulsive. Say you had a long, traffic-jammed commute on the way to the office, there’s a critical meeting with a client that you make with a minute to spare, and someone’s left a big, pink box of fresh donuts glistening there on the table. Then, even though you planned a day of healthy eating, with a homemade lunch and a healthy snack, before you have time to stop yourself, you somehow you find yourself with a half-eaten donut in your hand.... Does this sound familiar to anyone? According to The Willpower Instinct by Dr. Kelly McGonigal, you’re more likely to cave in to temptation when you’re experiencing the stress response than you are when you are in a state of relaxation.

“While your body was getting ready to defend your life, the alarm system in your brain was busy trying to make sure you didn’t get in the body’s way. It focused your attention on the saber-toothed tiger and your surroundings, making sure no stray thoughts distracted you from the threat at hand. That’s right, the fight-or-flight response wants to make you more impulsive.”

As is often the case, a response that makes sense when your life is actually in danger (a time when over-thinking is probably not a good idea) can backfire on you in modern times. The traffic jams and the meeting with the client that were stressing you out weren’t exactly life threatening, so not being “distracted” by your plans for healthy eating won’t improve the situation (and might even make you feel worse after you come down from your sugar high).

Line of Moss by Brad Gibson

Fortunately, yoga has a few solutions to offer, both for the short term and the long term, to help you reduce the impulsive behavior that can accompany chronic stress. For the short term, Dr. McGonigal recommends slowing down your breathing to four to six breaths per minute, which she says helps shift your body from a state of stress to “self-control mode.” This is obviously something you could do discretely at your desk or even in that conference room where the donuts lay glistening at you. (Your meeting might even go better if you stopped for a minute to “center” yourself this way before it begins.) And since lengthening your exhalation is also a good way to turn down the stress response, I’d add that you could practice any form of pranayama that emphasizes the exhalation over the inhalation.

For the longer term, Dr. McGonigal recommends that you spend some time practicing conscious relaxation to “restore your willpower reserve.” She suggests lying down and breathing deeply, which sounds like Savasana (Relaxation pose) to me! Besides this, of course, yoga has a huge repertoire of ways you can de-stress, including meditation, yoga nidra, restorative yoga, supported inverted poses, and active asana poses practiced with mindfulness (see The Relaxation Response and Yoga for further information).

So if you’re having trouble sticking to your healthy eating plans for the new year, why not experiment by trying one or more of these relaxation techniques and see if they strengthen your willpower. I’d love to hear back about any results. (Besides, if worse comes to worst, you’ll at least be less stressed out!)

Stress, Your Health, and Yoga

by Timothy

As I travel around the globe teaching workshops on yoga therapy—the use of yogic tools from postures to meditation to help people heal—I am struck by what an enormous problem stress-related illness is.  Everywhere I go, from ultra-modern cities like Stockholm where I've spent the last week, to less developed nations, people young and old are suffering the health consequences of their increasingly busy schedules and sometimes even busier minds.

Surprisingly, in this time of widespread tension, unrest and economic insecurity, most doctors still seem not to fully appreciate the deadly consequences of out-of-control stress or how much something like yoga can help. In medical school we were taught about the connection of stress to such health problems as duodenal ulcers, migraine headaches and irritable bowel syndrome. But scientific evidence is increasing indicating that stress can be a factor in life-threatening conditions from heart attacks to depression to hip fractures. Ironically, doctors may be among the most at-risk members of our society, due to their endemic stress and lack of understanding of simple non-drug tools like yoga that can fight it.

When scientists talk about the stress-response system, they are referring to a complex web of events that ramp the body up to deal with an acute crisis. The sympathetic nervous system—the so-called “fight or flight” system—kicks in, which among other things increases blood flow to the large muscles that help you defend yourself or run away from a physical threat. Stress hormones like adrenaline and cortisol are also released. In response, blood pressure and heart rate go up and breathing quickens. Blood sugar and other energy stores are mobilized to fuel whatever challenge you are about to face. In case you are injured, your blood begins to clot more easily. In crisis mode, the body shunts energy away from restorative functions like digestion and reproduction, mediated by the parasympathetic nervous system, which you can think of as the “rest and digest” system.

Arctic Landscape by Michele Macartney-Filgate

This built-in stress-response system is well-adapted to acute crises but can lead to all kinds of problems if it doesn’t gets switched off after the acute crisis passes. Blood clots increase the risk of a heart attack or a stroke, as does the high blood pressure and elevated blood lipids that stress contributes to. Elevated levels of cortisol are associated with everything from major depression to osteoporosis to overeating and weight gain (and the many problems that result from that). And while the immune system initially gets stronger during an acutely stressful event, it starts functioning less well if the stress goes on too long, raising the risk of serious infections and, as at least some evidence suggests, autoimmune diseases.

The problem is that the ancient human stress-response system isn’t so well adapted to mostly non-physical modern world stressors like work deadlines, traffic jams, and even abstract ideas about whether you are happy or fulfilled. If you repeatedly mull these problems over, the chemical and physical changes that were designed to deal with an acute threat to physical health—and which are then supposed to shut off when the threat is removed—remain activated. Such mental tape loops can thus turn abstract worries into concrete threats to health and even to life itself.

Yoga is arguably the best overall system of stress reduction ever invented. More and more evidence suggests the practice can help treat and prevent a wide range of health problems (for details see my web site). Beyond the harmful effects on the body, feeling stressed is a drag. It can make you feel anxious, preoccupied, full of dread.

Yoga can—sometimes within minutes—quiet down an overactive stress-response system. One of the great insights of the ancient yoga masters is that when you move and breathe with awareness, it calms your nervous system and slows down the tape loops in your mind. When your inner monologue slows, most people experience a sense of peace, relaxation and a feeling of being centered.

At first, this only happens when you are doing yoga and perhaps for a short time afterwards. But if you maintain a steady practice, more and more you become aware of and can tap into the tranquility you find in yoga throughout the rest of your day. Over time, you can actually make your nervous system less reactive to minor stressors, and less likely to get knocked off balance by life's inevitable ups and downs. You learn that you can be in a difficult situation, but nonetheless keep the breath slow and deep, and the mind both relaxed and attentive.

This sense of inner calm can make you feel more grateful for what you have, appreciate the beauty around you (which you otherwise might not have noticed) and help you realize that some of the stuff you're getting bent out of shape about may, ultimately, not be very important. And that may be one of the best stress reducers of all.

What is a Yoga Practice?

by Brad

A year or so ago I was talking with a colleague about a genomics study he was planning that was going to look at exercise and aging. Previously, he and his colleagues had shown that resistance exercise training had a significant effect on the genes that were transcribed in muscle tissue, and that the older people undergoing this training had gene transcription profiles that resembled much younger people. This time around they were planning a more nuanced study and would look at several exercise regimens, including yoga. I remembered asking him what type of yoga practice they planned to use, and was met with a slightly confused look. He wasn’t sure, but thought it was a “standard practice” involving some stretching and aerobic components. When I inquired further about whether it was Iyengar style or one of those high-energy aerobic practices (like Ashtanga Vinyasa), I realized that our discussion had reached a dead end. He had no idea what I was talking about.

Photo from Yoga: The Poetry of the Body by Yee and Zolotow

So when I ran across another article today on Yoga for Back Pain that was mentioned in the Science Times section of this weeks NY Times (see here), I decided to take a little closer look at what the actual practice was. I also looked back at the Ornish and Blackburn study I discussed a couple weeks ago (see here), as well as a few other studies I had run across. I was interested in seeing how well the practice was described and whether it made in sense.

I was surprised to find that the most high profile of these studies, the 2008 Ornish and Blackburn study (see here), had the least detail. What they described as yoga for stress management consisted of “gentle yoga-based stretching, breathing, meditation, imagery, and progressive relaxation techniques 60 min/day, 6 days/week”. In contrast, a study published this summer by Dr. Fishman on osteoporosis and yoga (see here ) was considerably more comprehensive, listing all 10 yoga poses by both Anglicized and Indian names, e.g., “Upward and Downward Dog poses (Adho Mukha Svanasana and Urdhva Mukha Svanasana),” as well providing an appendix of 13 figures illustrating each poses. It should be pointed out that the lead author of this study was extremely familiar with yoga, having practiced it in India for three before attending medical school.

Another group that was fairly thorough in their description was Sherman et al. which just appeared on-line a couple days ago (see here) in their study of chronic low back pain, where they describe a viniyoga practice consisting of 5-11 poses (with pictorial diagrams referenced from earlier 2005 paper by this same group (see here). Interestingly, these authors also provided the credential for the teachers as “instructors with at least 500 hours of viniyoga training, 5 years of teaching experience, and familiarity with the selected postures and who were briefed by our yoga consultant.” This paper also gave a defense of their yoga style (viniyoga), as “a therapeutically oriented style of yoga that emphasizes safety and is relatively easy to learn.” 

Iyengar-style yoga was used in another study examining stress and inflammation by Kiecolt-Glaser, et al (see here) because it ”emphasizes the use of props to help students achieve precise postures safely and comfortably according to their particular body types and need”. In this latter study, the 12 poses and timing of each were well described and was constant, and apparently selected “based on their purported relationship to immune function and/or restorative effects.”

Obviously not everyone is going to agree with what is a good or best yoga practice for stress, back pain, osteoporosis or whatever. But what is clear is that these studies need to provide a through description of the regimen (time, poses, teacher qualifications) and their overall rationale, so that if someone wanted to reproduce this study or compare it with another, they shouldn’t be in the dark as to what the yoga practice was. In the end, it’s you who is going to have to decide on what to believe, as the standards for comparing these practices, pose sequences, and yoga styles are confusing at best. Maybe Nina and Baxter can comment on this, as I’m not an expert.

STRESS TEST

by Nina

“You did great,” my oral surgeon said. “In fact, you were the most relaxed patient I’ve ever worked on. You even fell asleep there for a while.”

“Wasn’t asleep,” I mumbled through my numb and swollen lips. “Was doing yogic breathing.”

He looked at me with fascination, then quickly handed me a piece of paper and a pen. “Could you write down what you did for me?”

“Uh, email you later?”

Of course I didn’t become so good at yogic breathing just so I could stay, uh, relatively relaxed during gum surgery (though it was certainly an interesting test of my skills). As someone who once suffered from agitated depression, I’ve been using yogic breathing, along with many yoga techniques, for many years to manage my stress levels for my emotional wellbeing.

Under the Beach Umbrella by Joan Webster

Now it turns out that I’ve been practicing yoga for healthy aging while I was at it. Because I can tell you right now that along with exercise and diet, stress management is one of the most important keys to healthy aging. Chronic stress contributes to many common age-related diseases, such as high blood pressure and heart disease, and can cause a weakened immune system overall. It also affects the quality of your life. Possible effects of chronic stress include: chronic anxiety or depression, insomnia and/or fatigue, headaches, and digestive disorders.

And how does yoga help you manage your stress? Let me count the ways:

1. breath practices and meditation trigger the relaxation response 

2. inverted poses (and semi-inverted poses) physically reduce your stress levels

3. restorative yoga poses relax your body and quiet your nervous sytem 

4. active yoga poses (such as standing poses, twists, and backbends) release stress from your body and create a focus for your mind

5. yoga philosophy teaches you to cultivate equanimity in the face of difficulty

Over time, I’ll be providing detailed information and instructions for techniques in each of these different categories. And I hope very much that you’ll find one or more that’s useful.

And in case you’re wondering, yes, I did eventually email my oral surgeon. Next time you’re in a dentist chair (or are lying sleepless in bed, need a break after a stressful day, or just want to experiment), maybe you can try:

Breath awareness. Focus your attention on your natural breath, observing how your abdomen or chest rises with your inhalation and falls with your exhalation. When your mind wanders from your breath (to the dental procedure or any other topic), simply, and without judgment, return your attention to your breath. It is natural to be distracted from this practice, but it seems to work even if your attention wanders repeatedly.

Focusing on your breath will enable you to keep your mind of neutral topics rather than stressful ones, and after 10 or 20 minutes, the relaxation response (identified by Dr. Herbert Bensen of Harvard Medical School in the 1970s) will be triggered.

Extending the exhalation. The heart slows during the exhalation (and speeds up during the inhalation) so extending your exhalation is a relaxing breath practice (and also provides the benefits of breath awareness above). Take a deep soft inhalation followed by a deep soft exhalation. At the end of the exhalation, instead of inhaling again, retain your exhalation for one or two beats. Repeat through the procedure. Keep it easy. At no time should there be strain. If needed, return to your natural breath at any time.

During my procedure I did the second breath practice (extending the exhalation). But I’m very experienced with yogic breathing, and we generally recommend that beginners to start with simple breath awareness.