By Dr. Sat Bir S. Khalsa
Perceived stress and anxiety can be a normal and healthy response to life circumstances. But for some, the fast pace and uncertainty of modern society causes debilitating levels of stress and anxiety. Chronic, unmanaged stress hurts our quality of life and is responsible for an increase in health issues and disorders across the world. It is a psycho-social crisis that has been accelerated by the COVID-19 pandemic. Rates of anxiety in the U.S. have more than tripled in the second quarter, from 8.1% in 2019 to 25.5% in 2020. [1] The resulting negative emotions are not only traumatic, but also make our immune systems more vulnerable. Managing these draining emotions is difficult but doable.
Exercise, breathing techniques, relaxation and meditation have all been shown to mitigate anxiety. It is no surprise that traditional yoga — a practice that combines all four techniques — is what more people are relying on to manage their anxiety. However, yoga has not received the same level of attention from medical research. That is beginning to change. Health care professionals and researchers, like myself, are finding consensus around why yoga is such a powerful tool for regulating emotions and reducing anxiety.
Yoga as a Mind-Body Treatment
If anxiety increases, it may start to interfere with everyday activities and overall well-being and thereby meet the criteria for an anxiety disorder such as generalized anxiety disorder (GAD). Mentally, this includes pervasive day-long exaggerated worry and tension, inability to relax, difficulty concentrating, anticipation of disaster and excessive concern about life issues. Patients are unable to control this even though they realize that their anxiety is more intense than is warranted. However, many anxiety symptoms are actually physical, such as muscle tension, trembling, sweating and insomnia. Such symptoms are due to an activation of the fight or flight stress response, which prepares both the mind and body for real or imagined threats by causing significant changes in the body, mind and emotions.
Conventional medical treatments for anxiety include pharmaceuticals, which do not necessarily address the underlying causes of anxiety. Psychotherapeutic approaches, such as cognitive behavioral therapy (CBT; considered a gold standard behavioral GAD treatment), do address underlying mechanisms of anxiety in many patients, but they are not effective for all. Both approaches focus primarily on mental aspects of anxiety. Given the physical symptoms of anxiety, it follows that any successful anxiety treatment would be best if it addresses both the mind and body, which is what makes yoga such an effective option. Yoga can address both the symptoms and causes of anxiety, while strengthening the tools needed for emotional regulation.
Feelings of anxiety can quickly overwhelm us, leading to an automatic reactivity with no gap, filter or interval for response. Through practice, yoga breaks the patterns responsible for this automatic behavior. The meditation practice component of yoga works on improving self-regulation of the attention networks in your brain. As you gain more skill in the interface between your thought processes and emotion control, you simultaneously become more sensitive and less negatively reactive to your own thoughts and life situations. The physical components of yoga practice work effectively on anxiety symptoms in the body while also impacting mental functioning through the mind-body connection. Overall, these skills make it possible to have a degree of control over our emotional state and how we respond to stressful events. It’s what makes the mind-body practice of Yoga so powerful.