Why You Should Care About Your HPA Axis (and Find More Contentment)

by Ram

Taking Flight by Marie Lossky
(@Marie.Lossky on Instagram)

Recall the time when you were extremely irritable, anxious, moody, or facing some severe emotional upheaval. It was so severe that that all you wanted to do was drop everything and head to a quiet place that was far, far away from family, work, friends, etc. All you were looking for was some quietness and peace. Now if you wish to understand the cause or point fingers at something, you can blame it on your HPA axis. 

The HPA (hypothalamic–pituitary–adrenal) axis is a complex network of cellular interactions that trigger numerous biochemical responses and involves three main endocrine glands: the hypothalamus (aka the master gland), the pituitary gland (a pea-shaped structure located below the hypothalamus), and the adrenal glands (small organs on top of the kidneys). The physiological role of the HPA axis and the hormones associated with it are very fundamental, and similar systems exist in lower organisms as well. The hormones regulated by the HPA axis include: 

1. Vasopressin and Corticotropin Releasing Hormone (CRH). These are produced and secreted by the hypothalamus in response to either physical or psychological stress. While vasopressin controls water metabolism through its action on the kidneys, CRH regulates appetite, attention, and feelings of anxiety. Furthermore, it regulates the secretion of Adrenocorticotropic Hormone (ACTH).
2. Adrenocorticotropic Hormone (ACTH). This is released by the pituitary gland, and stimulates the adrenal glands to increase production of Glucocorticoids.
3. Glucocorticoid. These are a class of corticosteroids that regulate glucose metabolism and the immune system. Cortisol (or hydrocortisone) is the most important human glucocorticoid.
4. Cortisol. This is released in response to stress and low blood-glucose concentration, and regulates blood sugar, the immune system, and the metabolism of fat, protein, and carbohydrates. Cortisol also activates the body’s response to stress, injury, sleep deprivation, physical exhaustion, and anxiety. Low levels of the hormone has beneficial effects, such as protecting the body from stressful situations, providing more energy, increasing physical and mental performance, and memory recall. However, sustained high levels of cortisol can have deleterious effects. 

In short, the HPA axis coordinates effectively to modulate the stress response. Additionally, the HPA axis via all the above-mentioned hormones regulates other bodily processes, including digestion, mood, emotions, libido, metabolism, energy, and the immune system. So it appears that nearly all of the body’s physiological reactions and mental status are controlled by all of the above-mentioned hormones that are in turn regulated by the HPA axis. Each component of the HPA axis also has a negative feedback operation to keep the entire system in balance. Thus, any time there is an elevation/reduction in the levels of cortisol, this triggers the feedback loop to increase/reduce the output of CRH, which in turn raises/lowers the levels of ACTH and cortisol.

So when we define a person being a “yogi” or an individual existing in a state of equanimity (see 7 Ways to Cultivate Equanimity with Yoga), we are referring to those people whose HPA axis with its feedback loop works in a state of harmony. Any disturbance in this cycle or the feedback loop system and we are in an acute or chronic state of emotional turbulence. If the HPA axis is underactive, it results in a low production of the hormones, resulting in poor metabolism and brain function. Or, take the situation where an individual is facing a physical/emotional crisis, characterized by over production of cortisol. If the crisis is chronic, the sustained over-production of cortisol eventually desensitizes the HPA axis so it no longer responds to the feedback loop by “calming down.” In a chronically anxious or stressed state, we don’t give the HPA axis time to reset itself back to state of equilibrium, and as a result we get stuck in the sympathetic nervous system overdrive mode. A combination of the desensitized HPA axis and overdrive of the sympathetic nervous system triggers several diseases, including but not limited to abnormal moods, emotional upheaval, chronic fatigue, depression, OCD, multiple sclerosis, and thyroid abnormalities. 

Older individuals are more susceptible to a dysfunctional HPA axis and adverse effects of an elevated cortisol because of the poor functioning of the feedback system. Furthermore, a sustained over-activation of the HPA axis also causes destruction to the brain and body owing to elevated levels of cortisol. Hence, an elevated cortisol level in older adults is dangerous, as it can trigger mental or behavioral probles, as well as other physical problems (Reducing Cortisol Improves Anxiety). Thus, understanding the status of the HPA axis will help us to control our emotions and knee-jerk reactions, and bring ourselves back into a more relaxed state of mind and equanimity (see It's Complicated: Moving Toward Equanimity). 

There are several ways to reset the HPA axis and improve at all levels. Gentle physical exercises, being out in nature, proper sleep, and a nourishing diet are some of the practices that balance the body and mind thereby providing an overall sense of wellness. Additionally if you have a yoga and meditation practice, this helps as well in curbing the negative effects of the HPA axis (see Reducing Cellular Stress with Yoga). Yoga and mindfulness-meditation offer several benefits:

• Decreases in stress and anxiety
• Improvement in cognitive functioning and cardiovascular health
• Reduction in cortisol levels
• Reduction in pro-inflammatory molecules
• Decrease in systolic blood pressure

(See Mindfulness-Based Stress Reduction for Low-Income, Predominantly African American Women With PTSD and a History of Intimate Partner Violence.) Additionally, according to Rapid stress reduction and anxiolysis among distressed women as a consequence of a three-month intensive yoga program, stressed individuals who practiced yoga and mindfulness reported better sleep, were more attentive and experienced reduced trauma. 

Researchers hypothesize that yoga and mindfulness stimulate the relaxation response and reset the HPA axis by altering cerebral blood flow and improving endothelial function that in turn lowers inflammation. The relaxation induced from yoga and mindfulness may also stimulate the production of endogenous opiates and cannabinoids that not only trigger the feel-good response but also stabilize the mood. In short, a daily practice of yoga and mindfulness will not only stabilize your HPA axis but also bring with it contentment, a sense of accomplishment, and improved health. Time to roll out your yoga mat!

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Yoga for Anxiety: Krista's Story

by Krista Wood

Beams of Light by Melina Meza

Around 1990, at the age of twenty-four, I was diagnosed and treated for depression. Depression was just becoming a topic of discussion in mainstream along with the top antidepressant at the time, Prozac. Thankfully, I responded well to medication, and a year and a half later was able to stop taking it. I was doing well for a while but two years after being off anti-depressants I began to experience my first bouts of anxiety. I would lay awake at night drenched in sweat, gripped with fear, my heart pounding, and I didn’t know why. I made an appointment to see a doctor, was given a clean bill of health, and told I was suffering with anxiety and that I should try not to let stress get the better of me (though I was not given guidance on how to accomplish this). The only bit of comfort I received was that though the symptoms were frightening, they would not kill me. Luckily, this initial episode was short lived and I was anxiety-free for a few years. 

Around the age of thirty-one or so, however, my anxiety came back with a vengeance. One day heading to work, I began to feel out of sorts. I began to sweat and felt unable to breathe deeply. I pulled off to the side of the road and rolled down the driver-side window to get some air. Though this particular episode passed quickly, the attacks began to occur more frequently and my symptoms got progressively worse, including, profuse sweating, tingling in my extremities, tunnel vision, dizziness, and inability to catch my breath. After a particularly intense episode I found myself in the emergency room, followed with a visit with my family doctor who promptly put me on anti-anxiety medication. Though it helped, I didn’t like how it made me feel; I felt disconnected from my surroundings and my anxiety seemed more intense after the medication wore off. 

It was during this time that someone suggested yoga and gave me a video to try. My initial reaction, like many people’s, was there is no way I can do yoga; I can’t twist my body in those crazy poses, and, besides, how was it going to help with my anxiety? Still, I decided to give it a shot. The tape was “Yoga for Beginners” by Patricia Walden. I didn’t know why or how it worked, all I knew is I began to feel a sense of calm when I practiced. So I continued practicing along with this tape every day for months, gradually adding additional yoga tapes. Then I began going to yoga classes, and it was during this time that I was introduced to meditation and pranayama. Wanting to deepen my practice even more, I purchased books such as Light on Yoga, The Heart of Yoga, and The Women’s Book of Yoga and Health, to name a few. 

Since that introduction to yoga back in 1997, I continued to practice yoga and also added in complementary modalities, such as acupuncture, and all have worked wonders in helping me manage my anxiety and panic attacks. I say “manage” because, though few and far between, there are still days when the anxiety tries (and sometimes succeeds) in rearing its ugly head. However, instead of feeling helpless and out of control, my yoga practice enables me to bring myself back to a state of calm. 

The practice of sama vritti (equal breathing) and extended exhalations (where the exhalations are longer then the inhalations) are beneficial whenever I’m feeling anxious. My daily practice includes asanas and meditation, whether sitting in the classical sense or a walking meditation. My practice may be for 15 minutes or an hour. There are days when I favor a more physical practice and days when I feel the need to sit and just be. Yoga has taught me to be in the present moment; it has given me the tools to work with, not against, my anxiety. It is because of this I decided to embark on a yoga teacher training in 2011 so that I could share the benefits of a yoga practice with others. I now teach weekly yoga classes, one of which is geared toward others facing the same challenges as me. I can so relate to the struggles of others living with anxiety (the frustration, the helplessness, the fear, the anger) and to be able to share what has been beneficial for me and to see it help them is an incredible feeling.

Krista Wood lives and practices yoga in Rockaway, New Jersey. After many years of practice and experiencing firsthand the therapeutic benefits of a consistent yoga practice, Krista wanted to share this with others so she decided to embark on a teacher training. She completed her 200-hour training in 2011 and 500-hour training in 2015. She continues to broaden her knowledge about yoga's effects on mental health, addiction, and trauma, and is currently in the process of achieving her 700-hour Yoga Therapy certification. She teaches a mixed level hatha class at Purple Om Yoga, www.purpleomyoga.com in Denville, NJ. She teachers her small class geared toward those with anxiety in Rockaway, at 77 W. Main Street. See kristawood.com for information about how to contact Krista.

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Using Stress Management Techniques for Medical Conditions

by Baxter and Nina

Dandelion by Melina Meza

If you're suffering from a stress-related disease, such as heart disease, hypertension, diabetes, obesity and digestive disorders, reducing chronic stress can be very beneficial. Stress management can also help with emotional disorders—including anxiety and depression—that are caused by or worsened by stress.

Because stress management helps reduce inflammation, reducing chronic stress can also help with inflammation-related problems, including most forms of arthritis, as well as certain gastrointestinal conditions, such as celiac disease and leaky gut syndrome. 

In general, yoga stress management techniques can be preventive medicine, as lowering overall stress levels may reduce your chances of even developing stress-related illnesses. They could also be curative because spending significant amounts of time in Rest and Digest keeps your immune system and repair systems functioning optimally. Finally, you can use stress management as a palliative technique to help you cope with the stress of living with a chronic illness, improving the quality of your life.

This provides some basic tips for practicing stress management when you have a medical condition. We'll address physical disorders first and then discuss emotional disorders. See The Relaxation Response and Yoga for general information about using stress management when you're healthy. 

Cautions: Generally stress management techniques are very safe. However, meditation is generally not recommended for depression or anxiety, because sitting alone with your thoughts can cause you to spiral downward. So avoid meditation unless you have a teacher experienced at working with your condition who can guide you. People who have uncontrolled high blood pressure should not practice full or partial inverted poses. 

For Physical Disorders

For digestive disorders, for periods without active symptoms, practice a well-rounded stress reducing sequence, combining active poses, both dynamic and static, and restorative poses, as well as meditation and breath work. For periods with active symptoms, stay with gentle poses, including easy dynamic poses and restorative poses, that do not create pressure on your abdomen (for example, no Cobra or Locust pose), and avoid twists. But you can practice any stress management techniques that work well for you, including focused relaxation, quieting breath practices, and meditation. For most digestive issues, you can include supported inversions. However, for hiatal hernias and gastro-esophageal reflux (GERD), symptoms will often worsen with inverted poses, so you should avoid them. 

For inflammation-related conditions, for the non-asana part of your practice, you can practice whatever stress management techniques work best for you. For arthritis of the lower back on down to the feet, supported inverted poses can be particularly helpful. 

For cardiovascular disorders, all of the stress management tools can be helpful, particularly meditation, calming breath practices, restorative poses, and focused relaxation. Just be aware that for certain conditions, such as congestive heart failure, lying flat in Savasana may bring on symptoms. In such cases, elevating your head and chest may relieve the symptoms. the head and chest may permit you to do Savasana safely. 

For cardiovascular diseases for which your doctor has warned you about situations that may increase your blood pressure, such as coronary artery disease and risk of stroke, practice supported inversion only if they do not cause an increase in your blood pressure. (Check your blood pressure with a home monitor immediately before trying a short hold of supported inversion and check again immediately afterwards to see if your numbers go high. Discuss with your doctor if you are uncertain how to proceed.)

One of the significant issues for people with just about any chronic is that the illness itself if a significant daily stressor. Examples are cardiovascular disease, diabetes and related conditions (metabolic syndrome), autoimmune diseases such as and rheumatoid arthritis, to name just a few. For all these conditions, you can use whichever stress management techniques make you feel better and do not aggravate your symptoms. Obviously, if you are seriously ill, practices that are physically undemanding, such as meditation, breath work, and focused relaxation (which you can do lying down as well as sitting) will be more accessible to you.

For Emotional Disorders

Because emotional disorders, including depression and anxiety, are either caused by or worsened by stress, practicing stress management for these medical conditions is extremely beneficial and may make you feel better, either immediately or with consistent practice over time. 

However, many stress management practices, such as restorative yoga, focused relaxation, and mediation are typically practiced with closed eyes. If this causes you to become more depressed or anxious, try practicing with your eyes open instead, keeping them softly focused. If trying to concentrate on your breath or physical sensations causes your symptoms to worsen, try using a mantra, a formal meditation practice, or a recorded relaxation practice that employs vivid imagery.

Anxiety. Because people with anxiety often have a hard time staying still, we recommend that you begin with a strong asana sequence to tire yourself out a bit before trying stress management techniques. Supported Inverted poses are particularly beneficial for anxiety, as the physical orientation of the poses triggers the Relaxation Response and concentration isn’t as essential. But if you find other techniques effective, use whichever ones you prefer. 

Lying on your back with your front body exposed can increase anxiety in some people, so for you prone restorative poses, such as Child’s pose, may be better than supine poses, such as Reclined Cobbler’s pose. If Savasana on your back creates anxiety, try lying on your belly or on your side instead, or skip the pose entirely and do Legs Up the Wall pose instead. 

Depression. For clinical depression, which has symptoms of lethargy and despair, if lying or sitting still causes symptoms to worsen, try a mindful asana practice with either short holds in static poses or slow dynamic poses. For restorative poses, choose backbend shapes, such as Reclined Cobbler’s pose, which can be uplifting, rather than forward bend shapes. In Savasana, try a supported version, with your torso lifted and your chest open, rather than lying flat.

For agitated depression, follow our suggestions for anxiety, adding in restorative backbends if those work for you.

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Keeping Your Cool: Stress Management and Equanimity

by Nina

Karen Knight, Age 54

I learned about dangers of chronic stress the hard way. Back in the early nineties, I had a job as the documentation manager and lead technical writer at a software start-up company, while at the same time I was raising two children. As you might imagine, the pressure was intense as our small company struggled to meet our first deadline, the first test of the product by real customers (who needed my manuals to teach them how to use the product!). As the deadline approached and I started working overtime, I began having difficulty sleeping. I also started losing weight because the stress made me so feel nauseated that I lost my appetite. Eventually I was so anxious, exhausted and nauseated that even though I met my deadline (and the company went on to success), I couldn’t bounce back to normal health. What began as simple, chronic stress had ultimately turned into something more serious: agitated depression. It took a year and half of therapy, medication, and lifestyle changes for me to recover completely.

So, yes, chronic stress is not only dangerous for your physical health, but it can have a strong impact on your mental health, affecting the way you feel, the way you think, and the way you sleep. 

Moods and Emotional Disorders 

To start with, chronic stress has a negative effect on your moods. When your sympathetic nervous system is over-stimulated, you may experience any of the following negative feelings: anxiety, restlessness, lack of motivation or focus, irritability or anger, sadness or depression. Obviously those moods are not only unpleasant but they can interfere with your ability to conduct yourself in a way that is in line with your values and goals. For example, if you’re restless and irritated, it’s hard to be patient with and loving to family members and friends. 

Then, for people who are susceptible, full-blow anxiety or depression may develop. There are several different theories about the mechanisms that cause depression and anxiety. Chronic stress leads to elevated hormones such as the “stress” hormone cortisol and reduced serotonin and other neurotransmitters in the brain , including dopamine, all of which are associated with depression. And, lately, there is a new theory that depression may be caused by inflammation, which itself can be triggered chronic stress (see Depression May Be Caused by Inflammation). High levels of cortisol can also be responsible for causing Generalized Anxiety Disorder, a common anxiety disorder in older adults (see Reducing Cortisol Improves Anxiety).

Even though research about the exact mechanisms is ongoing, the bottom line is that there is agreement that chronic stress can cause a whole range of emotional problems, including both depression and anxiety.

Stress and Your Thoughts

In my post Stress and Your Thought-Behavior Repertoire, I described how when you’re in stress mode, your thoughts narrow and become limited to fight or flight strategies, while when you are calmer, your thoughts are more expansive, and therefore include a much wider range of possibilities. Practicing stress management on a regular basis allows you to keep your level of arousal (the intensity of the Stress or Fight or Flight response) appropriate to your current environment. For example, for a soldier, a very high level of arousal is appropriate in an actual battle, but that same level is not appropriate if he or she is stuck in a traffic jam or working at the office. On the other hand, when your arousal level is "optimum" for your situation, your thoughts and behavior possibilities expand, until it is possible to consider altruistic possibilities and living in line with your basic values and goals. Here’s how psychologist Dan Libby puts it:

"The basic gist is that regulating our autonomic nervous system, which really means activating the more newly evolved part of the parasympathetic nervous system via the vagus nerve, allows for an expansion of your thought-behavior repertoire. Instead of having a limited, narrow, tunnel-vision, like we do when our sympathetic nervous system is dominant, we have more cognitive and behavioral options available to navigate our world."

Obviously being able to live in line with your basic values and goals is going to contribute to your equanimity. You’ll be able to interact with people and solve problems in a more peaceful and productive way. And reducing chronic stress will help you keep your thought-behavior repertoire appropriate to your circumstances.

Stress, Your Sleep, and Your Emotions and Thoughts

One of the common effects of an overactive sympathetic nervous system is insomnia, something I know about all too well. Your nervous system keeps you on the alert—and awake—so you’re prepared to face imminent danger, except in the middle of the night when your worries are about everyday life, that’s rather counterproductive. And, according to Ram, our brain health expert, lack of sleep or sleep deprivation triggers accelerated mental decline. Sleep appears necessary for our nervous systems to work properly. Too little sleep leaves us drowsy and unable to concentrate, and leads to impaired memory and physical performance. If sleep deprivation continues, hallucinations and mood swings may develop.

Just as sleep gives the body time to heal itself, sleep allows neurons to lower down their neurochemical activity and repair themselves. Without sleep, neurons become “fatigued” and begin to malfunction. Sleep helps to clear out toxins from the brain as well as from the body (see Sleep, Alzheimer's Disease, and Yoga). Finally, the brain gets exposed to thousands of stimuli through the five senses, and sleep helps to reduce chaos and bring order to the information flow, helping to put an order to these information inputs and archive them as memories. 

Whew! Do I even have to explain chronic insomnia is going to interfere with your ability to face life’s difficulties with equanimity? So, if sleep is problem for you, it’s a really good idea to consciously manage your daytime stress levels so you don’t go to bed with an over-active nervous system—that’s going to improve your nights as well as your days. 

How to Practice Stress Management for Equanimity

Practicing stress management in general is good preventative medicine for fostering good emotional and mental health, just as it helps foster physical healthy. And when you are trying to deal with existing mood and/or emotional problems as part of a self-care program, you should definitely include stress management techniques in your yoga practice. All the stress management techniques we describe in The Relaxation Response and Yoga will help you reduce chronic stress levels, with the only exception that for people with depression, meditation is not recommended (it can cause a downward spiral). Re-patterning your nervous system as described in Re-Patterning Your Nervous System will train you so you don’t react as intensely to stressors in the first place. And learning to self-regulate as described at Self-Regulation and Yoga: Managing Your Internal States will allow monitor and manage your internal states, so you can take appropriate actions to calm yourself, comfort yourself, uplift yourself, or energize yourself, and bring yourself to a more balanced state. For extra information about improving your sleep, see 5 Tips for Better Sleep.

Although I'm sold on the effectiveness of yoga for keeping us as physically healthy as possible, I actually became a yoga teacher specifically because I realized that my yoga  practice was helping to keep me emotionally healthy and that was something I wanted to share with others. So if you're someone who wants to cultivate emotional stability, I hope this post will inspire your practice!

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Reducing Cortisol Improves Anxiety

by Nina

New Leaves in the Desert by Melina Meza

Have you noticed that whenever we talk about the dangers of chronic stress (see About Stress: Acute vs. Chronic), we always mention anxiety? That’s because anxiety is basically on every doctor’s list as one of the potential problems that can result from ongoing stress. And my personal experience has been that anxiety is the first problem I start to suffer from when I go through a period of chronic stress. That is why I personally value yoga’s stress management tools so much; I’ve learned how much better my life is if I can nip those stress levels in the bud before my emotions get out of control. 

But even though I knew that chronic stress could cause anxiety, I didn’t really know exactly why. You know me—I always want to know why—when it’s possible to know why—so I was very interested to read this paper about anxiety and cortisol levels Elevated cortisol in older adults with Generalized Anxiety Disorder is reduced by treatment: a placebo-controlled evaluation of escitalopram. Even though this paper had nothing to do with yoga (the scientists were using a drug to reduce cortisol levels in older people with anxiety), I was interested to learn that older adults with Generalized Anxiety Disorder have higher levels of the stress hormone cortisol. The paper put it this way:

“Generalized Anxiety Disorder (GAD) is a common and impairing anxiety disorder in older adults, and it has been associated with elevated cortisol in this age group.”

And the paper also said that the experiment they did with reducing cortisol levels in this group helped improve the anxiety!

"Compared with placebo-treated subjects, SSRI-treated subjects had a significantly greater reduction in both peak and total cortisol. This reduction in cortisol was limited to subjects with elevated (above the median) baseline cortisol, in whom SSRI-treated subjects showed substantially greater reduction in cortisol than did placebo-treated subjects. Reductions in cortisol were associated with improvements in anxiety."

In the past, we’ve talked about cortisol in the past in terms of inflammation and celluar stress (Reducing Cellular Stress with Yoga and Cortisol, Stress and Yoga) as well as stress eating (see Yoga, Stress and Weight Management and Stress Eating and the Healthy Eating Meditation Practice), but we’ve never addressed its effects on our emotions. In my post Stress and Your Thought-Behavior Repertoire, I talked about how while you’re in stress mode, your thoughts are restricted to Fight or Flight options. Now it seems possible elevated cortisol levels might be to blame for this and/or for raising levels of anxiety or worry in general.

The paper also said that older adults in general have a harder time with elevated cortisol as, “aging increases vulnerability to adverse effects of elevated cortisol, because compensatory mechanisms preventing its deleterious effects are diminished.” It also mentioned that that chronic over-activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis causes wear and tear to the brain and body via toxic effects of elevated cortisol levels.

So, the bottom line is that elevated cortisol levels in older adults is particularly dangerous, potentially causing Generalized Anxiety Disorder as well as other diseases and physical problems. But although the researchers of this paper used medication to lower cortisol levels, this may not be the only way to do lower them. If you’re feeling well enough to forgo medication (and your doctor agrees with you about this) or if you just want to practice to prevent future problems with anxiety, you can use yoga to lower your cortisol levels. 

Reducing Anxiety with Yoga

I’ve done several posts in the past about how to use yoga to reduce anxiety (see 10 Ways to Soothe Anxiety with Yoga and Yoga Solutions for Anxiety). But it’s worth emphasizing here that some of the techniques we recommend for stress management in general, including meditation and restorative yoga, might not work well for anxiety. That’s because it’s very hard for many anxious people to lie or sit still, as they tend to become even more anxious if they are alone with their thoughts. See When Relaxing Isn't Relaxing.

On the other hand, while an active yoga practice can engage your mind and distract you from your worries (a welcome relief!) it is not necessarily going to lower your cortisol levels. An active practice is generally more stimulating than relaxing, although it is useful for tiring you out (plus, everyone needs exercise).

So, if you’re someone who has trouble lying still due to anxious thoughts, who feels generally hyper (I know that feeling!), or who has been sitting all day for work and needs to move, I recommend starting with an active practice, such as Featured Sequence: Lower Body Strength or Upper Body Strength. Then, after you’ve released some of your excess energy, try practicing one or more supported inverted poses. Because the Relaxation response is triggered by your physical position, supported inverted poses don’t require a mental focus (see Why You Should Love Your Baroreceptors). So you can keep your eyes open and even listen to music while you are practicing them and you’ll still quiet your nervous system. Of course, as with any pose, if you feel bad in an inverted pose, come out of the pose immediately. See All About Supported Inverted Poses to find a supported inverted pose that's right for you.

See When Relaxing Isn't Relaxing for more suggestions for what to do when anxiety means that relaxing isn’t relaxing. Of course, if you’re not experiencing anxiety and are comfortable with other forms of stress management, continue to practice the way you enjoy it the most (see The Relaxation Response and Yoga). Keeping cortisol levels low may very well help prevent problems such as anxiety from occurring or re-occurring in your future.

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2 Steps to Take Charge of Your Stress or Anxiety

by Nina

Enclosed Field with Rising Sun by van Gogh

Lately I’ve been trying to help several people who are suffering from stress and/or anxiety. Although these people are all quite different from each other—they range from a young woman with a new baby to man with newly diagnosed heart disease to an older man with chronic insomnia—I found myself saying the exact same things to each one of them. And since my advice was, in a way, very basic, I thought I’d write it up for the blog.

One of the things that motivated me to share this advice was that I was struck by something my friend said when talking over her daughter’s problems with her. “Well, I guess, anxiety just comes and goes.” My friend seemed to feel that her daughter was at the mercy of some emotion that took her over periodically and that there was nothing she could do to change that. But I feel that through a combination of educating yourself and making some lifestyle changes, you can empower yourself to deal more effectively with stressful situations and hopefully also reduce the levels of stress and/or anxiety that you are suffering from. 

And the advice I’ve been giving boils down to two simple steps.

1. Learn About Your Nervous System.

The first thing I always tell people I’m teaching to manage stress and anxiety is to read The Relaxation Response by Herbert Benson so they can learn about how their nervous system—specifically the autonomic nervous system—works. I recommend this book because although we have some information on the blog about the nervous system (see Chronic Stress: An Introduction and Stress, Your Health and Yoga), we don’t yet have a comprehensive overview of the nervous system. (I am going to write one tomorrow, though, because I’ve realized how important it is!) 

I feel strongly that educating yourself about your nervous system will help eliminate some of the mystery of what’s happening to you and empower you to make some important decisions. Knowing the symptoms of chronic stress, such as insomnia, digestive problems, headaches, high blood pressure and so on, will help you choose the right solutions (see below) for you and to take action before things get out of hand. And I also believe that knowing about how your nervous system works and understanding the difference between sleep and conscious relaxation (see Conscious Relaxation vs. Sleep) will motivate you to start practicing stress management. Otherwise, you might think—as one friend did—that exercise and sleep are all that is needed.

For example, I can always tell when I’m getting stressed out because I start sleeping poorly, lose my appetite (sometimes even feeling nauseated), and, because my mind is racing, I talk more than usual! If things get really bad, I start to feel a burning sensation in my chest. So rather than just waiting until things get even worse (I have been there—“going over the edge” I call it), I double down and focus my yoga practice on stress management (see Friday Q&A: Practicing to Manage Stress). I believe this has helped keep me emotionally healthy for almost 20 years now.

2. Find Ways to Manage Your Stress and Reduce Anxiety, and Practice Them.

Once you’ve learned about your nervous system and how important conscious relaxation is for your emotional as well as physical health, you should take the time to explore the possibilities yoga offers for helping you manage your stress and reduce your anxiety. We’ve been writing about the different ways that yoga can help you manage stress since the very earliest days of the blog. And throughout the years, we’ve continued to write about this. That’s because we feel that yoga includes such a wide range of possibilities that you’re sure to find something that works for you. Interestingly, the paper I wrote about in Self-Regulation, Psychological Health, and Yoga confirmed this very opinion!

But everyone needs to experiment to find what suits them best. For example, even though breath practices (see Friday Q&A: Breath Practices for Anxiety) are traditionally thought to be helpful for stress and anxiety, one person I’m working with found that breath practices I recommended tend to agitate him. Happily, however, I introduced him to supported forward bends, which he immediately found soothing. Another man I’ve been counseling does find breath work helpful, and he has used to it to relax while getting medical procedures that make him tense. He also really enjoys the guided relaxation tracks we have available on our site (see Audio Tracks). 

I myself love the breath practices and supported inversions (see All About Supported Inversions). But I never enjoy restorative yoga, unless I’m super exhausted, and I don’t like listening to an audio recording of any kind while I practice, which are two of Baxter’s favorite things. Hey, we’re all different, not only in our tastes but in the ways we get stressed out. See The Relaxation Response and Yoga for an overview of the different practices.

Finally, once you’ve identified the practices that work for you, you need to practice them regularly. This is crucial! Although some of the practices can provide quick, temporary relief, none are going to instantly re-balance your nervous system. After all, it probably took a while for your nervous system to become over-stressed, so it will take some time to return it to normal. But making the commitment to actively take care of yourself by practicing regularly is empowering—you are no longer at the complete mercy of outside forces—and that in itself is a huge step to take.

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Friday Q&A: Breath Practices for Anxiety

Statue and Bird by Melina Meza

Q: I’ve been having bouts of anxiety lately, especially first thing in the morning after I wake up. Is there a short, simple practice that I can do before I get out of bed that will calm me down so I can start my day in a better emotional state?

A: There definitely are some simple breath practices that you can use in the morning before you get up as well as any time during your day that you may find very helpful! In his post How Your Breath Affects Your Nervous System, Baxter gives the scientific background about why breath practices are so effective. And I myself regularly use a simple breath practice to help me relax when I’m feeling stressed and to help me fall back to sleep if I awake in the night.

I discussed your question with Baxter, and together we came up with a list of three practices that you can choose from. In general, all three are different ways of lengthening your exhalation. Because your heart rate is naturally slower on your exhalation than on your inhalation, making your exhalation longer than your inhalation begins to slow down your overall heart rate, sending a message to your brain that everything is more peaceful and calm than it was five minutes ago. This message encourages your brain to support this shift by activating the Rest and Digest or Relaxation Response (see The Relaxation Response and Yoga), which will reduce your stress hormones, quiet your mind, and hopefully quell your anxiety. 

Try all three techniques and see which ones work best for you. When you are initially learning the practices, it is best to do them for shorter periods. But I recommend over time working your way up to ten-minute sessions because it seems to take about 7 or 8 minutes for the Relaxation Response to take full effect. However, in a pinch, even a minute or two of a simple breath practice can help head off an anxiety attack, so even a short session can be very beneficial.

Exhalation Pausing. The simplest breath practice you can do is to pause briefly at the end of each exhalation. You can do this practice in a seated position or even lying in bed, on your back with your head supported by a pillow. Start by practicing basic breath awareness. This means focusing your mind on how your breath moves in your body, perhaps on how your belly rises and falls with your breath or, if it’s easier, how your chest moves with your breath. You could also focus on the more subtle sensations, such as the feeling of your breath moving in and out or your nostrils or, if you prefer, the sound your breath makes in your body. I actually like to lie on my back with my hands on my belly because that makes it very easy for me to feel the movement in my abdomen.

Now you’re ready to try pausing at the end of your exhalation. When you reach the end of your next exhalation, simply add a beat or two—without straining—before moving on to your inhalation. Keep it relaxed and easy. And if the practice irritates you in any way, simply return to your natural breath.

If at any point you realize your attention has wandered from your breath (it will, of course), simply—and without self-judgment—bring your attention back to your breath.

Bhramari (Buzzing Bee) Breath. This breath practice, in which you make a buzzing sound as you exhale, naturally lengthens your exhalation. To practice a simple version of Bhramari, start by inhaling normally through your nose. Then, keeping your mouth closed, make a low- to medium-pitched humming sound in your throat as you exhale. As you make the buzzing sound—which should last the entire length of the exhalation—tune into the literal vibration of the sound waves in your throat and even in your skull and brain. After you complete your exhalation, inhale through your nose, and if you're comfortable, repeat the cycle. Try to make your transitions into and out of each humming exhalation as smooth as possible. See Pranayama for Everyone: Bhramari Breath for more information.

1:2 Breath. In this breath practice, you actually control the length of your inhalations and exhalations, and aim for a ratio of 1:2, for example, a one-second inhalation and a two-second exhalation or a two-second inhalation and a four-second exhalation. 

Before starting this practice, spend a little time observing your natural breath and mentally counting the length of your typical inhalations and exhalations. If your inhalation is longer than your exhalation, start by making them the same length by consciously slowing your exhalation. 

Once your inhalation and exhalation are equal, try gently increasing the length of your exhalation by releasing air more slowly. Keep your breathing relaxed so you are not straining, and if at any time you begin to feel agitated, simply return to your natural breath. As long as your breath feels smooth and relaxed, continue to gradually increase your exhalation bit by bit until it is twice as long (but no more than twice as long) as your inhalation. If the 1:2 ratio feels uncomfortable or if you're gasping on your next inhalation, return to a ratio that is more comfortable. You can gradually work up to the 1:2 ratio with practice. 

Another way to lengthen your exhalation to a 1:2 ratio is to use a gentle version of Ujjayi breathing for your exhalation only. To do this, breath in normally through your nose, with a relaxed feeling in your throat and vocal cords. Then, as you start to exhale, slightly constrict your throat, keeping it very gentle and relatively quiet. This action in your throat is similar to the one who use on your sunglasses when you try to clean them off, and it will naturally slow down your exhalation a bit and bring you closer to the 1:2 ration. As you practice this form of breathing, relax your throat as you inhale, engage your throat a little as you exhale. 

Baxter recommends doing a set number of repetitions of the 1:2 breathe, such as six rounds or twelve rounds. Then let your breath return to its natural length and depth, and notice how things feel internally. 

If controlling your breath in this manner is stressful, practice the exhalation pausing practice described above instead, and maybe give the 1:2 practice another try after you have some experience with breath work under your belt.

Because chronic stress can exacerbate or even cause anxiety (see Chronic Stress: An Introduction), I think it is also important that you address your overall stress levels in general (see The Relaxation Response and Yoga). So see if you can manage to incorporate some time for gentle or restorative yoga or any form of conscious relaxation into your schedule.

—Nina 

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Anxiety, Yoga, and Brain Chemistry

by Ram

Child with Dove by Picasso*

There are so many scientific studies that indicate benefits of yoga (asanas, meditation and pranayama) in combating stress, improving the digestive capacity, helping in the sleeping process, improving the health of the heart and blood vessels, reducing blood pressure, reducing arrhythmia, improving metabolic parameters, including blood lipid profiles, and keeping strokes at bay, all of which result in keeping the individual physically stable. 

Furthermore, at the mental/emotional level, yoga contributes to a feel-good response and wards off mental stress. It stimulates the brain in a positive way that results in optimal brain function keeping an individual alert and sharp. Yoga reduces anxiety and depression, and combats age-associated memory loss thereby promoting a mentally stable and active life. The breath work and the need to focus on the asana practice are excellent ways to rein in our emotions. Yoga’s profound beneficial effects on emotional wellbeing and general mental acuity without any side effects prompted Yoga Journal to aptly title one of its articles Better Than Prozac?

While all of the above studies sum up the power of yoga, one may wonder how yoga promotes such numerous benefits. While it does through multiple cellular mechanisms, a couple of recent studies zeroed in on the mechanism by which yoga exerts anxiolytic effects (reversing anxiety disorders). According to these studies, a regular practice of yoga releases a neurotransmitter chemical called GABA (gamma-aminobutyric acid) in a region of the brain called thalamus. In the brain, GABA serves as an inhibitory neurotransmitter, that is, this neurochemical plays a central role in suppressing excess neural activity throughout the nervous system. Hence, individuals who exhibit anxiety disorders, including excessive fear, worry, or anxiety, have reduced levels of GABA that contribute to this disorder. Such individuals are prescribed anti-anxiety medications, such as benzodiazepines, which work by encouraging the synthesis and release of GABA in the central nervous system. Through its inhibitory action, GABA curbs all the ill effects that come from excessive anxiety, worry, or fear.

In the research studies, GABA was shown to be significantly higher in the brains of those subjects who had been doing yoga. When the levels of GABA were compared before and after a one-hour yoga session, the researchers observed a 27% increase in GABA levels.  The stretching from the yoga asanas, the brief meditative session and the continuous breathing may be signaling the brain to release GABA, which neutralizes all the negative mood effects in the hours following a session of yoga. Additionally, the elevated levels of GABA following the yoga session were sustained during the 12-week yoga intervention. The authors believe that these sustained levels of GABA over a period of regular yoga practice may help the brain to rewire itself and overcome anxiety attacks in the face of daily stressors.  

Interestingly, the studies also indicated that the yoga group displayed greater improvements in mood and decreases in anxiety compared to the metabolically matched walking group, suggesting that the effect of yoga on mood and anxiety goes far beyond than just the metabolic demands of the activity. The researchers’ findings suggest that a simple but regular session of yoga that increases the activity of the GABA could serve as a better alternative than powerful pharmacologic agents that have their own baggage of non-specific side effects.

On a final tipsy note, a similar calming effect can also come from a glass of beer, which mimics the effects of GABA by signaling an analogous mechanism in the brain.  However, if I were you, I would finish a long day of work with a one-hour session of yoga rather than having a beer. For I know that the calmness I experience from a glass of alcoholic drink may not last long while the calmness I experience from a yoga session might stay forever.

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When Relaxing Isn't Relaxing

by Nina

Cactus Flower by Melina Meza

On Friday, Baxter wrote about how meditation and other forms of conscious relaxation, such as yoga nidra, can be agitating for certain people (see Friday Q&A: Can Meditation Be Dangerous?). I wouldn’t be surprised if that were true for many of us at certain times. Sometimes when you’re feeling anxious or depressed having to sit quietly with your thoughts can be overwhelming. The same thing is true for lying down on your back in Savasana or restorative poses with your eyes closed. Even practicing supported forward bends, which many people find soothing, can cause you to brood rather than quiet down. 

A more active yoga practice will be easier for you when you’re depressed or anxious—the physical challenges and mindful movements will engage your mind—yet it’s still important for you to manage your stress (see One Thing: Yoga, Zen, Whatever). So here are some ideas for different things you can try when classic relaxation techniques just aren’t working for you.

Eyes Open: If closing your eyes in Savasana or any restorative pose causes agitation or brooding, try keeping your eyes open but with a soft focus.

Crocodile Pose: Sometimes lying on your back can make you feel exposed and vulnerable (see Anxiety, Yoga and the Front Body). So try lying on your belly in Crocodile pose (Makrasana) instead to see if that is more comforting. If your lower back curves too much in Crocodile pose, place a folded blanket (long rectangle) under your lower belly. 

If you don’t find Crocodile comfortable, you could try a supported version of Savasana, as raising your torso higher than your legs might feel better than being flat on your back, or even a side-lying Savasana (see Corpse Pose Variations).

Supported Child’s Pose: Like Crocodile pose, Supported Child’s pose allows you to relax without feeling exposed or vulnerable. Many people actually find hugging their bolsters very comforting. You can turn your head to side and keep your eyes open if that helps; just be sure to turn your head to the other side for an equal amount of time.

Supported Inversions: because the Relaxation response is triggered by your physical position, supported inverted poses don’t require a mental focus (see Why You Should Love Your Baroreceptors). So you can keep your eyes open and even listen to music while you are practicing them and you’ll still quiet your nervous system. These are also great alternatives to forward bends, which cause some people to brood and others just find unpleasant. Of course, as with any pose, if you feel bad in an inverted pose, come out of the pose immediately. See All About Supported Inverted Poses to find a supported inverted pose that's right for you.

Choose Appropriate Breath Practices: Never do a breath practice that makes you feel uncomfortable in any way. Practices that encourage you to take a longer and/or deeper inhalation can actually be agitating for people with anxiety. The safest thing to do is just to practice simple breath awareness. But if that isn’t enough to engage your mind and you keep being distracted by depressing or anxious thoughts, try a practice that’s recommended for your particular state (see Balancing Your Emotions with your Breath).

And please let me know if you have any further recommendations! I'd love to add more ideas to my list.

Finally, if you are a teacher who is teaching one or more students with mental disorders, it is always a good idea to let the class know that if anyone becomes seriously agitated, anxious or depressed during meditation or relaxation, they should stop and raise their hand so you can help them find an appropriate alternative. 

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Yoga for Emotional Wellbeing: An Epiphany

by Nina

Sand Dollar by Melina Meza

I don’t have a particularly exciting story about why I started practicing yoga. (It’s kind of humorous actually. When I was in my late twenties, I was working at a small software company and we wanted to start an on-site exercise class. One of our co-workers said that his wife could come and teach us, so we decided to give it a go. We had no idea she was a yoga teacher! So there we were, for our first class, and she asked us to stand in “Mountain pose,” with our big toes together and our heels slightly apart, which was the opposite of the foot position I was used to doing in ballet and modern dance, my previous forms of preferred exercise. And just standing that way felt so wonderful for my body, I thought, whatever this is, this is for me!). However, I do have a more dramatic story about why I decided to become a yoga teacher.

During the period when I was studying yoga with Rodney Yee and writing our first book together, Yoga: The Poetry of the Body, Rod helped me understand how my yoga practice was benefiting me in emotional and spiritual ways, as well as physical ones. It turned out that by practicing regularly at home—something I had taken up intuitively rather than with any specific goals in mind—I had been learning to manage my stress, balance my emotions and cultivate equanimity without even realizing it. (If you read the dialogues in the book Yoga: The Poetry of the Body, you can witness Rod helping me toward that realization.) And as someone who had suffered in the past from chronic stress (working full time at a software start-up while raising two children!), which had led to a bout of agitated depression, I began to see the tremendous power yoga had for helping people with emotional difficulties of all kinds, including stress, depression, anxiety, anger, and general dissatisfaction or unhappiness.

Then, one morning when I was practicing yoga with Rod and his best friend, Ian, Ian began talking about how he had just learned that a colleague of his had committed suicide.  (Yes, sorry to disillusion you, those guys chatted constantly while they were practicing.) And while I was in Shoulderstand, I kept thinking about about Ian’s story, and filled with compassion for his friend—for the suffering he must have experienced to lead him to take his life—I began to cry. I realized then that while I could not help Ian’s friend, I did have quite a lot of knowledge that I could use to help other people who were suffering. And while I had no particular ambition to become a yoga teacher per se, I understood at that moment that I really should look into finding a way to share what I knew. Yes, it was one of those actual epiphanies (and I had it while I was doing a yoga pose).

After that, I started doing two things. First, I began taking as many workshops as I could from teachers like Patricia Walden, who teaches workshops on Yoga for Depression (I took that more than once!) and Yoga for Emotional Healing, and Roger Cole, who teaches about the physiology of inversions. Then, I enrolled in a three-year teacher training program at The Yoga Room, in Berkeley. Clearly I believe in being thoroughly prepared! Finally, when I felt ready (and when I got the go-ahead from Patricia, who was informally mentoring me) I did begin teaching workshops on Yoga for Emotional Wellbeing, Yoga for Stress and Yoga for Better Sleep. Those were rewarding—there is nothing like having even just one person tell you that you made a difference in their lives by teaching them a simple practice, like breath awareness—and I still teach them occasionally. But I eventually realized that writing is still my forte and that I could reach a larger audience through my writing than by teaching local workshops.

When Baxter and I came up with the idea of starting a blog, I realized that a blog could be the perfect venue for me; having our own blog would allow me to give myself the power to write about what I wanted to write about, the way I wanted to write about it (frankly, the way some publications edit/rewrite you can be positively painful). And because the blog was free and accessible world wide, I could reach people who would never be able to study with me in person.

Because I not only write for the YFHA blog but I’m also the Editor in Chief, I work on the blog at least five days a week (and sometimes behind the scenes on the weekends). And that takes a lot of dedication. But that original epiphany I had in Shoulderstand and my ongoing passion for sharing what I know about the emotional and spiritual benefits of yoga—as well as the physical ones—are a wellspring that never runs dry.

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