3 Tips for Managing the Blues with Yoga

by Beth

Winter Trees by Melina Meza

You wake up one morning and feel the weight of the world on your shoulders. Or, at some point during the day your body’s energy and your mental state plummet. You feel heavy, sluggish, and “stuck in the mud” of inaction. Every item on your to do list seems insurmountable. You feel like Sisyphus, that legendary king of Corinth, condemned eternally in Hades to repeatedly roll a heavy rock up a hill only to have it roll down again as it nears the top. So why bother doing anything? It seems so fruitless. Clearly, there is an energetic imbalance happening. 

The blues. We all get them from time to time. Because we are spiritual beings having a human experience, this happens. And because we are all different in so many ways, my blues, will not look or feel like your blues. If the energy state is temporary and does not linger—I draw the line at 3 days—we can choose to use our knowledge of yoga to shift our energy into a state where we feel more stable, embodied, grounded, safe, and connected to the physical world, our families, friends, and support communities. We can work toward a balance that lifts the perceived weight from our physical bodies (anamayakosha), restores our lagging energy (pranamayakosha), and calms the mind (manomayakosha), which may be stuck at any point between a deep well of dense, leaden earth and a fast moving cloud of anxious restlessness.

1. Self Study and Discipline

When I find myself in this sate of imbalance and want to shift myself to a more balanced state, I turn to the niyamas. The first step is self-awareness (svadhyaya) and the question: why is this imbalance manifesting at this time? Sometimes I’ll find an answer and sometimes I won’t, but the important part of the process is to ask the question. The next step is discipline (tapas) and the question: which yoga techniques can help shift the imbalance?

I lead an active life with a full schedule of teaching, writing, mentoring, volunteering, and keeping up with family and social groups from my book club to my “neighbors without a hood” Friday night dinner friends. When the blues manifest, it’s usually one of two reasons. Either I have overextended myself, and my body takes over to slow me down for rest and relaxation. Or, there is some creative impulse or life lesson that needs to come up to come out, and my body takes over to slow me down and let the gestation process move forward. At this stage of my life, I’ve learned to first be with and watch the process instead of rushing to shift the imbalance. Then, with or without an answer, I can choose my yoga approach to shift the energy. 

2. Creating Heat

Doing yoga poses in a way that creates heat, encourages a feeling of stimulation, and intention is helpful. I focus on the feeling of moving purposefully at a comfortable rate of speed and determination. A flow that I love and use frequently is Downward-Facing Dog to Plank pose. When dealing with the blues, I add in longer holds with a conscious mental focus of, “stimulate, strengthen, and energize.” 

Downward-Facing Dog to Plank Pose. In this mini vinyasa, I hold each asana for several breaths, usually 20 – 30 seconds, while keeping the focus on strengthening my arms and lengthening my spine. I keep my knees slightly bent for comfort. I repeat this flow several times using normal breathing with a bit more emphasis on the inhalation, and rest for a few breaths in Child pose between repetitions if needed.

This is my usual go-to flow when both body and mind sink into that deep well of dense leaden earth. But sometimes the body wants something else. For example, the last time it happened, I just “knew” that I needed a serious inversion to stimulate myself and move the energy upward in order to “get the lead out.” I went to my yoga swing and hung upside down like a bat for 3 minutes. Relief!

3. Calming Your Mind

On the rare occasion when my body feels heavy and immobile but my mind is stuck in that aforementioned fast-moving cloud of anxious restlessness, I first work to calm and quiet my mind before dealing with the bodily sensations of heaviness. I will do a short practice of either a mini vinyasa of Downward-Facing Dog pose to Child’s pose or 10 minutes in a supported inverted pose, and finish with a short session of seated meditation.

Downward-Facing Dog to Child Pose. I hold Downward-Facing Dog for about 5-10 seconds and Child’s pose for 30 seconds or longer, depending on how I’m feeling. I repeat the flow several times using slow even breathing or a calming breath practice (see Calming Breath Practices We Recommend), along with a mental focus of calming, grounding and warming. To complete the flow, I rest in Child Pose for a few minutes.

Supported Inverted Poses. If I just want one posture, my asana of choice is Legs Up the Wall pose or Easy Inverted pose for 10 minutes, with normal even breathing and a mental focus on all the parts of me that are connected to the floor or chair. 

Seated Meditation. To complete my practice, I do a moment or two of seated meditation with Hakini mudra for integration and balance.

These are a few of the ways I manage my blues. Hope you find the tips helpful as you explore ways to manage yours.

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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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Learning About Yoga for Depression

by Nina

Terri Alexander, Age 55 (Backbends can be uplifting for people with depression)

This morning I received an email from new reader in Japan who wants to introduce yoga for depression to the Japanese people and add the choice of yoga “in their pocket.” What an admirable goal! This has been one of my areas of interest for a long time because I feel yoga has so much to offer in the area of emotional wellbeing. So because I can’t teach this woman what I know in person and there is apparently no one teaching on this topic who lives in Japan (correct me if I’m wrong), I started thinking about how I could coach her a bit from a distance.  

I realized quite quickly that there were some basic things anyone needs to start by understanding before they can really study yoga for depression, and since I was going to write them down for her, I thought I should share them with you as well.  

Learn about Yoga for Stress Management

I feel the first place to start is to learn about the functions of the autonomic nervous system and chronic stress. The reason for this is that stress is one of the things that can cause depression, and for people whose depression has other causes, being stressed can exacerbate the depression (and being depressed can cause you to stress out!). So it is important to understand what chronic stress does to your nervous system and how you can use yoga to help manage your basic stress levels. Personally, as someone who has suffered from two bouts of agitated depression, this knowledge has been extremely valuable, enabling me to keep myself healthy for the past two decades.

So start by learning about the autonomic nervous system in general by reading my post Life-Changer: Understanding Your Autonomic Nervous System. Then, after you’ve learned about the nervous system itself, learn about the difference between acute and chronic stress by reading my post About Stress: Acute vs. Chronic. Finally, learn about how to use yoga for stress management by reading The Relaxation Response and Yoga. And if you are not doing so already, try practicing yoga stress management techniques on a regular basis so you are really familiar with them and the differences between them. (This is because while stress management in general is beneficial for all, some techniques will work well for various people with depression while others may not. For example, Savasana with eyes closed can be very challenging for people with depression while a supported inverted pose with eyes open could work very well. And meditation may even be harmful—see Friday Q&A: Depression, Medication, and Meditation.)  

Learn About the Types of Depression

Another very important subject area to study is the two types of depression, which are very different and need to be addressed differently with yoga. In my post Tamasic and Rajasic Depression, I discuss the differences between clinical depression (tamasic) and agitated depression (rajasic), and describe the different approaches you need to take for the two. Generally, because of the lethargic aspect of clinical depression, people with this form of depression need energizing as well as uplifting while because the anxious/agitated aspect of agitated depression, people with this form of depression need calming and soothing, rather than energizing. The more you understand about these two different forms of depression, the better you will be able to help someone (or yourself) who is suffering from one or the other. 

Some other posts with information about yoga for depression that you might find useful include: Balancing Your Emotional Body with Counter-Poses and Balancing Your Emotions with Your Breath.

I also highly recommend reading the book The Noonday Demon: An Atlas of Depression by Andrew Solomon as a way to learn even more about the different types of depression. (Even though—bad Andrew—the only thing he says about yoga is snide and ignorant.)

Yoga is Not a Standalone Cure

Finally, always keep in mind that yoga is a supplementary treatment for depression, not a standalone cure. You can use it to help someone who is recovering from depression or to help someone who has once suffered from it to prevent its recurrence. But serious depression (as opposed to, say, just feeling mildly depressed about life) can be a life-threatening disease and someone with serious depression should be under professional care. While yoga teachers can work with someone who has serious depression, the teacher should always make sure the student is also seeing a trained professional. See Drawing a Line in the Sand: Where Yoga Teachers Should Not Go and No Shame, Please! (Western Medicine and Yoga are Complementary).

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Friday Q&A: Depression, Medication, and Meditation

The Gray Tree by Piet Mondrian

Q: I am an avid follower of Yoga for Healthy Aging and have benefitted greatly from the wisdom imparted on this site. Perhaps you can shed some light on the following question: I am taking several medications for depression and anxiety. I would like to start a meditation practice but am unsure about the interactions between psychotropic medications and meditation. Can you offer me some advice with this?

A: Your question is timely and important. As you know, today we turn toward combining the wisdoms of the East and the West. More and more people are managing their moods and physical states by using meditation and body /mind systems to deal with anxiety and depression. There is a newly emerging discipline called “yoga therapy,” which specializes in different forms of treatment.

Meditation is powerful, as you know. But one problem of meditating when you have depression is that the meditation itself can turn on you and become a litany of self-blame and despair. You might think you’re meditating and helping yourself, but you’re not; you’re ruminating, digging yourself into a deeper and deeper hole. So the biggest contraindication to meditating is severe unregulated depression, and this must be respected because the rumination picks up steam and can drive you into the depths. So it’s wise to wait until you’ve achieved balance before beginning a meditation program. 

You’re wise to ask about the interactions between psychotropic medications and meditation. Most research indicates that it is safe to meditate and medicate both, but until the medication has been carefully titrated and shown to work over a period of time, it is safer to allow yourself to come to your center before beginning anything new. Of course, there are no hard and fast rules; this varies from one individual to the next.

To play it safe, here is what I would do. First off, I would consult with my doctor to check that my moods have stabilized and that meditation is okay. Does your doctor practice Integrative Medicine? That might prove to be an important piece in your decision making process.

Then, if I decided to begin a daily medication practice, I would consult a meditation specialist, an expert teacher, and work closely with that person to make sure that I got on the right track and stayed there. Meditation is a simple practice, so simple that it can be hard to learn. You and your teacher will work together to find the methods that are best for you as an individual. The rewards of a daily meditation practice accrue slowly, but over time they add up and they help you learn to know yourself and to accept yourself deeply. This deep acceptance of self in the moment, whoever that self might be, plays a big part in helping with depression.

Since you’re a regular reader of  Yoga for Healthy Aging, I guess that you probably are already involved in yoga, which is another form of meditation. Yoga is often called a moving meditation. You might consider consulting with a yoga therapist who specializes in mood disorders, someone who will help you find the best yoga moves for you and teach you meditation and pranayama or breath work practices. Different movements have different emotional effects, too, as can the length of time the different positions are held. 

You might benefit from reading Amy Weintraub's book Yoga for Depression. Amy has a training program where she works with therapists to teach them yoga skills. Or you might look for a yoga therapist on the International Association of Yoga Therapists (IAYT) website, where there is a list of therapists, organized by location. 

I’m talking a lot about yoga because you’re a reader of Yoga for Healthy Aging, but maybe you would rather choose another kind of meditation practice. There are different schools for you to check out, and the essential factor is: do you like it? Does it appeal to your taste? Investigate, try different approaches. What is your gut feeling? 

You might start your research by reading a few books like The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness (Book & CD), by Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn, or A Path with Heart by Jack Kornfeld. You could check out a Zen Center. There’s lots of choices, and I’m always happy to say it’s a big world! Whatever your choice, I wish you success. And thanks for asking.

—Lynn


Lynn Anjali Somerstein, PhD, NCPsyA, LP, RYT, is a licensed psychotherapist and yoga therapist in private practice, specializing in anxiety, depression and PTSD. She is also the author of numerous articles about yoga, anxiety, attachment issues and psychotherapy. Lynn is grateful to her many teachers at the Integral Yoga Institute and the National Psychological Association for Psychoanalysis who offered her extensive and deep training in yoga, yoga therapy, and psychoanalysis. See lynnsomerstein.com for more information about Lynn. 

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Featured Sequence: Mini Uplifting Practice

by Nina

I almost always feel better after practicing yoga, but sometimes when I’m feeling mildly depressed, discouraged, or lethargic, it’s hard to motivate myself to get started. While I learned from Patricia Walden that moving between Mountain pose and Arms Overhead pose with your breath can be slightly uplifting and energizing—and it is for me—sometimes even that feels like a bit too much to begin with. And I’ve found that starting on my hands and knees with a very simple Cat-Cow pose feels much more accessible on some days. So I came up with this very simple mini sequence for myself. Typically, after I’m through with this series of poses, I’ll be feeling more lively and ready to move onto an active practice of energizing standing poses. But I expect you could simply do the mini practice on its own, and there is no rule that says you can’t finish a yoga practice standing up. As a matter of fact, I once took a class where we finished our practice in Mountain pose, and it was a revelation for me because I left the class feeling quite lively instead of quiet and spaced out. 

Because Baxter did his post on Cat-Cow pose this week, today seemed like a good time to share my little sequence with you.

1. Cat-Cow Pose, for six or more rounds. 

See Featured Pose: Cat-Cow pose for information on Cat-Cow.

2. Downward-Facing Dog pose for 1 minute. Or less. Or more.

If this pose is difficult for you because you have tight shoulders or hamstrings, practice it with bent knees so it is comfortable. Rather than paying too much attention to your alignment, focus on feeling your breath move in your body. 

See Featured Pose: Downward-Facing Dog Pose for information on Downward-Facing Dog.

3. Standing Forward Bend, just briefly. 

From Downward-Facing Dog, walk forward into Standing Forward Bend. If this pose is difficult for you because you have tight hamstrings, practice it with bent knees so it is comfortable. Yes, I'm talking to you, Baxter!

Thank you, that's much better. Stay briefly, just for a few breaths. Now get ready to come up into Arms Overhead pose on your next inhalation.

4. Arms Overhead Pose, on your inhalation.

From your Standing Forward Bend, inhale and come up into Arms Overhead pose by taking your arms out to your sides in a swan-dive position as you come up. 

5. Mountain Pose/Arms Overhead pose, for six or more rounds.

On your next exhalation, release your arms by your sides into Mountain Pose. Then, repeat the cycle of inhaling your arms overhead and exhaling them by your sides for at least six rounds. 

6. Mountain pose, as long as needed.

Stand in Mountain pose with your eyes closed and ask yourself what you feeling like doing next. Warrior 2 pose? Sun Salutations? Legs Up the Wall pose? Taking a walk? Working in your garden? Making your bed? When you decide, just go ahead and follow your intuition. 

If you give this a try, let me know how goes!

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Depression May Be Caused by Inflammation

by Nina

Burning House by Marc Chagall*

“Inflammation is our immune system’s natural response to injuries, infections, or foreign compounds. When triggered, the body pumps various cells and proteins to the site through the blood stream, including cytokines, a class of proteins that facilitate intercellular communication. It also happens that people suffering from depression are loaded with cytokines.” —Tim De Chant

The first thing I did after I read a short article Depression May Be Caused by Inflammation was write to Ram. After all, Ram has written more than once about the dangers of chronic inflammation (see Chronic Inflammation and Yoga: Combating the Fiery Killer and Yoga’s Healing Powers), but he never mentioned depression as a problem that could be caused by inflammation. Here is his reply:

"Yes, I saw this item this morning and it does not surprise me. Inflammation is now thought to be the underlying event for a number of health issues including Alzheimer's, diabetes, obesity, hypertension, thyroid issues, arthritis, etc. What was once thought of as a novel and protective mechanism for the hunter-gatherers has now gone haywire thanks to modern interventions/lifestyle that has extended the median life span.”

So with that nod of approval, I decided to look more into the matter. After all, if yoga can help with chronic inflammation and depression is caused by chronic inflammation, then practicing yoga for chronic inflammation could be helpful to people suffering from depression. So, what are scientists saying about how is depression connected to chronic inflammation? An article in the Guardian Is depression a kind of allergic reaction? put it this way:  

“Both cytokines and inflammation have been shown to rocket during depressive episodes, and – in people with bipolar – to drop off in periods of remission. Healthy people can also be temporarily put into a depressed, anxious state when given a vaccine that causes a spike in inflammation. Brain imaging studies of people injected with a typhoid vaccine found that this might be down to changes in the parts of the brain that process reward and punishment. Depression may be triggered by an immune response.” 

And because these scientists are now thinking that depression may be a side effect of inflammation, they are exploring new treatments that address the inflammatory symptoms of depression with positive results. For example, a study The cyclooxygenase-2 inhibitor celecoxib has therapeutic effects in major depression: results of a double-blind, randomized, placebo controlled, add-on pilot study to reboxetine in Molecular Psychiatry concluded that an anti-inflammatory medication had therapeutic effects for depression.

But as Ram wrote in Yoga’s Healing Powers, a regular yoga practice is also effective for reducing chronic inflammation. He said that yoga:

1. Brings down the levels of stress hormones that promote inflammation
2. Lowers the levels of a number of pro-inflammatory molecules in the body
3. Reduces a subset of pro-inflammatory molecules called cytokines

Yes! Yoga helps reduce those pesky cytokines, which are exactly what the scientists are thinking may be responsible for triggering depression, as well as reducing inflammation in general. And, stress, which promotes inflammation, has also been long thought to be a factor in depression, as Timothy McCall wrote in Stress, Your Health, and Yoga.

So I’m going to make the leap and say if you want to reduce chronic inflammation and lower your levels of cytokines to help depression: focus at least some of your practice on stress management (see The Relaxation Response and Yoga). In general, supported inversions (see All About Supported Inversions) are particularly good for people with depression because you can keep your eyes open while practicing and don’t need to focus internally, which can lead to brooding. 

But, as always, you should experiment to find out what works for you, and if you enjoy restorative yoga or guided relaxation or breath work, go for it. In general, the way you practice yoga should probably depend on the type of depression you have, rajasic or tamasic. See Tamasic and Rajasic Depression for further information.

I came to the conclusion that yoga for depression should include stress management practices a long time ago because I had two bouts of agitated depression that both followed periods of sustained stress. And since I’ve learned to manage my stress levels with yoga, I’ve managed to avoid any more episodes (going on 20 years now!). Of course, until recently, I only had what scientists call “anecdotal evidence” and the wisdom of my yoga teachers to back me up. Now it’s great to have a possible scientific explanation as well!

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Attachment (Raga), Depression, and Plan Z

by Nina

Plan E

Did you read my recent post about attachment Attachment (Raga) to Our Ideas About Ourselves? Because I’m starting to feel I’m going to be exploring this topic for some time. For one thing, just a couple of days someone close to me found out that he has heart disease, and I know this means he’s going to have to let go of some of his plans/dreams for his future. I don’t know how this is going to play out, but I know it will be painful for him because he was particularly “attached” to his vision of how he should live his life. Also, I know that Jill is going to write something very interesting about her attachment to her appearance. (Jill and I are having a very interesting time exploring the overlap between Buddhism and yoga philosophy.)

But for today I simply want to clarify something about my previous post, because a conversation on Facebook made me realize that something I said may have been misleading and I really want to be clear that I do not see meditation or a even well-rounded yoga practice as a cure for depression. I’ll begin with the Facebook comments from the reader, Lynn Somerstein, and me, and then I’ll comment further. (The really wonderful thing about this Facebook discussion was not only that it made me think, but I also ended up chatting with Lynn, who is a psychologist, a yoga teacher, and a writer, privately. So now we’re friends and may even work on some projects together in the future!)

Lynn: Although I read your blog regularly and gladly, I think today's post is a dangerous oversimplification of what depression is, does, and how it should be treated. People who are depressed often are unable to meditate-- instead they focus on all that they feel is wrong and they experience this as meditation, rather than a symptom of their illness. Depressed people need therapeutic help.

Nina: Sorry if you thought this was about depression. It is not. The person in question is getting professional help and medication. I always recommend that and consider yoga as a supplement only. However, I do think that part of recovering means being able to let go of certain things, and I know this from having gone through this myself (including therapy). I have written some about yoga for depression on the blog, which if you read those posts you will see that I never claim yoga can cure depression. –Nina

Lynn: Thanks Nina. Yoga and Psychotherapy together are a great help for depression and anxiety too. Thank you for answering my comment. I do read your every post. Namaste.

The post I was referring to about the limits of yoga for helping with depression was Yoga is a great thing, but..., in which I addressed the issue directly. The issue of problems that people with depression, anxiety, and other emotional or mental imbalances might have with so-called "relaxing" poses in When Relaxing Isn't Relaxing. Baxter also wrote a relevant post  Friday Q&A: Can Meditation Be Dangerous? about this.

After this discussion I contacted Lynn privately to ask if I could use her comments in a post and she agreed. After she agreed, I asked her if there was anything she wanted to add to her comments. By then, she had read my articles, and she sent me the following comment by email:

I agree, as you wrote in "Relaxing Isn't" that opening your eyes can help. For those who simply don't profit from meditation using a simple movement that can be connected with the breath, like walking or swimming, for example, may work better; as the body and breath unite, the mind quiets.

So, yes, just to be completely clear: I do not believe that meditation or yoga alone can cure depression, and anyone who is suffering from this illness should seek help from a professional. And thank you, Lynn, for helping me realize I needed to clarify this.

However, yoga can be a wonderful supplement in the recovery process, as the asana practice (like walking or swimming) can help get you out of your head and into your body, and sometimes certain asanas can energize or calm you (depending on which you need). See Tamasic and Rajasic Depression. Patricia Walden, a senior Iyengar yoga teacher, who herself suffers from depression, teaches workshops on yoga for depression, and you can find out more about her work in Yoga As Medicine by Timothy McCall (Patricia was Timothy’s first main teacher, and he did his teacher training with her). I have taken her workshop several times, and have been very inspired by her work. I still believe, however, that for some people, part of the process of recovering from depression (and maybe this is an essential part of therapy, but I can't speak to that) includes letting go of certain attachments, including the agenda you had for your life. And before you can move on to that step, you need to be ready to admit that attachment, as Patanjali says, IS an affliction.

2.3 avidya asmita raga dvesha abhinevesha klesah


The five afflictions (klesas) which disturb the equilibrium of consciousness are: ignorance or lack of wisdom, ego, pride of the ego or the sense of ‘I,’ attachment to pleasure, aversion to pain, fear of death and clinging to life. —Yoga Sutras, translation by Edwin Bryant 

To end on a lighter note, I’ll tell you a little story about letting go of plans that I’ll call “Plan Z.” On Sunday my companion and I went into New York City for lunch and a walk around Alphabet City (so many wonderful community gardens there!), and our plan was to take the PATH train home in the mid-afternoon and then do some work we needed to finish. Let’s call that Plan A. Well, it turned out the PATH was completely closed down due to a fire in the tunnel. So Plan B was splurge on a taxi (we weren’t going very far from home, and if there had been a way to walk across the Hudson river, we could just have walked). After a long time trying to flag one down and failing (Other people who couldn’t take the train? People leaving from the Climate March? Both?), we moved on to Plan C, which was calling Uber and/or a car service. Uber was surge pricing, which offended my companion, and we couldn't get through to the car service, so we came up with Plan D, which was to take a ferry to a certain city in New Jersey, and then walk home from there. Our backup plan for that was to go to Penn Station and take a train to Newark, but we knew by now that Penn Station was going to be super crowded. (My companion joked that Plan Z was that we would drink the entire bottle of artisan cucumber vodka we had purchased as a gift for someone and spend the night in Washington Square. Obviously, we weren’t going to do this, but it was a joke that we kept making that cheered us up, and also allowed us to discuss the whole concept of staying calm while letting go of plans in a light-hearted way—okay, maybe black humor—but we like that stuff.)

We decided to walk on the High Line (the beautiful elevated park) to make the most of our walk to the ferry, but we were rushing a bit because it was getting later and later, and the ferries stopped at seven. When we finally made it to the ferry terminal we found that the ferries to the city we wanted to go to didn’t run on weekends, so we made a snap decision to take the ferry to Hoboken instead, and figured from there we could either take the light rail train or walk. We called this Plan E. Plan F was if we couldn’t get on that ferry, we’d go to Penn Station. Long story short-ish, we got the second ferry to Hoboken (some other people had the same idea about how to escape from Manhattan) and then had nice dinner in an outdoor restaurant. Refreshed after our rest and meal, we were able to walk the rest of the way home. 

Obviously, this “escape from Manhattan” could have been very stressful (we had reasons why we needed to get back home that night) but our joking about all our plans and backup plans and how we had to keep letting go of them, helped us stay calm and even enjoy many aspects of our adventure. There were people playing bagpipes below the High Line at one point—why?

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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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