How Much Protein You Need and

Pro Bodybuilders eat about one gram (sometimes even 1.5 grams) of protein per pound of body weight or per pound of non-fat tissue. I'm sure you've seen that the recommended dail

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Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts

Wednesday, December 3, 2014

Yoga for Biploar Disorder: A Conversation Between Lynn Somerstein and Stephen Lewis


by Lynn Somerstein, PhD, RYT, LP
Two Flowers in Conversation by Shitao
Stephen Lewis, LMHC, NCC, E-RYT and I became acquainted several years ago when we were introduced by a mutual friend, who knew we were both interested in yoga and psychotherapy. We’ve had many conversations since then about the effects yogic practice has on mental health, including its usefulness working with Bipolar Disorder. We’re both psychotherapists and yoga therapists in private practice in New York City, and we integrate mind-body techniques, especially yoga and mindfulness, into our psychotherapy work. We’re also both committed to promoting a wellness lifestyle and to removing the stigma often associated with mental health problems.

Lynn: Steven, I began doing yoga over 50 years ago, when I was still in high school. I learned it from a book, since there were no yoga studios near where I lived, and I loved it right away. I was a jumpy teenager and it calmed me down. What first drew you to yoga?

Stephen: My journey started about 15 years ago. At that time and for the four years that followed, yoga was primarily a physical practice for me as well as one that helped me relax and feel centered.

Lynn: Yes, typically people are first drawn to yoga as a physical practice. I was, too. And then if you stick with it, things deepen.

Stephen: It was when I started practicing on a daily basis that I began to experience the more profoundly positive effects of yoga. In reading about the yogic lifestyle and yoga psychology I became excited by the idea of immersing myself in the practice of yoga.

Lynn: When I was in my twenties I started studying yoga at the Integral Yoga Institute, and forty years later I’m still immersed in advanced studies there. There is so much to learn!

Stephen: I went to the Kripalu Center for Yoga and Health, practicing seva (selfless service) as a karma yogi, and I noticed the transformative effects a holistic yoga lifestyle had on me and those around me. I became certified as a yoga instructor at Kripalu and then was drawn to travel to India, the birthplace of yoga. In Varanasi I felt called to integrate yoga and psychotherapy. When I returned to America, I took steps to do just that.

Lynn: I also felt a deep need to integrate yoga and psychotherapy. I found that the combination of the two has a calming, centering effect on people in my therapy practice—and on me, too! Among other things, yoga is about deep energy work. It is effective for people with anxiety, PTSD, and depression, and I think it can help people with Bipolar Disorder, although so far there is not much research on it.

Stephen: When it comes to scientific research, the jury is still out in regards to whether yoga can be helpful for those with Bipolar Disorder. As of this date, very few studies have been published on the question and those few leave much to be desired in terms of their quality. 

Lynn: The International Association of Yoga Therapists has a small bibliography about yoga and BD. People with BD often need to take medication and always need to live a structured life as free from stress as possible, attend to nutrition, and get enough sleep and exercise. Psychotherapy helps, too. Clearly, a yogic lifestyle encourages a wellness approach by teaching people to have deep sensitivities to their needs, and giving them the means to meet their needs in healthy and appropriate ways.

Stephen: It’s important to concentrate on a calming, centering yoga practice.

Lynn: But sometimes neither yoga nor medication seem to work. For example, some years ago I worked with a young man with Bipolar Disorder. He was on medication but it was quite difficult to titrate, and he had many relapses, which is why he came to me for treatment. He said he was powerless in the face of his disease, and that he felt like a werewolf. We worked together for several months to try to ground and balance his energy using talk therapy, pranayama, and calming asana, but we weren’t successful. People often describe the “highs” that are associated with Bipolar Disorder as enjoyable, but they certainly weren’t to this man. When he relapsed he was supercharged and miserable. His body and face were painfully taut, his eyes protruded; he said he felt like a slave to some malevolent force. His disease was unusually virulent.

However, often people with BD can find the right combination to achieve balanced lives, and a yoga lifestyle coupled with psychotherapy and medication, if needed, can be very helpful. Some of the yoga practices that help are breath work, asana, and restorative techniques. But it is important to work with a yoga therapist who has specialized training in talk therapy and who understands how to help people in recovery, people with mood disorders, or people who have been traumatized. 

Stephen, how do you help people with BD?

Stephen: I use calming and balancing pranayama, including nadi shodhana (alternate nostril breathing), yogic/3-part/dirga breathing, and bhramari (bee’s breath).

Lynn: Like me. What about asana?

Stephen: Cat/Cow warm ups, gentle backbends and forward bends can promote balance. Backbends tend to open the heart and can instill a sense of openness, energy, and positivity. Forward bends can help people feel safe, grounded, and calm. Managing this balance in a slow and mindful way can act as model for maintaining balance in mood states. Twists tend to cleanse and neutralize, and are helpful to intersperse throughout a practice.

Lynn: Are there any particular poses or practices that you feel should be avoided at certain times? Or at all times?

Stephen: Extremes are best to be avoided, as balance is the key in using yoga for Bipolar Disorder. When it comes to pranayama (breathing exercises), we should be careful with intense practices that are prolonged and energizing, such as kapalabhati, breath of fire, or Sudharshan Kriya Yoga (SKY). Asana practices that are fast, vigorous, or practiced in a heated environment can aggravate or push people towards imbalance. Some examples of this are intense vinyasa classes, hot yoga, power yoga, Kundalini and Bikram yoga.

Lynn: Interesting that the kinds of yoga to be avoided are some of the most popular kinds of yoga today and just what an energetic young person might be drawn to. People don’t understand the powerful effects of yoga.

Stephen: Maybe so. Forms such as Hatha, Kripalu, Iyengar, Ishta, Anusara, Integral and Restorative Yoga are preferred for those with Bipolar Disorder, but we all need to manage our physical and mental energy so we can maintain and restore balance.

Stephen Lewis, LMHC, NCC, E-RYT, specializes in Integrative (Holistic) Psychotherapy, with years of training and experience in a wide range of techniques such as Mindfulness and Meditation, Cognitive Behavioral Therapy (CBT), Yoga Therapy, Dialectical Behavioral Therapy (DBT), and Hypnosis, amongst others. I earned my Masters degree at NYU and was trained at Bellevue Hospital. See stephenflewis.com for more information about Stephen. 


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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Monday, February 4, 2013

Yoga for Neuropsychiatric Disorders

by Ram

"The demand for clinically efficacious, safe, patient acceptable, and cost-effective forms of treatment for mental illness is growing. Several studies have demonstrated benefit from yoga in specific psychiatric symptoms and a general sense of well-being." —Balasubramaniam, et al

Among the vedic sciences, Ayurveda is considered the healing side of yoga, and yoga the spiritual side of Ayurveda. Both these sciences are considered as two sides of the same coin, as they emphasize a complete approach to the well-being of the body, the mind, and the spirit. Both yoga and Ayurveda describe the disease process as taking its roots first in the mind. If we fail to recognize the disease process in the mind and continue to make wrong choices, the disease overflows into the physical body as specific symptoms. Thus, symptoms are simply the body’s voice communicating that we are living out of harmony. When we live out of harmony we suffer. When we change our life to bring greater harmony, our bodies reflect this change and there is less suffering.

Turn to yoga philosophy and one of the main tenets in the Yoga Sutras is:

Yogas chitta vritii nirodhah

yoga =union, to join; chitta = mutable thoughts of the mind-field; vritti = mental fluctuations/ modifications, nirodhah = coordination, regulation, channeling.

Swami Jnaneshvara translates this as: Yoga is the control (nirodhah, regulation, channeling, mastery, integration, coordination, stilling, quieting, setting aside) of the mutable thoughts/modifications (gross and subtle thought patterns) of the mind field. In other words, when you achieve a union of the body, mind and spirit, all mental fluctuations and turbulence cease.
The Shady Side of the Mountain by Brad Gibson
Dissect this tenet in more simple terms and this is the message: human being as a whole is a combination of body, mind and spirit, with physical, mental (psychological) and spiritual dimensions. When we just think of ourselves as a physical body and lose our connection with the mind and spirit, we become susceptible to mental and physical diseases. If this theory is hard to follow, understand that we share a close relationship with our environment, the world around us. If an individual is living in harmony with the environment, optimum health is possible. However, the further out of harmony an individual is living, the less likely it is that they will reach their full life potential in either length or quality of life. Healing is the process of returning to harmony by becoming one with our environment. Once back in harmony, the body and the mind have no reason to communicate symptoms. The body is at ease; the mind attains peace.

Mention the mind-body relationship to a scientist or a medical doctor and you will immediately notice their discomfort as this relationship lacks sufficient scientific backing. In addition, I have noticed that the general public is less likely to embrace some of these theories and alternative therapeutic interventions unless they have been proved by science. At one of the national Ayurveda/Yoga conferences, I had suggested some yoga modalities for ADHD patients but since I could not provide a scientific rationale, my suggestions were met with skepticism.  So does it surprise me now when a review published in the journal, Frontiers in Psychiatry titled Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders by Balasubramaniam, et al describes yoga to be “highly promising” as a complimentary care to medication for psychiatric disorders (the authors examined the literature for a gamut of psychiatric illness) but without the negative side effects that come with pills? Not in the least. Because all psychiatric disorders have a mind component, a mind-body integrative program, such as yoga, can definitely assist people in their pursuit of peace and calmness, and bring greater wholeness and integration in their lives.

Unfortunately, if you just mention this 5000-year-old ancient practice as a standalone solution, you will have skeptics. Bring in statistics, scientific methodology and other modern applications, however, and people will start believing you.

"There is emerging evidence from randomized trials to support popular beliefs about yoga for depression, sleep disorders, and as an augmentation therapy. Limitations of literature include inability to do double-blind studies, multiplicity of comparisons within small studies, and lack of replication. Biomarker and neuroimaging studies, those comparing yoga with standard pharmaco- and psychotherapies, and studies of long-term efficacy are needed to fully translate the promise of yoga for enhancing mental health."—Balasubramaniam, et al

But whatever it takes, the mind-body connection definitely needs to be considered seriously!