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Introduction

Adult depression is a pressing health concern across the world in the contemporary time. N Australia, 1 million adults suffer from this mental condition, increasing the burden of treatment in health care facilities. Recognising the far-reaching impact of depression and the identifying suitable strategies to overcome them is essential at present (Titov et al. 2015). The intervention that is considered for the present literature review is the yoga which is a group of mental, spiritual and physical practice. Impact of yoga and its extent of effectiveness in treating different diseases have been studied extensively in the literature. The present paper would highlight the impact of yoga in reducing and/or eliminating depression of adults.

Depression And Non-Pharmacological Treatment

Depression is the mental condition in which an individual suffers from negative feelings, sadness, loss of interest in life and daily activities. These symptoms, when persisting, affect the life substantially. The causes of depression are multi-faceted and a complex combination of environmental, psychosocial, biological and genetic factors. Depression is not the common fluctuation in an individual’s mood that persists for a short span of time. Instead, it persists for a long span of time and challenges the normal daily functioning. It is a psychiatric disorder that is highly prevalent across the globe, and tends to be chronic and recurrent (Greenberg 2017).

Though pharmacological treatment has been the primary therapeutic approach taken for combating depression, different non-pharmacological interventions are now regarded as more effective as therapy (Gilbert 2016). As per the author, non-pharmacological treatment options are still under examination to come up with a standardised treatment procedure. Yoga has drawn attention in the recent past as a possible intervention for depression. Through the reduction of anxiety and stress, yoga aims to alter the stress response system. Yoga is found to change the body’s functioning that in turn alters the ability of the body to response to arising stress in a more flexible manner.

Synthesis Of Literature

Uebelacker et al. (2017) conducted a randomised control trail to understand the experiences of individuals suffering from depression and undergoing a ten-week hatha yoga program. After ten weeks of yoga class, the participants provided written responses to questions framed in an open-ended manner to understand whether they found the classes helpful and effective or not. The study concluded that elements of the classes increased the acceptability for the individuals when there was a promotion of non-judgemental and non-competitive atmosphere. When given a warm and affectionate approach, the therapy was more effective. However, there were challenges concerning the physical ability to carry out all exercises.

Medical interventions considering both mind and body are useful in coping up with depression and yoga is one of the commonly used techniques of this category (Cramer et al. 2013). The authors carried out a systematic review and meta-analysis to assess the efficacy of yoga for addressing depression. The results revealed that there was moderate evidence supporting the short-term impact of yoga as compared to usual care process. Detailed analysis indicated the effectiveness of short-term impact of the same in patients who suffered from high levels of depression. The study showed that yoga could be considered as an auxiliary or supplementary treatment option for those who show depressive symptoms.

Uebelacker et al. (2017) attempted to determine whether hatha yoga is useful as an adjunct intervention when given to patients with continued symptoms along with antidepressant treatment. A randomised control trial was conducted for ten weeks that compared yoga classes and heath education classes. While the primary outcome was symptoms of depression, secondary outcomes were the role and social functioning, physical functioning, pain, and general health perceptions. Though there was no statistically significant difference between the two groups, the followup period had participants showing lower levels of depression. It was found that patient given yoga therapy demonstrated the better role and social functioning and had better health perceptions.

According to Taso et al. (2014), anxiety and depression are the most important problems influencing the quality of life for those who have suffered breast cancer and have received chemotherapy. The researchers studied the impact of yoga exercise program for eight weeks in the promotion of the physical and psychological health of women with breast cancer in terms of depression. A quasi experimental research with sixty participants gave rise to the result that yoga therapy provided for an hour for two days a week brought a reduction in the overall rate of fatigue but not depression. 

Positive impacts of yoga in reducing depression and stress in pregnant woman have been long researched into (Field et al. 2013). The study conducted by the researchers had ninety-two pregnant women suffering from prenatal depression assigned to yoga/tai chi or a control group. The participants of the intervention group underwent a 20 minutes session in a week for 12 weeks. The results showed that tai chi/ yoga group had lesser scores for depression. In addition, the subscale scores for vegetative symptoms were also less. Yoga contributed to a positive change for women regarding the reduction of pain and stress caused by pregnancy.

Louie (2014) explored the effectiveness of yoga in treating depression through a critical literature review. The review considered six studies that discussed yoga as a primary intervention for depression. It focused on different yoga styles and posed as the core components. Collectively, it came into light that yoga, in which different body positions are considered, is a popular, cost-effective and safe method for amelioration of depression. Yoga might be used together with medication or as a separate intervention. It is a versatile therapy, allowing for personalisation. This is of much significance for addressing patient-specific issues. Health care providers are to be more engaged in providing support to patients to undergo this therapy.

Against the backdrop that depression is a leading cause of disability across the globe, Manimcor et al. (2016) carried out a randomised control trial for understanding the impact of individualised yoga on depression and improvement of the wellbeing of patients at home settings. One hundred and one people suffering from depression were subjected to six-week-long yoga intervention. This was provided in adjunct with normal treatment. There were statistically significant differences between yoga and control groups in regards to reduction of depression scores. It was concluded that yoga therapy in conjunct with regular care is better for treating symptoms as compared with conventional care.

Uebelacker and Broughton (2016) opined that the interest in gaining insights into applications of yoga is increasing. As per the authors, yoga has come a long way in being a treatment option for depression as it is accessible, appealing and affordable. There are affective and biological processes by which yoga exerts a positive impact on patients suffering from depression. In their review of research undertaken previously by healthcare providers, the authors further highlighted that preliminary evidence indicates yoga practices to be helpful. The present evidence base is strongest for yoga, but there a number of risks to engage in yoga too.

Duan-Porter provided an evidence map of yoga for depression, anxiety disorder, posttraumatic stress disorder and panic symptoms. A literature review was conducted with systematic reviews and randomised controlled trials. All studies identified indicated the useful of yoga therapy against depression.  It gave additional information on how yoga can bring improvement in short-term depressive symptoms. The search highlighted that there is a scarcity of information on training processes of yoga instructors and the extent of instructions provided.

Schuver and Lewis (2016) explored the usefulness of 12-week mindfulness-based yoga intervention in treating depressive symptoms suffered by depressed women. A randomised controlled trial was undertaken where participants were given mindfulness-based yoga intervention that encompassed home-based yoga positions and postures, along with meditation practice. Education was provided to the patients over telephonic conversations. The findings suggested that such interventions act as valuable tools for managing ruminative thoughts in those who suffer such symptoms. During yoga, the process that takes place is that mindfulness decreases rumination as participants are provided with an opportunity to put their focus on substitute thoughts.

Conclusion

The prevalence of depression in adults is a serious concern at the contemporary era since the social and health burden of the same is increasing. Depression is the loss of pleasure or low mood that a person experiences for more than a month. Attempts are being made to investigate novice methods by which depression can be treated. Yoga offers a wide range of benefits that re related to the reduction of depressive symptoms in patients. It is to be highlighted that patients with different causes of depression can be treated with yoga. These encompass cancer and pregnancy. Mindfulness as an element of yoga helps in reducing the depressive symptoms. Patients can achieve enhanced mood and emotions through this. Yoga can be done in combination with conventional treatments for this mental health condition. The concern that arises in this context that there are certain risks related to the practice of yoga. There is a need of training yoga professionals on delivery intervention on an individual basis. Safety issues are to be looked after while delivery yoga intervention.

References

Cramer, H., Lauche, R., Langhorst, J. and Dobos, G., 2013. Yoga for depression: A systematic review and meta?analysis. Depression and anxiety, 30(11), pp.1068-1083.

Duan-Porter, W., Coeytaux, R.R., McDuffie, J.R., Goode, A.P., Sharma, P., Mennella, H., Nagi, A. and Williams Jr, J.W., 2016. Evidence Map of Yoga for Depression, Anxiety, and Posttraumatic Stress Disorder. Journal of Physical Activity and Health, 13(3), pp.281-288.

Field, T., Diego, M., Delgado, J. and Medina, L., 2013. Tai chi/yoga reduces prenatal depression, anxiety and sleep disturbances. Complementary therapies in clinical practice, 19(1), pp.6-10.

Gilbert, P., 2016. Depression: The evolution of powerlessness. Routledge.

Greenberg, L.S., 2017. Emotion-focused therapy of depression. Person-Centered & Experiential Psychotherapies, pp.1-12.

Louie, L., 2014. The effectiveness of yoga for depression: a critical literature review. Issues in mental health nursing, 35(4), pp.265-276.

Manincor, M., Bensoussan, A., Smith, C.A., Barr, K., Schweickle, M., Donoghoe, L.L., Bourchier, S. and Fahey, P., 2016. Individualized yoga for reducing depression and anxiety, and improving well?being: a randomized controlled trial. Depression and anxiety, 33(9), pp.816-828.

Schuver, K.J. and Lewis, B.A., 2016. Mindfulness-based yoga intervention for women with depression. Complementary therapies in medicine, 26, pp.85-91.

Taso, C.J., Lin, H.S., Lin, W.L., Chen, S.M., Huang, W.T. and Chen, S.W., 2014. The effect of yoga exercise on improving depression, anxiety, and fatigue in women with breast cancer: a randomized controlled trial. Journal of Nursing Research, 22(3), pp.155-164.

Titov, N., Dear, B.F., Staples, L.G., Bennett-Levy, J., Klein, B., Rapee, R.M., Shann, C., Richards, D., Andersson, G., Ritterband, L. and Purtell, C., 2015. MindSpot clinic: an accessible, efficient, and effective online treatment service for anxiety and depression. Psychiatric Services, 66(10), pp.1043-1050.

Uebelacker, L.A. and Broughton, M.K., 2016. Yoga for depression and anxiety: A review of published research and implications for healthcare providers. RI Med J, 99, pp.20-22.

Uebelacker, L.A., Kraines, M., Broughton, M.K., Tremont, G., Gillette, L.T., Epstein-Lubow, G., Abrantes, A.M., Battle, C. and Miller, I.W., 2017. Perceptions of hatha yoga amongst persistently depressed individuals enrolled in a trial of yoga for depression. Complementary Therapies in Medicine.

Uebelacker, L.A., Tremont, G., Gillette, L.T., Epstein-Lubow, G., Strong, D.R., Abrantes, A.M., Tyrka, A.R., Tran, T., Gaudiano, B.A. and Miller, I.W., 2017. Adjunctive yoga v. health education for persistent major depression: a randomized controlled trial. Psychological Medicine, pp.1-13.

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