AS per the World Health Organization (WHO), ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO, 1948). WHO defines mental
health as a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to his or her community (WHO, 2001). Dr Brock Chisholm, the first Director General of WHO, went on to state that “there is no health without mental health”.
Mental health conditions remain among the leading causes of disease burden worldwide.
According to the WHO, in 2019, one in every eight people, or 970 million people around the world were living with a mental disorder, with anxiety and depressive disorders the most common. In 2020, the number of people living with anxiety and depressive disorders rose significantly because of the COVID-19 pandemic. People with mental health conditions die 10–20 years sooner than the general population, often due to concomitant physical illness.
Suicide is also a significant risk associated with mental illness.
Good health is important not only for a person to lead a happy life, but also for the growth, development, and productivity of society. Yoga-based interventions and their application not only promote wellness but also help to treat clinical conditions associated with mental illness.
Mental health
MENTAL health is a critical factor for the well-being of an individual. A healthy mind is as important as a healthy body, if not more so. As we have been programmed to be ignorant of our mental health,
addressing the issues of the mind might seem a bit like an alien concept. Any person can suffer from mental ailments. In fact, some of the mental issues are so common and prevalent in almost every human being in the modern age that one would not want them to qualify as mental issues. Many people are
surprised to know that conditions as common as stress and anxiety are mental issues too.
Mental issues and disorders are real, and they exist.
Anyone can fall prey to them, and they are detrimental to an individual’s overall health and sometimes even life itself. It is also important to realise that the sufferer is not responsible for their suffering. It is not the individual’s fault that they are affected by a mental illness because, in most cases, they are unaware of their condition themselves. This makes it more important that such issues are acknowledged and treated in time. To treat them, their root cause must be identified.
Understanding what causes mental disorders will help better in treating them.
The human brain is usually considered the intersection and triple focal point of an individual’s spiritual, mental, and physical well-being. It is widely regarded as the most intricate and sophisticated system in the entire known living environment and endlessly owns the responsibility of driving manifold tasks. Like any other complex mechanism, the human brain also requires persistent nurturing and care.
In accordance with the saying ‘healthy mind lives in a healthy body’, it is innately important to understand that the objective of the intake of a proper and balanced diet is to attain mental agility and self-control in addition to maintaining a healthy body.
Student mental health is a rising public health issue.
Universities around the world are faced with an increasing prevalence of mental health problems among their students (Auerbach et al., 2018; Hunt & Eisenberg, 2010). A high level of distress is associated with
decreased well-being, academic impairment, and adverse socioeconomic effects (Bruffaerts et al., 2018). Mental health problems account for nearly half of the disease burden of young adults (Erskine et al., 2015).
Investing in the mental health of young adults will not only generate health-related and economic benefits today, but also for decades to come and for future generations (Patton et al., 2016; World Health
Organization, 2008). Mental health initiatives should be holistic and emphasise the promotion of mental health, including increased well-being, as well as alleviating mental distress (Winzer, Lindberg, Guldbrandsson, & Sidorchuk, 2018). Traditional one-on-one psychotherapy is costly and may also not be acceptable to first-time users of mental health services (Brown, 2018).
While modern science has its own take on treating mental disorders, ancient texts, and scriptures also provide insights into the causes and treatments of mental issues.
Yoga
“Yoga is not an ancient myth buried in oblivion. It is the most valuable inheritance of the present. It is the essential need of today and the culture of tomorrow” – Swami Satyananda Saraswati. An ancient tradition developed in India over 5000 years ago, yoga is based on a holistic health system that incorporates mind, breath, and body as well as spiritual, ethical, and lifestyle factors that promote physical and mental well-being.
The word yoga means “unity” or “oneness” and is derived from the Sanskrit word “Yuj”, which means “to join or to unite or to yoke”. This unity or joining is described in spiritual terms as the union of the individual consciousness with the universal consciousness. On a more practical level, yoga is a means
of balancing and harmonising the body, mind, and emotions.
It is the science of right living and, as such, is intended to be incorporated into daily life.
It works on all aspects of the person: the physical, vital, mental, emotional, psychic, and spiritual.
In the Western world, yoga is often perceived as a physical activity with the focus primarily on the “asana” or posture component of the practice. But, in Eastern traditions, yoga is a comprehensive science and psychology that aims to unite the body, mind, and spirit.
Some have pointed out that in the West, the focus is on the physical benefits of yoga (such as relaxation and stress relief), while in the East the focus is on the integration of the body and the mind.
The concept of Yoga has been well enunciated by Sage Patanjali in the Yoga Sutras.
The eight-limbed path of yoga (Ashtanga Yoga of Sage Patanjali) includes ethical practices (yamas), disciplines (niyamas), physical postures (asana), breathing practices (pranayama), sensory awareness and control (pratyahara), concentration (dharana), meditation (dhyana) and absorption (samadhi).
The practice and adaptation of Ashtanga Yoga in one’s life is helpful in removing ‘Chitta Vrittis’ (thoughts that clutter the mind) and ‘Chitta Vikshepa’ (distraction or diversion of the mind). It gives a steady and calm mind, which is free from all kinds of ‘Klishta Vrittis’ (painful mind-stuff) and
‘Alklisht Vrittis’ (non-painful mind-stuff), which helps a person control, manage, and regulate his/her mind in the right way. The concept of ‘Chitta Prasadanam’ (making the mind pure and blissful) in Yoga talks about how one can remain positive even in adverse situations by cultivating positive thoughts.
The Yoga Vashishta refers to the mind as a mere thought; thought is the mind’s motion, and its actions are directed by the nature of thoughts; the result of actions is felt in every part of the body through the
mind. This ancient text also describes how mental disturbances produce physical disturbances.
Yoga and mental health
The word “healthy” comes from two words: “heal” and “thy”. “Heal” means a cure or to make whole or sound and well, and ‘thy’ means you; thus ‘healthy’ means to make yourself whole or well and sound.
Yoga is proposed to exert its benefits through a variety of mechanisms. One well-accepted mechanism is that yoga confers its benefit to mental health through the regulation of the autonomic nervous system.
Another potential mechanism is through the release of endogenous opioids and other neurochemicals, such as serotonin and gamma-aminobutyric acid (GABA), which are involved in the regulation of mood and anxiety (Streeter et al., 2010). The physical postures and breathing exercises in yoga have been shown to stimulate the release of these neurochemicals, leading to improvements in mood and reduced anxiety.
A systematic review by Cramer et al. (2013) found that yoga interventions led to significant improvements in symptoms of depression, anxiety, and stress across various populations, including individuals with clinical depression and anxiety disorders.
Sathyanarayanan et.al conducted a research review to see the role of yoga and mindfulness in severe mental illnesses and found that yoga and mindfulness interventions appear to be useful as an adjunct in
the treatment of severe mental illnesses, including schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD). Studies have shown improvements in psychopathology, anxiety, cognition, and
functioning of patients with schizophrenia. They found that asanas and pranayama are the most studied forms of yoga for schizophrenia.
Lin et al. (2015), conducted a randomised control trial to examine the effect of yoga on work-related stress and autonomic nerve activity in mental health professionals. Results show that mental health professionals in the yoga group experienced a significant reduction in work-related stress and a signifi cant enhancement of stress adaptation when compared to the control group without yoga intervention.
Clark and et al. conducted a research study (feasibility test) to evaluate the use of yoga as a group therapy for female victims of partner violence with symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD). Twelve-week trauma-sensitive yoga intervention with psychotherapy was administered once weekly for 30–40 minutes at the end of each group therapy session.
The control group underwent only psychotherapy. Significant changes were seen in the yoga group, especially in primary outcomes such as anxiety, depression, and PTSD symptoms.
Yoga is increasingly being recognized as an effective intervention for a range of mental and physical health conditions (Brown and Gerbarg, 2005; Field, 2011). In 2006 the yoga in Australia survey was undertaken to examine the characteristics and practices of yoga students and teachers throughout Australia (Penman et al., 2012).
The survey found that although most people start a yoga practice for health and fitness benefits, many continue for stress management. Furthermore, more people practice yoga for mental health rather than
physical health conditions, suggesting that mental health may be the main health-related motivator for yoga practice (Penman et al., 2012).
Despite the positive findings, some studies have reported mixed results or no significant effects of yoga on mental health. For instance, a study by Uebelacker et al. (2010) found that yoga did not lead to significant improvements in depression and anxiety symptoms in patients with major depressive
disorder compared to a control group. However, this study had a small sample size and did not use a standardised yoga intervention.
Conclusion
Mental health is an essential component of overall health and well-being. Mental disorders lead to a poor quality of life. Mental health problems are spreading at a fast rate due to multiple reasons. Mental
health disorders such as depression, anxiety, and stress affect millions of people worldwide, leading to a significant burden on individuals and society.
The conventional treatment for mental health disorders usually involves medications and psychotherapy. There is growing research evidence supporting the use of yoga as an adjunct or combination therapy for the management of stress, anxiety, and depression.
Studies suggest that practicing yoga regularly can have significant positive effects on mental health, including reductions in symptoms of depression, anxiety, and stress, as well as improvements in overall well-being and quality of life.
Yoga, a popular and readily available mind–body practice, is safe, has a low barrier to entry, and may easily be cost-effective as it is offered to large groups. Yoga is an integrated holistic system that provides
a path to alleviate suffering physically, mentally, and emotionally, and as such may be a useful tool in the treatment of mental health conditions.
DR SIVASELVAM SIVAKUMAR is the head of the Lab and Transfusion Service and consultant histopathologist and cytopathologist at Oceania Hospitals Pte Ltd. The views expressed are his and not
necessarily of this newspaper.
