March 21 by The Running Son
Pranayama and its Effects on Anxiety
by Helen Manzella
Posted on 5/5/2012 at http://yogatheoryculturepractice.blogspot.com
by Helen Manzella
Anxiety in its purest form is our body’s natural way of telling us to prepare ourselves for impending danger. Anxiety is a physiological adaptation to help us mechanize quickly against threat. The response of our body allows us to function at a high level of performance in a situation that requires our most needed energy. Anxiety only becomes dangerous when that response starts to trigger all the time, even when there is no actual danger present. When one becomes anxious in an unhealthful way the person afflicted tends to feel distress and fear that interferes with their ability to function normally. In effect, the sufferer is not equipped to deal with the everyday challenges and motions of life.
In biological terms this response is called “fight-or-flight” which is an evolutionary adaptation that once in prehistoric times helped us defend against predators, or quickly beckoned us to grab our young and retreat to a safe cave when our tribe was under attack. The [fight-or flight] “response occurs to any perceived threat, whether it is physically real, psychologically upsetting, or even imaginary” (Khalsa, 256). This response occurs in our Central Nervous System. The nervous system is linked to our brain, spinal cord and peripheral nerves, which are divided into two separate parts: the voluntary nervous system and the involuntary (or autonomic) nervous system. The voluntary nervous system controls your immediate reactions to sensory stimuli, such as the action of touching a hot stove, and quickly removing your hand once the pain fibers are engaged and sent to your brain. All of this happens quickly, without one having to “think” about it. The autonomic nervous system on the other hand, controls the functions unbeknown to us during our daily functioning such as: muscle tension, pulse rate, respiration, glandular function and the circulation of the blood.
The autonomic nervous system is divided into two separate parts as well which are called the sympathetic and parasympathetic nervous systems. These two system’s jobs are to balance and regulate the body. If we become frightened and our heart starts pumping incredibly hard the parasympathetic nervous system will intervene and slow down the heart rate. If the heart rate then drops too dramatically the sympathetic nervous system then will begin to speed up the heart rate to keep the body functioning on a sustainable level. Inside the body when our sympathetic nervous system becomes engaged the adrenal glands increase adrenaline and cortisone production. This is what causes the common symptoms people often associate with anxiety. For instance, the heart rate begins to soar and the breathing becomes shallow, the hands and feet become cold and muscles tighten and contract.
Since the 1970’s researchers have been testing how yoga and other stress-reduction and meditation techniques can reduce the presence of anxiety. With research still on the rise today, yoga has been greatly commended for its triumphs in “modulating stress response systems” (Kirkwood, 890). The physiological symptoms associated with anxiety mentioned previously have all been found to become significantly reduced in many cases of research, including heart rate, blood pressure, and respiration.
A particular form of yoga, which invites controlled breathing, was studied for its positive affects on eliminating anxiety. The breath-work yoga technique is called Sudarshan Kriya yoga (SKY). SKY “involves several types of cyclical breathing patterns, ranging from slow and calming to rapid and stimulating” (Janakiramaiah, 258). In one study, participants conducted 30 minutes of SKY breathing six days a week. This study compared the use of this breathing technique with bilateral electroconvulsive therapy and the antidepressant, Imipramine in 45 people who were hospitalized for anxiety/depression.
The study showed that out of the participants who used the SKY breathing technique, 67% achieved remission. Although the participants who received electroconvulsive treatment (93%) and Imipramine (73%) achieved a greater success rate then those who participated in SKY breathing, the study reveals a notably positive improvement which is still incredibly valuable. This technique offers a natural, healthy and safe alternative to deal with this disorder.
There are four focal techniques used in SKY breathing. The first is called Ujjayi or “Victorious Breath,” it is also sometimes referred to as “Ocean Breath.” It is called this “because the sound created by the gentle contraction of the laryngeal muscles (respiratory and phonoatory) and partial closure of the glottis (vocal cords) is reminiscent of the sound of the sea” (Brown, 711). The effect that this technique has on the subject is that of mental calmness and alertness. The next technique is called the Bhastrika or “Bellows Breath.” During Bhastrika “air is rapidly inhaled and forcefully exhaled at a rate of 30 breaths per minute (Brown, 711). Bhastrika breathing is said to create a sense of extreme excitement, quickly followed by a deep feeling of calm. During very long bouts of exhalation the “Om” mantra is also chanted three times. This helps center the body and bring focus and awareness to the breath. Finally, Sudarshan Kriya or “Proper Vision by Purifying Action” is an advanced form of cyclical breathing that alternates between slow, medium and faster speeds.
The SKY method has been shown to reduce anxiety in medical students with examination anxiety, caregivers of demented persons and patients with mild anxiety disorders. In stressful situations the Ujjayi method can be employed to help restore a sense of control in the person suffering. It is urged however that patients who are about to begin treatment with SKY should be slowly assimilated into the treatment for fear that the rapid breathing techniques may mirror too closely the symptom of hyperventilation, that are all too familiar to those who suffer from panic attacks. For this reason, it is very important that the instructor remind the patient that at anytime they may discontinue their rapid breath and return to a medium or slow cycle of breathing that feels easeful and comfortable to them. The patient should also be informed that just because of the rapidness of breath this does not mean that they need to exhale forcefully. The over-exhalation of carbon dioxide can induce tingling and cramping in the extremities that can prove to be counterproductive in the alleviation of anxiety. Some symptoms that go hand in hand with overuse of the SKY method are dizziness, lightheadedness, irritability, euphoric states, and psychosis. So it is also very important that the student make sure to follow the “prescribed” amount given to them by their instructor.
The SKY method is said to be most effective when paired appropriately with pranayama, asanas, and meditation. From documented evidence it can be concluded that Sudarshan Kriya Yoga is a “potentially beneficial, low-risk adjunct for the treatment of stress, anxiety, PTSD, depression, stress-related medical illnesses, substance abuse, and for the rehabilitation of criminal offenders”(Brown, 715). On a simpler note, yoga has much history and literature to back its remarkable outcomes. It has been widely agreed upon amongst researchers, physicians and scientists that yoga is a dependable practice to help stabilize mood, attention, mental focus and improve overall well being in its followers. Yoga has also been praised for its mass accessibility; the more habitual the practice becomes in one’s daily routine the greater the results. It is also suggested that one make sure they have a reliable yoga instructor that can provide important advice. It is also recommended that it is most beneficial if he person can attend weekly sessions in which members of the group can process and share their experiences amongst themselves as well as support one another fully.
The use of breath work, or pranayama, is useful to those who suffer from anxiety particularly because breathing exercises help combat the physiological symptoms such as, short, tight upper-chest breathing. Relaxation is the key to the elimination of anxiety because when one deepens the breath by lengthening the exhalation they are reducing the short shallowness of breath that is associated with the inhalation. It is maintained that this lengthening of the exhalation can help the person achieve a healthy level of carbon dioxide in the bloodstream that helps in the relaxation process.
One technique that can be particularly helpful for the eradication of anxiety in pranayama is called Bahmari, which in Sanskrit means “bee.” Appropriately given because of the buzzing sound one makes when they are doing this technique. To practice Brahmari pranayama, find a place that is quiet and sit comfortably, with the spine elongated, the shoulders relaxed and the shoulder blades rotated toward one another. Start the exercise taking breaths as your body would naturally, without effort. You may close your eyes, but it is also perfectly acceptable to keep them slightly open if that feels more comfortable. Keep the lips slightly sealed, but do not tighten them or clench the jaw, inhale deeply through the nostrils, exhaling completely all of the air in you diaphragm, make the sound of the letter “M.” Hold the sound for as long as possible before the inclination to inhale once again arises. Repeat this for several minutes making sure to bring awareness to your body’s limitations and sensations.
The point is not to exhaust or push yourself, you want the exercise to be stress relieving not stress inducing. Finally when you feel satisfied with the practice sit there and take a few breaths and inquire into how you are feeling in your body in that very moment. Do you notice a change in your mood or breath or do you feel calmer? Even if the exercise did not successfully alleviate your anxiety, it is important to tune into that feeling and notice it, you will still be building a strong foundation for future practice. Be mindful of this reality. The more effort you give to keeping with practices like this one, the easier it becomes to master your anxiety.
Another study involving yoga and its potential benefits to those who suffer from anxiety was taken at the All India Institute of Medical Science in New Delhi. The overall aim of the study was to research the short-term impact of a comprehensive but brief lifestyle intervention based on yoga and anxiety levels in normal and diseased subjects. The sufferers that participated in the study had a variety of illnesses including hypertension, coronary artery disease, diabetes, obesity, gastrointestinal problems, thyroid disorders and psychiatric concerns (which anxiety fell under). Although the study included several different categories of intervention, the focus on pranayama is one that will be given particular attention. Anxiety is treated as the largest major concern that contributes to unhealthy lifestyles and eventually manifests itself as “pathogenesis of not only psychiatric but also systemic disorders” (Grupta, 42). The article also insists that the intervention of anxiety is absolutely necessary if the person with disease wants to prevent and manage their disease on a long-term basis.
The study was made up of 175 subjects in total who ranged from 19-76 years in age. The program that the subjects endured was an 8-day outpatient course that was comprised of 3-4 hours of daily practice and lasted 10 days. As a part of a normal day the patients would start by doing asanas (postures) followed by pranayama (breathing) for 1 hours time. Along with the physical practice they also were counseled on how to make proper nutritional choices and engage in other relaxation activities. The ending of the day concluded with shavasana (relaxation technique) or meditation. The pranayama techniques that were covered in the course were dog breathing, tiger breathing, hands in and out breathing, interlocked hand position breathing, chest holding breathing and stretch breathing.
During the activities the anxiety levels of the participants were assessed using a questionnaire called the ‘State Trait Anxiety Inventory’ (STAI) (8). STAI is a self-report method of assessment that is made up of two types of measurements. The first measurement is called State anxiety (S-Anxiety). “S-Anxiety is defined as a transitory emotional state characterized by consciously perceived feeling of tension and apprehension. Trait anxiety (T-Anxiety) refers to relatively stable individual differences in anxiety proneness” (Grupta, 44). Along with the original assessment process, is the process of subscale assessment in which the participants are asked to provide statements that they would use to describe themselves. The qualities they evaluate are on the basis of feelings of apprehension, tension, nervousness, and worry.
The results of this study concluded that at the end of the 10-day program both the State and Trait Anxiety scores were “significantly lower than at the beginning in the intervention group” (Grupta, 45). In the intervention group the mean scores for total anxiety were 24.4, the State Anxiety (12.4) and Trait Anxiety (12.0). By the end of the 10-day period the total mean had dropped to 22.0, State Anxiety (11.0) and Trait Anxiety (10.6). The study found that overall Yogic relaxation which includes pranayama, amongst asana, relaxation techniques, and advice on how to conduct a healthier lifestyle all reduced the physiological symptoms of anxiety such as racing heart, palpitations, tremors, sweating, increased blood pressure, dry mouth, avoidance behavior, signs of restlessness, and heightened responsiveness. In essence the study proved that psychological stress has a clear correlation with the risk of disease and proved the validity of pranayama and other yogic stress- relieving techniques as valuable strategies to prevent anxiety.
Through the techniques of Sudarshan Kriya Yoga and other pranic forms of breathing a sufferer of chronic anxiety has the opportunity to reduce the presence of both their physiological symptoms and the psychological problems beneath them. Pranayama and yogic breath work offers a safe, gentle and very effective alternative to medical treatment and the use of prescription drugs to help reduce anxiety. It seems that the commitment to a yogic lifestyle is indicative to living a life in which the whole body’s health is attended to. One cannot employ just one strategy and continue on with all of their same destructive habits. It is a commitment to the highest degree. It is important that in conjunction with pranayama techniques one must also make an attempt to radically improve their lifestyle. The practice of pranayama is only effective if it is done consistently and with awareness. One must pay attention to what is going on in their body and listen deeply to these inner cues; otherwise the practice will bare little effectiveness for the afflicted person.
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Pranayama and its Effects on Anxiety
Yoga: Theory, Culture and Practice
Professor Laura Douglas