Each year the National Institute for Mental Health reports that anxiety and depressive disorders make up the largest percentage of mental health disorders recorded in the United States among adults.
This is no surprise to me since that’s pretty much all that I treat in my practice – adults with anxiety and depressive disorders. Common questions asked of me in early sessions often include: “What are you going to do to me and how long (or how many sessions) will it take?” I usually explain that, I will not do anything TO them, but rather WITH them and that there is no “magic wand” or “one size fits all” approach to helping someone with an anxiety or depressive disorder. It’s probably not the answer they are looking for, but everyone experiences depression and anxiety disorders differently and there are numerous, different types of such disorders. So, of course it follows that the treatment must vary as well to meet the individual needs of the patient. I also almost always discuss with my patients that it is impossible to expect all the change to happen solely as the result of a number of 50-minute sessions in the office.
I have always practiced from a belief that patients can benefit from “working” at improving their mental health outside sessions as well. The “outside work” used to focus more on practicing changing irrational thoughts and bibliotherapy, and sometimes it still does. However, the “work” I suggest patients consider doing outside of sessions has changed in nature over the years. What has changed is that the suggested adjuncts to therapy fall more in the domain of complementary and alternative therapies, like mindfulness and meditation, which I wrote a few years ago. In the last few years, I have also added mindful exercise, like yoga, to the tools I suggest patients try to incorporate into their journey towards better mental health.
The growing body of research on the benefits of yoga – which have included reducing muscle tension, relieving stress, sharpening attention, and calming the nervous system – have been acknowledged for more than a decade and contributed to the American Psychological Association’s acceptance of yoga as a practice tool (APA feature, Amy Novotny, Nov. 2009). Yoga has become more mainstream as evidenced by the many yoga studios and classes available in our neighborhoods, and if you ask why people take those classes, they will likely respond with a host of different answers that revolve around improving mental and physical health.
Indeed, it was two patients a few years ago that shared with me that they found regular yoga practice helped them manage their extreme anxiety symptoms, which led me to explore the components and benefits of yoga more closely. In doing so, it made sense that the most common type of yoga practiced in the U.S. (Hatha Yoga) would reduce the impact of heightened stress responses common in anxiety and depression. It entails using three elements 1) asanas or postures/poses, 2) controlled breathing practiced with the asanas and 3) a short period of deep relaxation.
Why I find this a great adjunct to psychotherapy in the office is because of the accessibility. Like any type of exercise, if you have physical health problems, you should check with your medical doctor, but yoga can really be done by most everybody and classes can vary from gentle and accommodating to strenuous and challenging. Some registered yoga instructors, like local instructor Rita Foegen, RYT of Boonton, have even adapted their classes for aging populations and offer chair-yoga, where participants don’t have to get down or up off the floor to practice helpful poses and breathing. A number of my patients over 65 find these classes very helpful. Rita, a retired advanced practice nurse, who specialized in mental health nursing and addictions, feels that the breath work and holding steady of the poses in the chair yoga class can help participants manage racing thoughts, that often come with anxiety disorders.
Additionally, for those who find it hard to go to a class because of transportation or time constraints, there are many smartphone apps and YouTube videos that teach the basics of yoga all the way up to expert level. My favorite free app is called YOGA because all the mindful yoga exercises on it can be done in 7-14 minutes per day, leaving little room for excuses!
Hayley Hirschmann, PhD