This is a guest post by my Mother, Mrs. Suniti Patanaik. She is a Yoga therapist from Bihar School of Yoga. She can be contacted at sunitiin<at the rate>gmail.com
Depression is an illness that involves the body, mood and thought. It a one feels affects the way a person eats and sleeps, the way one thinks about things. People with depressive illness can’t merely pull themselves together and get better. Depression is a stress related illness. It is the most common illness most people suffer at some time of their life. One in six women and one in nine men suffer from depression. Depression does not always have a definite cause and can strike suddenly. It is related to stress, mostly emotional and if you are under stress for a long period you are likely to become depressed. Your depression may start with a feeling of being under the weather. When depression begins you feel low, your self esteem falls and you lose your motivation. Procrastination sets in and you feel worst. This is the start of a spiral downwards.
Depression disorders come in different forms just as is the case with other illness such as heart diseases. When we hear the word “depression” the first thing that comes to our mind is sadness. Depression is a state of sadness.
- Simple depression- it lasts for short time and can be treated easily.
- Major depression (MD) - it is the form of depression which is of grave concern for the family members of the patient. It is also called clinical depression. Major depression is a mental condition characterized by severe state of sadness or melancholy that has reached the point of hindering a person from functioning well socially. Episodes of MD may occur suddenly or gradually and usually lasts several months. It is common for episodes to recur and suicide is the major risk. MD is currently leading cause of disability in North America as well as in other countries and expected to become the second leading cause of disability worldwide by year 2020 according to WHO
- Dysthymia- this is long term depression that lasts for at least two years. Its symptoms are the same but not as intense as those of MD, although people who suffer from dysthymia are also prone to major depression.
- Bipolar depression- This is characterized by mood swings that go from depression to mania (extremely elevated mood) and vice versa.
- Post Partum Depression- This is experienced by women sometime in the first two years after giving birth as a result of physical, mental and emotional fatigue. This type of depression must be treated immediately as it deters the mother from being with her new born baby.
- Seasonal affective disorder (SAS)- Also known as winter depression. A person who has SAD possesses normal health condition throughout the year but suffers from depression during winter.
In this article we will deal with the case of major depression, which as mentioned above is the major cause of suicide.
Signs and Symptoms-
- Persistent sad, anxious or empty mood
- Loss of appetite and/or weight loss or over eating and weight gain.
- Insomnia, early morning awakening or oversleeping.
- Restlessness or irritability
- Feeling of worthlessness, inappropriate guilt, helplessness
- Feeling of hopelessness, pessimism.
- Difficulty in thinking, concentrating, remembering or making decisions.
- Thoughts of death or suicide or suicide attempts.
- Loss of interest or pleasure in hobbies and activities that were once enjoyed including sex.
- Decreased energy, fatigue, feeling sluggish.
- Persistent physical symptoms that do not respond to treatment such as head ache, digestive disorders and chronic pain.
The cause of MD can’t be narrowed down to a single factor. However it appears that brain chemistry plays a major role in the disorder. Brain chemicals called neurotransmitters convey messages b/w nerves. Too many or too few neurotransmitters particularly nor epinephrine, serotonin and dopamine are believed to cause alternation in mood but root cause of brain chemistry disorder is due to stress specifically emotional and mental like death of a loved one, divorce, death of a parent, issue with biological development, school related problems, abandonment or rejection, neglect, chronic illness, physical, psychological or sexual abuse can also increase likelihood of depression later in life. Job loss, poverty, financial difficulties, gambling addiction, eating disorders, long periods of unemployment, loss of spouse or any family members, rape, inability to have proper sex, premature ejaculation, other traumatic events, long term stress at home may trigger MD. Unrealistic or unreachable expectations or life goals or major obstacles to life goals and expectation may increase risk of MD.
The major risk of MD is suicide. According to National Mental Health Association suicide is the third leading cause of death in adolescents and second leading cause of death in collage going youth. It is believed that most of the suicide victims suffer from untreated depression.
- Psychotherapy or talk therapy. Some people with milder forms may do well psychotherapy alone.
- Medication: Medicines include antidepressants. It may include selective serotonin reuptake inhibitors. These antidepressants increase the level of serotonin in brain. Tri cyclic antidepressant alters the level of several chemicals in brain. Monamin oxidase inhibitors are also used for depression patients.
- Electro-convulsive therapy- It is a procedure in which an electric current is used to produce a seizure in the patient.
- Vogal nerve stimulation- It is devised to treat adult patients with long term or recurrent MD.
- Alternative treatment- It aims at reducing stress by providing forms of relaxation and relief thereby bringing about general health and well being. Alternative therapy includes acupuncture, guided imagery, zero chiropractic treatments, yoga, hypnosis, bio feedback, aroma therapy, relaxation, herbal remedies, massage and many others.
By now this must be clear that medication can’t be sole treatment for depression. Despite the fact that medication works by providing relief by suppressing the effects of depression, but fails to provide cure for sole cause of it. So medication must be complimented with some sort of treatment that will aid it by answering the cause. As depression is stress related disorder it can’t only be treated with medication. Medication is greatly useful in severe form of depression. It just lifts the person from severe agony for time being. No doctors will advice his patient to rely only on medicine. They will surely advice you to follow other methods like exercise to come out of serious situation quickly. Besides that there are some drawbacks of anti depressants like nausea, sudden and severe head ache, stiff neck, rapid heartbeat and palpitation, confusion and sweating. Anti depressants may be monitored closely for unusual changes in behavior. Exercise has shown to have positive antidepressant effects in individuals. While medication can help to improve depressive symptom it can’t change the events, thoughts or behaviour that are problematic or distressing for a patient. For some people MD may not be preventable. A healthy lifestyle that includes a balanced diet and exercise and strong social and interpersonal relations may help.
Now we come to Yoga. What it can do to a depression patient. Though some doctors advise yoga with medication but a yoga therapist knows it is a complete therapy in itself. In allopathic treatment along with medication counseling is said to be the main course of the treatment. As it is a stress related problem the root cause starts from close environment of patient. But often it happens, the close relatives of the patient are unable to understand the problem of the patient rather than aggravate the situation. The role of near and dear ones is very important for the patient to overcome the situation. But often it doesn’t happen so. For this reason some patients commit suicide. It is a traumatic situation which the near and dear one has to handle carefully. If the patient gets support from environment he or she may overcome the situation in no time, though this happens rarely. In this situation yoga helps the patient in such a way that the attitude of the patient changes automatically. How?
According to Yogic philosophy what happens during stress? When we come under stress the first attack is on our nervous system. The autonomous nervous system comes under severe attack. Then what happens? Our breathing pattern changes, it becomes shallow and unrhythmic, respiration rate changes drastically. As the breathing pattern changes it attacks the endocrine system of the body, natural imbalance of these is hormonal imbalance in our body and mind. Because of hormonal imbalance some toxins are produced in body and mind. The toxins that are produced in the body are acid, gas and mucus. Toxins of mind are negative thoughts, distraction and ignorance. In terms of Yogic philosophy negative thoughts are produced by over dominance of any of the six demons residing inside us . They are kama(lust), krodha(anger), lobha(greed), moha(infatuation), abhimana(pride) and mada(arrogance). In case of depression mostly over dominance of kama and moha over the mind is the cause. So in first step of yoga therapy we purify body and mind through shatkarmas (purification process) by reducing excessive toxins in body. Then we adopt various asanas(postures). Asanas are synonymous with exercise but with more benefit. In Hatha Yoga breathing is the main thing we practise. By correcting the breathing pattern we control the nervous system. The asanas are specially designed in such a way that it supply sufficient amount of oxygenated blood to the organ which is under attack, the brain. In case of depression those asanas are adapted which induces sufficient blood supply to the brain as well as all parts of body like.
- The Sun salutation
- Bow pose
- Corpse pose
- Maha mudra
- Plough pose
- Shoulder stand
In case of depression we call the prana(vital energy) has become very weak. According to Yogic philosophy prana, the vital energy or the current is responsible for all work carried out in our body, without it not a single part of the body or mind functions. In case of depression the voltage of this energy is so low that it is unable to run the machineries inside us. Our consciousness and mind all which requires oxygen and in that sense oxygen and prana can be considered equivalent. It plays essential role in all chemical and metabolic processes in body right down to the level of DNA. When that prana is weak it attacks the mind, it is distracted to such an extent that it doesn’t come under control. Through the practice of pranayam we bring the mind under control because prana and mind are two sides of same coin. One can control prana by controlling the mind and vice versa. But controlling prana through pranayama is easiest way which everyone can do and can control the mind. But it is very difficult to control the mind and thereafter control the prana.
Ujjayi pranayama is said to be more beneficial for depression than other pranayams including bhasttrika, suryabhedi pranayam, kapalbhati and nadisodhan. But a systematic and correct practise of pranayama under guidance of a guru will help the patient most. Adoption of some mudras, bandhas, yoganidra and meditation are helpful to some patients. Only a therapist can judge which are most beneficial to a patient. To get maximum benefit one must practise under the guidance of a qualified therapist.
The other form of yoga called as mantra yoga has great effect over the mind. Both medical science and yoga believe in counseling which is must for depression patients. In yoga we call it satsanga which is easily available now days in TV. In western countries there are sufficient counseling centre for these patients but in India counseling centers are very few. But Satsanga is easily available, it helps to change ones attitude towards life. It teaches one the art of living in all adverse situations.
Lastly, I’ll say that depression is a disorder which can attack any person at any time, no matter how strong one may be. Regular practice of Asanas and Pranayam prevents occurrence of depression and with time cures depression also. Those depression patients who are in medication for long period have to gradually reduce their medication in consultation with the doctor.
From our history we know Abraham Lincon, Wilson Churchill, Queen Victoria also suffered from depression. We also know that that the Hindu mythology Gita is the outcome of depression. When Arjun was in severe depression Lord Krishna counseled and taught all forms of Yoga. It is obvious that from Mahabharata era counseling is the first form of treatment for depression. In Ramayana era also we know King Dashratha died of depression.
In Yoga sutras, Rishi Patanjali states that our inner obstacles create a mental distraction which in turn leads to Daur Manasya, depression. These inner obstacles can be removed by the practice of yogic techniques asanas, pranayama and meditation. Besides that light therapy, message, change of environment may be adopted for further benefit.
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