Role of Yoga and Mindfulness in Severe Mental Illnesses:
A Narrative Review
By Emily Badillo
Yoga, translated as “union,” is a philosophical science that offers body, breath, and meditation techniques and practices that have demonstrated significant results in the treatment of various physical and psychiatric disorders.
Another age-old technique, mindfulness, similarly attracts attention in the scientific sphere. Mindfulness stems from the Buddhist culture and emphasizes nonjudgmental focused attention of the present moment and acceptance of internal experiences.
Evidence-based scientists have found mindfulness to aid in improvement in coping and self-compassion, reducing stress, anxiety, depression, and obsessive-compulsive symptoms in individuals.
Most patients with severe mental illnesses (SMIs) such as schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD) have found that current pharmacological agents do not aid in attaining complete remission. Additionally, minimal effects on cognitive deficits coupled with adverse side effects of current medications have led scientists to seek out alternative therapeutic modalities such as yoga and mindfulness to aid in the treatment of SMIs.
The current study reviewed the wider scientific literature for the role of yoga and mindfulness interventions in the treatment of SMIs. Sathyanarayanan and colleagues (2019) reviewed scientific literature from the past 10 years that focused on either yoga therapy (YT) or mindfulness-based interventions (MBI) that ranged from 40 to 90 min and 60 to 120 min per session in the YT and MBI groups, respectively.
“The current study concludes with emphasizing the importance of integrating yoga and mindfulness interventions as add-on therapy for major mental health disorders.”
Effects of YT and MBI on schizophrenia and other psychotic spectrum disorders
Both YT and MBI found positive functional outcomes for schizophrenic individuals including better social and occupational functioning, quality of life, achieving functional remission, flexibility of thinking, subjective well-being, improvements in state anxiety, reduction of paranoid beliefs hygiene, life skills, interpersonal activities, and communication. To note, clinicians may want to consider sleep-deprivation or stress derived psychosis and mania before suggesting yoga or yoga-trainings to certain patients (Lu and Pierre, 2007).
YT and MBI in bipolar disorder
The review also examined the effects of YT and MBI on BD. Of those included, YT and MBI were found to improve focusing ability, relaxation, distraction from negative thoughts, a sense of accomplishment, reduction in anxiety and depression, and reduction of negative effects such as agitation with rapid breathing. YT and MBI have also been found to induce a sense of stability in participants that is self-reported to help with managing mood changes and further relapse and facilitate reframing negative thoughts. On the other hand, one study found that heated energetic yoga facilitated patients from hypomanic to manic states and found an increase in depression-like symptoms with meditation, thus further research is required to fully understand how YT and MBI effect BD.
YT and MBI in major depressive disorder
Both YT and MBI have demonstrated significant improvement in depression. Interestingly, YT has also been found to improve anxiety, increase behavioral activation, and increase life satisfaction in depressed patients. Maintenance of positive effects produced require continued practice of mindfulness skills and depressive symptoms appear to be directly related to the baseline magnitude of depression.
Sathyanarayanan and colleagues emphasize that the studies included in this review, similar to the greater body of scientific literature, have several limitations. Some limitations include patients groups initially experiencing low levels of symptom severity before treatment, lack of waitlist control groups, varying frequencies and lengths of time in each session of yoga and mindfulness-based training and practice, and a lack of personalized instruction from a trained yoga therapist. These limitations can be addressed in future research studies.
The current study concludes with emphasizing the importance of integrating yoga and mindfulness interventions as add-on therapy for major mental health disorders. Further systematic studies are needed to study the beneficial effects and potential neurobiological mechanisms to fully understand the clinical application of yoga therapy and mindfulness-based interventions in the treatment of severe mental illness.
