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Can Yoga Reduce Symptoms of Anxiety and Depression?
Yes, yoga can reduce symptoms of anxiety and depression (strength of recommendation [SOR]: B, systematic reviews of randomized controlled trials [RCTs] with significant heterogeneity). Across multiple RCTs using varied yoga interventions and diverse study populations, yoga typically improves overall symptom scores for anxiety and depression by about 40%, both by itself and as an adjunctive treatment. It produces no reported harmful side effects.
EVIDENCE SUMMARY
Across 3 systematic reviews of yoga for depression, anxiety, and stress, yoga produced overall reductions of symptoms between 12% and 76%, with an average of 39% net reduction in symptom scores across measures (TABLE).1-3 The RCTs included in the systematic reviews were too heterogeneous to allow quantitative analyses of effect sizes.
Yoga found to significantly reduce depression symptoms
Two 2012 systematic reviews of yoga for depression evaluated 13 RCTs with a total of 782 participants, ages 18 to 80 years with mild to moderate depression. In the 12 RCTs that reported gender, 82% of participants were female; in 6 RCTs a total of 313 patients had cancer.1,2
The RCTs compared yoga to wait-list controls, counseling, education, exercise, or usual care. They evaluated yoga both as a stand-alone intervention and an adjunct to usual care. Yoga sessions varied from 1 hour weekly to 90 minutes daily over 2 to 24 weeks and included physical postures, relaxation, and breathing techniques.
Eight moderate- to high-quality RCTs with a total of 483 participants reported statistically significant reductions in depression symptoms in the yoga groups compared with control groups. In 3 RCTs, yoga was equivalent to wait-list controls; 2 RCTs showed results equivalent to exercise and superior to wait-list controls.
Yoga alleviates anxiety and stress without adverse effects
A 2012 systematic review of yoga for stress and anxiety evaluated 10 RCTs with a total of 813 heterogeneous participants, ages 18 to 76 years, including pregnant women, breast cancer patients, flood survivors, healthy volunteers, patients with chronic illnesses, perimenopausal women, adults with metabolic syndrome, and people working in finance, all with a range of anxiety and stress symptoms.3 The RCTs compared yoga, as an adjunctive or stand-alone treatment, with wait-list controls, relaxation, therapy, anxiety education, rest, or exercise. Yoga regimens varied from a single 20-minute session to 16 weeks of daily 1-hour sessions, with most regimens lasting 6 to 10 weeks.
Of the 10 RCTs reviewed, 7 moderate- to high-quality studies with a total of 627 participants found statistically significant reductions in anxiety and stress in yoga groups compared with control groups. Of the remaining 3 studies, 1 found yoga equivalent to cognitive therapy; 1 found a nonsignificant benefit for yoga compared with wait-list controls; and 1 found no improvement with either yoga or relaxation.
Study limitations included a range of symptom severity, variable type and length of yoga, lack of participant blinding, wait-list rather than active-treatment controls, and a lack of consistent long-term follow-up data. The RCTs didn’t report any adverse effects of yoga, and yoga is considered safe when taught by a competent instructor.3,4
Continue for recommendations >>
recommendations
The Institute for Clinical Systems Improvement and the Canadian Network for Mood and Anxiety Treatments recommend yoga as an effective adjunctive treatment to decrease the severity of depression symptoms.5,6
The Veterans Health Administration and the US Department of Defense recommend yoga as a potential adjunctive treatment to manage the hyperarousal symptoms of post-traumatic stress disorder (PTSD).7
The Work Loss Data Institute recommends yoga as an intervention for workers compensation conditions including occupational stress, major depressive disorder, PTSD, and other mental disorders.8
1. Balasubramaniam M, Telles S, Doraiswamy PM. Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders. Front Psychiatry. 2012;3:117.
2. D’Silva S, Poscablo C, Habousha R, et al. Mind-body medicine therapies for a range of depression severity: a systematic review. Psychosomatics. 2012;53:407-423.
3. Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17:21-35.
4. Brown RP, Gerbarg PL. Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II—clinical applications and guidelines. J Altern Complement Med. 2005;11:711-717.
5. Mitchell J, Trangle M, Degnan B, et al. Institute for Clinical Systems Improvement. Adult depression primary care. Available at: https://www.icsi.org/_asset/fnhdm3/Depr-Interactive0512b.pdf. Updated September 2013. Accessed March 6, 2014.
6. Ravindran AV, Lam RW, Filteau MJ, et al; Canadian Network for Mood and Anxiety Treatments (CANMAT). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments. J Affect Disord. 2009;117(suppl 1):S54-S64.
7. US Department of Veterans Affairs. VA/DoD clinical practice guideline for management of post-traumatic stress disorder and acute stress reaction. US Department of Veterans Affairs Web site. Available at: http://www.healthquality.va.gov/ptsd/. Accessed March 6, 2014.
8. Agency for Healthcare Research and Quality. Mental illness & stress. Agency for Healthcare Research and Quality Web site. Available at: http://www.guideline.gov/content.aspx?id=47588. Updated May 2011. Accessed June 17, 2014
Yes, yoga can reduce symptoms of anxiety and depression (strength of recommendation [SOR]: B, systematic reviews of randomized controlled trials [RCTs] with significant heterogeneity). Across multiple RCTs using varied yoga interventions and diverse study populations, yoga typically improves overall symptom scores for anxiety and depression by about 40%, both by itself and as an adjunctive treatment. It produces no reported harmful side effects.
EVIDENCE SUMMARY
Across 3 systematic reviews of yoga for depression, anxiety, and stress, yoga produced overall reductions of symptoms between 12% and 76%, with an average of 39% net reduction in symptom scores across measures (TABLE).1-3 The RCTs included in the systematic reviews were too heterogeneous to allow quantitative analyses of effect sizes.
Yoga found to significantly reduce depression symptoms
Two 2012 systematic reviews of yoga for depression evaluated 13 RCTs with a total of 782 participants, ages 18 to 80 years with mild to moderate depression. In the 12 RCTs that reported gender, 82% of participants were female; in 6 RCTs a total of 313 patients had cancer.1,2
The RCTs compared yoga to wait-list controls, counseling, education, exercise, or usual care. They evaluated yoga both as a stand-alone intervention and an adjunct to usual care. Yoga sessions varied from 1 hour weekly to 90 minutes daily over 2 to 24 weeks and included physical postures, relaxation, and breathing techniques.
Eight moderate- to high-quality RCTs with a total of 483 participants reported statistically significant reductions in depression symptoms in the yoga groups compared with control groups. In 3 RCTs, yoga was equivalent to wait-list controls; 2 RCTs showed results equivalent to exercise and superior to wait-list controls.
Yoga alleviates anxiety and stress without adverse effects
A 2012 systematic review of yoga for stress and anxiety evaluated 10 RCTs with a total of 813 heterogeneous participants, ages 18 to 76 years, including pregnant women, breast cancer patients, flood survivors, healthy volunteers, patients with chronic illnesses, perimenopausal women, adults with metabolic syndrome, and people working in finance, all with a range of anxiety and stress symptoms.3 The RCTs compared yoga, as an adjunctive or stand-alone treatment, with wait-list controls, relaxation, therapy, anxiety education, rest, or exercise. Yoga regimens varied from a single 20-minute session to 16 weeks of daily 1-hour sessions, with most regimens lasting 6 to 10 weeks.
Of the 10 RCTs reviewed, 7 moderate- to high-quality studies with a total of 627 participants found statistically significant reductions in anxiety and stress in yoga groups compared with control groups. Of the remaining 3 studies, 1 found yoga equivalent to cognitive therapy; 1 found a nonsignificant benefit for yoga compared with wait-list controls; and 1 found no improvement with either yoga or relaxation.
Study limitations included a range of symptom severity, variable type and length of yoga, lack of participant blinding, wait-list rather than active-treatment controls, and a lack of consistent long-term follow-up data. The RCTs didn’t report any adverse effects of yoga, and yoga is considered safe when taught by a competent instructor.3,4
Continue for recommendations >>
recommendations
The Institute for Clinical Systems Improvement and the Canadian Network for Mood and Anxiety Treatments recommend yoga as an effective adjunctive treatment to decrease the severity of depression symptoms.5,6
The Veterans Health Administration and the US Department of Defense recommend yoga as a potential adjunctive treatment to manage the hyperarousal symptoms of post-traumatic stress disorder (PTSD).7
The Work Loss Data Institute recommends yoga as an intervention for workers compensation conditions including occupational stress, major depressive disorder, PTSD, and other mental disorders.8
Yes, yoga can reduce symptoms of anxiety and depression (strength of recommendation [SOR]: B, systematic reviews of randomized controlled trials [RCTs] with significant heterogeneity). Across multiple RCTs using varied yoga interventions and diverse study populations, yoga typically improves overall symptom scores for anxiety and depression by about 40%, both by itself and as an adjunctive treatment. It produces no reported harmful side effects.
EVIDENCE SUMMARY
Across 3 systematic reviews of yoga for depression, anxiety, and stress, yoga produced overall reductions of symptoms between 12% and 76%, with an average of 39% net reduction in symptom scores across measures (TABLE).1-3 The RCTs included in the systematic reviews were too heterogeneous to allow quantitative analyses of effect sizes.
Yoga found to significantly reduce depression symptoms
Two 2012 systematic reviews of yoga for depression evaluated 13 RCTs with a total of 782 participants, ages 18 to 80 years with mild to moderate depression. In the 12 RCTs that reported gender, 82% of participants were female; in 6 RCTs a total of 313 patients had cancer.1,2
The RCTs compared yoga to wait-list controls, counseling, education, exercise, or usual care. They evaluated yoga both as a stand-alone intervention and an adjunct to usual care. Yoga sessions varied from 1 hour weekly to 90 minutes daily over 2 to 24 weeks and included physical postures, relaxation, and breathing techniques.
Eight moderate- to high-quality RCTs with a total of 483 participants reported statistically significant reductions in depression symptoms in the yoga groups compared with control groups. In 3 RCTs, yoga was equivalent to wait-list controls; 2 RCTs showed results equivalent to exercise and superior to wait-list controls.
Yoga alleviates anxiety and stress without adverse effects
A 2012 systematic review of yoga for stress and anxiety evaluated 10 RCTs with a total of 813 heterogeneous participants, ages 18 to 76 years, including pregnant women, breast cancer patients, flood survivors, healthy volunteers, patients with chronic illnesses, perimenopausal women, adults with metabolic syndrome, and people working in finance, all with a range of anxiety and stress symptoms.3 The RCTs compared yoga, as an adjunctive or stand-alone treatment, with wait-list controls, relaxation, therapy, anxiety education, rest, or exercise. Yoga regimens varied from a single 20-minute session to 16 weeks of daily 1-hour sessions, with most regimens lasting 6 to 10 weeks.
Of the 10 RCTs reviewed, 7 moderate- to high-quality studies with a total of 627 participants found statistically significant reductions in anxiety and stress in yoga groups compared with control groups. Of the remaining 3 studies, 1 found yoga equivalent to cognitive therapy; 1 found a nonsignificant benefit for yoga compared with wait-list controls; and 1 found no improvement with either yoga or relaxation.
Study limitations included a range of symptom severity, variable type and length of yoga, lack of participant blinding, wait-list rather than active-treatment controls, and a lack of consistent long-term follow-up data. The RCTs didn’t report any adverse effects of yoga, and yoga is considered safe when taught by a competent instructor.3,4
Continue for recommendations >>
recommendations
The Institute for Clinical Systems Improvement and the Canadian Network for Mood and Anxiety Treatments recommend yoga as an effective adjunctive treatment to decrease the severity of depression symptoms.5,6
The Veterans Health Administration and the US Department of Defense recommend yoga as a potential adjunctive treatment to manage the hyperarousal symptoms of post-traumatic stress disorder (PTSD).7
The Work Loss Data Institute recommends yoga as an intervention for workers compensation conditions including occupational stress, major depressive disorder, PTSD, and other mental disorders.8
1. Balasubramaniam M, Telles S, Doraiswamy PM. Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders. Front Psychiatry. 2012;3:117.
2. D’Silva S, Poscablo C, Habousha R, et al. Mind-body medicine therapies for a range of depression severity: a systematic review. Psychosomatics. 2012;53:407-423.
3. Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17:21-35.
4. Brown RP, Gerbarg PL. Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II—clinical applications and guidelines. J Altern Complement Med. 2005;11:711-717.
5. Mitchell J, Trangle M, Degnan B, et al. Institute for Clinical Systems Improvement. Adult depression primary care. Available at: https://www.icsi.org/_asset/fnhdm3/Depr-Interactive0512b.pdf. Updated September 2013. Accessed March 6, 2014.
6. Ravindran AV, Lam RW, Filteau MJ, et al; Canadian Network for Mood and Anxiety Treatments (CANMAT). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments. J Affect Disord. 2009;117(suppl 1):S54-S64.
7. US Department of Veterans Affairs. VA/DoD clinical practice guideline for management of post-traumatic stress disorder and acute stress reaction. US Department of Veterans Affairs Web site. Available at: http://www.healthquality.va.gov/ptsd/. Accessed March 6, 2014.
8. Agency for Healthcare Research and Quality. Mental illness & stress. Agency for Healthcare Research and Quality Web site. Available at: http://www.guideline.gov/content.aspx?id=47588. Updated May 2011. Accessed June 17, 2014
1. Balasubramaniam M, Telles S, Doraiswamy PM. Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders. Front Psychiatry. 2012;3:117.
2. D’Silva S, Poscablo C, Habousha R, et al. Mind-body medicine therapies for a range of depression severity: a systematic review. Psychosomatics. 2012;53:407-423.
3. Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17:21-35.
4. Brown RP, Gerbarg PL. Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II—clinical applications and guidelines. J Altern Complement Med. 2005;11:711-717.
5. Mitchell J, Trangle M, Degnan B, et al. Institute for Clinical Systems Improvement. Adult depression primary care. Available at: https://www.icsi.org/_asset/fnhdm3/Depr-Interactive0512b.pdf. Updated September 2013. Accessed March 6, 2014.
6. Ravindran AV, Lam RW, Filteau MJ, et al; Canadian Network for Mood and Anxiety Treatments (CANMAT). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments. J Affect Disord. 2009;117(suppl 1):S54-S64.
7. US Department of Veterans Affairs. VA/DoD clinical practice guideline for management of post-traumatic stress disorder and acute stress reaction. US Department of Veterans Affairs Web site. Available at: http://www.healthquality.va.gov/ptsd/. Accessed March 6, 2014.
8. Agency for Healthcare Research and Quality. Mental illness & stress. Agency for Healthcare Research and Quality Web site. Available at: http://www.guideline.gov/content.aspx?id=47588. Updated May 2011. Accessed June 17, 2014
Can yoga reduce symptoms of anxiety and depression?
Yes, yoga can reduce symptoms of anxiety and depression (strength of recommendation [SOR]: B, systematic reviews of randomized controlled trials [RCTs] with significant heterogeneity). Across multiple RCTs using varied yoga interventions and diverse study populations, yoga typically improves overall symptom scores for anxiety and depression by about 40%, both by itself and as an adjunctive treatment. It produces no reported harmful side effects.
EVIDENCE SUMMARY
Across 3 systematic reviews of yoga for depression, anxiety, and stress, yoga produced overall reductions of symptoms between 12% and 76%, with an average of 39% net reduction in symptom scores across measures (TABLE).1-3 The RCTs included in the systematic reviews were too heterogeneous to allow quantitative analyses of effect sizes.
Yoga found to significantly reduce depression symptoms
Two 2012 systematic reviews of yoga for depression evaluated 13 RCTs with a total of 782 participants, ages 18 to 80 years with mild to moderate depression. In the 12 RCTs that reported gender, 82% of participants were female; in 6 RCTs a total of 313 patients had cancer.1,2
The RCTs compared yoga to wait-list controls, counseling, education, exercise, or usual care. They evaluated yoga both as a stand-alone intervention and an adjunct to usual care. Yoga sessions varied from 1 hour weekly to 90 minutes daily over 2 to 24 weeks and included physical postures, relaxation, and breathing techniques.
Eight moderate- to high-quality RCTs with a total of 483 participants reported statistically significant reductions in depression symptoms in the yoga groups compared with control groups. In 3 RCTs, yoga was equivalent to wait-list controls; 2 RCTs showed results equivalent to exercise and superior to wait-list controls.
Yoga alleviates anxiety and stress without adverse effects
A 2012 systematic review of yoga for stress and anxiety evaluated 10 RCTs with a total of 813 heterogeneous participants, ages 18 to 76 years, including pregnant women, breast cancer patients, flood survivors, healthy volunteers, patients with chronic illnesses, perimenopausal women, adults with metabolic syndrome, and people working in finance, all with a range of anxiety and stress symptoms.3 The RCTs compared yoga, as an adjunctive or stand-alone treatment, with wait-list controls, relaxation, therapy, anxiety education, rest, or exercise. Yoga regimens varied from a single 20-minute session to 16 weeks of daily 1-hour sessions, with most regimens lasting 6 to 10 weeks.
Of the 10 RCTs reviewed, 7 moderate- to high-quality studies with a total of 627 participants found statistically significant reductions in anxiety and stress in yoga groups compared with control groups. Of the remaining 3 studies, 1 found yoga equivalent to cognitive therapy; 1 found a nonsignificant benefit for yoga compared with wait-list controls; and 1 found no improvement with either yoga or relaxation.
Study limitations included a range of symptom severity, variable type and length of yoga, lack of participant blinding, wait-list rather than active-treatment controls, and a lack of consistent long-term follow-up data. The RCTs didn’t report any adverse effects of yoga, and yoga is considered safe when taught by a competent instructor.3,4
RECOMMENDATIONS
The Institute for Clinical Systems Improvement and the Canadian Network for Mood and Anxiety Treatments recommend yoga as an effective adjunctive treatment to decrease the severity of depression symptoms.5,6
The Veterans Health Administration and the US Department of Defense recommend yoga as a potential adjunctive treatment to manage the hyperarousal symptoms of post-traumatic stress disorder (PTSD).7
The Work Loss Data Institute recommends yoga as an intervention for workers compensation conditions including occupational stress, major depressive disorder, PTSD, and other mental disorders.8
1. Balasubramaniam M, Telles S, Doraiswamy PM. Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders. Front Psychiatry. 2012;3:117.
2. D’Silva S, Poscablo C, Habousha R, et al. Mind-body medicine therapies for a range of depression severity: a systematic review. Psychosomatics. 2012;53:407-423.
3. Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17:21-35.
4. Brown RP, Gerbarg PL. Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II—clinical applications and guidelines. J Altern Complement Med. 2005;11:711-717.
5. Mitchell J, Trangle M, Degnan B, et al. Institute for Clinical Systems Improvement. Adult depression primary care. Available at: https://www.icsi.org/_asset/fnhdm3/Depr-Interactive0512b.pdf. Updated September 2013. Accessed March 6, 2014.
6. Ravindran AV, Lam RW, Filteau MJ, et al; Canadian Network for Mood and Anxiety Treatments (CANMAT). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments. J Affect Disord. 2009;117(suppl 1):S54-S64.
7. US Department of Veterans Affairs. VA/DoD clinical practice guideline for management of post-traumatic stress disorder and acute stress reaction. US Department of Veterans Affairs Web site. Available at: http://www.healthquality.va.gov/ptsd/. Accessed March 6, 2014.
8. Agency for Healthcare Research and Quality. Mental illness & stress. Agency for Healthcare Research and Quality Web site. Available at: http://www.guideline.gov/content.aspx?id=47588. Updated May 2011. Accessed June 17, 2014
Yes, yoga can reduce symptoms of anxiety and depression (strength of recommendation [SOR]: B, systematic reviews of randomized controlled trials [RCTs] with significant heterogeneity). Across multiple RCTs using varied yoga interventions and diverse study populations, yoga typically improves overall symptom scores for anxiety and depression by about 40%, both by itself and as an adjunctive treatment. It produces no reported harmful side effects.
EVIDENCE SUMMARY
Across 3 systematic reviews of yoga for depression, anxiety, and stress, yoga produced overall reductions of symptoms between 12% and 76%, with an average of 39% net reduction in symptom scores across measures (TABLE).1-3 The RCTs included in the systematic reviews were too heterogeneous to allow quantitative analyses of effect sizes.
Yoga found to significantly reduce depression symptoms
Two 2012 systematic reviews of yoga for depression evaluated 13 RCTs with a total of 782 participants, ages 18 to 80 years with mild to moderate depression. In the 12 RCTs that reported gender, 82% of participants were female; in 6 RCTs a total of 313 patients had cancer.1,2
The RCTs compared yoga to wait-list controls, counseling, education, exercise, or usual care. They evaluated yoga both as a stand-alone intervention and an adjunct to usual care. Yoga sessions varied from 1 hour weekly to 90 minutes daily over 2 to 24 weeks and included physical postures, relaxation, and breathing techniques.
Eight moderate- to high-quality RCTs with a total of 483 participants reported statistically significant reductions in depression symptoms in the yoga groups compared with control groups. In 3 RCTs, yoga was equivalent to wait-list controls; 2 RCTs showed results equivalent to exercise and superior to wait-list controls.
Yoga alleviates anxiety and stress without adverse effects
A 2012 systematic review of yoga for stress and anxiety evaluated 10 RCTs with a total of 813 heterogeneous participants, ages 18 to 76 years, including pregnant women, breast cancer patients, flood survivors, healthy volunteers, patients with chronic illnesses, perimenopausal women, adults with metabolic syndrome, and people working in finance, all with a range of anxiety and stress symptoms.3 The RCTs compared yoga, as an adjunctive or stand-alone treatment, with wait-list controls, relaxation, therapy, anxiety education, rest, or exercise. Yoga regimens varied from a single 20-minute session to 16 weeks of daily 1-hour sessions, with most regimens lasting 6 to 10 weeks.
Of the 10 RCTs reviewed, 7 moderate- to high-quality studies with a total of 627 participants found statistically significant reductions in anxiety and stress in yoga groups compared with control groups. Of the remaining 3 studies, 1 found yoga equivalent to cognitive therapy; 1 found a nonsignificant benefit for yoga compared with wait-list controls; and 1 found no improvement with either yoga or relaxation.
Study limitations included a range of symptom severity, variable type and length of yoga, lack of participant blinding, wait-list rather than active-treatment controls, and a lack of consistent long-term follow-up data. The RCTs didn’t report any adverse effects of yoga, and yoga is considered safe when taught by a competent instructor.3,4
RECOMMENDATIONS
The Institute for Clinical Systems Improvement and the Canadian Network for Mood and Anxiety Treatments recommend yoga as an effective adjunctive treatment to decrease the severity of depression symptoms.5,6
The Veterans Health Administration and the US Department of Defense recommend yoga as a potential adjunctive treatment to manage the hyperarousal symptoms of post-traumatic stress disorder (PTSD).7
The Work Loss Data Institute recommends yoga as an intervention for workers compensation conditions including occupational stress, major depressive disorder, PTSD, and other mental disorders.8
Yes, yoga can reduce symptoms of anxiety and depression (strength of recommendation [SOR]: B, systematic reviews of randomized controlled trials [RCTs] with significant heterogeneity). Across multiple RCTs using varied yoga interventions and diverse study populations, yoga typically improves overall symptom scores for anxiety and depression by about 40%, both by itself and as an adjunctive treatment. It produces no reported harmful side effects.
EVIDENCE SUMMARY
Across 3 systematic reviews of yoga for depression, anxiety, and stress, yoga produced overall reductions of symptoms between 12% and 76%, with an average of 39% net reduction in symptom scores across measures (TABLE).1-3 The RCTs included in the systematic reviews were too heterogeneous to allow quantitative analyses of effect sizes.
Yoga found to significantly reduce depression symptoms
Two 2012 systematic reviews of yoga for depression evaluated 13 RCTs with a total of 782 participants, ages 18 to 80 years with mild to moderate depression. In the 12 RCTs that reported gender, 82% of participants were female; in 6 RCTs a total of 313 patients had cancer.1,2
The RCTs compared yoga to wait-list controls, counseling, education, exercise, or usual care. They evaluated yoga both as a stand-alone intervention and an adjunct to usual care. Yoga sessions varied from 1 hour weekly to 90 minutes daily over 2 to 24 weeks and included physical postures, relaxation, and breathing techniques.
Eight moderate- to high-quality RCTs with a total of 483 participants reported statistically significant reductions in depression symptoms in the yoga groups compared with control groups. In 3 RCTs, yoga was equivalent to wait-list controls; 2 RCTs showed results equivalent to exercise and superior to wait-list controls.
Yoga alleviates anxiety and stress without adverse effects
A 2012 systematic review of yoga for stress and anxiety evaluated 10 RCTs with a total of 813 heterogeneous participants, ages 18 to 76 years, including pregnant women, breast cancer patients, flood survivors, healthy volunteers, patients with chronic illnesses, perimenopausal women, adults with metabolic syndrome, and people working in finance, all with a range of anxiety and stress symptoms.3 The RCTs compared yoga, as an adjunctive or stand-alone treatment, with wait-list controls, relaxation, therapy, anxiety education, rest, or exercise. Yoga regimens varied from a single 20-minute session to 16 weeks of daily 1-hour sessions, with most regimens lasting 6 to 10 weeks.
Of the 10 RCTs reviewed, 7 moderate- to high-quality studies with a total of 627 participants found statistically significant reductions in anxiety and stress in yoga groups compared with control groups. Of the remaining 3 studies, 1 found yoga equivalent to cognitive therapy; 1 found a nonsignificant benefit for yoga compared with wait-list controls; and 1 found no improvement with either yoga or relaxation.
Study limitations included a range of symptom severity, variable type and length of yoga, lack of participant blinding, wait-list rather than active-treatment controls, and a lack of consistent long-term follow-up data. The RCTs didn’t report any adverse effects of yoga, and yoga is considered safe when taught by a competent instructor.3,4
RECOMMENDATIONS
The Institute for Clinical Systems Improvement and the Canadian Network for Mood and Anxiety Treatments recommend yoga as an effective adjunctive treatment to decrease the severity of depression symptoms.5,6
The Veterans Health Administration and the US Department of Defense recommend yoga as a potential adjunctive treatment to manage the hyperarousal symptoms of post-traumatic stress disorder (PTSD).7
The Work Loss Data Institute recommends yoga as an intervention for workers compensation conditions including occupational stress, major depressive disorder, PTSD, and other mental disorders.8
1. Balasubramaniam M, Telles S, Doraiswamy PM. Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders. Front Psychiatry. 2012;3:117.
2. D’Silva S, Poscablo C, Habousha R, et al. Mind-body medicine therapies for a range of depression severity: a systematic review. Psychosomatics. 2012;53:407-423.
3. Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17:21-35.
4. Brown RP, Gerbarg PL. Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II—clinical applications and guidelines. J Altern Complement Med. 2005;11:711-717.
5. Mitchell J, Trangle M, Degnan B, et al. Institute for Clinical Systems Improvement. Adult depression primary care. Available at: https://www.icsi.org/_asset/fnhdm3/Depr-Interactive0512b.pdf. Updated September 2013. Accessed March 6, 2014.
6. Ravindran AV, Lam RW, Filteau MJ, et al; Canadian Network for Mood and Anxiety Treatments (CANMAT). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments. J Affect Disord. 2009;117(suppl 1):S54-S64.
7. US Department of Veterans Affairs. VA/DoD clinical practice guideline for management of post-traumatic stress disorder and acute stress reaction. US Department of Veterans Affairs Web site. Available at: http://www.healthquality.va.gov/ptsd/. Accessed March 6, 2014.
8. Agency for Healthcare Research and Quality. Mental illness & stress. Agency for Healthcare Research and Quality Web site. Available at: http://www.guideline.gov/content.aspx?id=47588. Updated May 2011. Accessed June 17, 2014
1. Balasubramaniam M, Telles S, Doraiswamy PM. Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders. Front Psychiatry. 2012;3:117.
2. D’Silva S, Poscablo C, Habousha R, et al. Mind-body medicine therapies for a range of depression severity: a systematic review. Psychosomatics. 2012;53:407-423.
3. Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17:21-35.
4. Brown RP, Gerbarg PL. Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II—clinical applications and guidelines. J Altern Complement Med. 2005;11:711-717.
5. Mitchell J, Trangle M, Degnan B, et al. Institute for Clinical Systems Improvement. Adult depression primary care. Available at: https://www.icsi.org/_asset/fnhdm3/Depr-Interactive0512b.pdf. Updated September 2013. Accessed March 6, 2014.
6. Ravindran AV, Lam RW, Filteau MJ, et al; Canadian Network for Mood and Anxiety Treatments (CANMAT). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments. J Affect Disord. 2009;117(suppl 1):S54-S64.
7. US Department of Veterans Affairs. VA/DoD clinical practice guideline for management of post-traumatic stress disorder and acute stress reaction. US Department of Veterans Affairs Web site. Available at: http://www.healthquality.va.gov/ptsd/. Accessed March 6, 2014.
8. Agency for Healthcare Research and Quality. Mental illness & stress. Agency for Healthcare Research and Quality Web site. Available at: http://www.guideline.gov/content.aspx?id=47588. Updated May 2011. Accessed June 17, 2014
Evidence-based answers from the Family Physicians Inquiries Network