Mind-Body Interventions to Reduce Coronavirus Pandemic Stress and Support Long-Term Recovery

The COVID-19 pandemic is causing global stress, trauma and mental illness that has already outpaced current healthcare resources. Inequalities in the burden of illness, death, and economic loss are exacerbated by inequalities in the provision of mental health care. Minority populations and indigenous peoples bear the brunt of both inequities. Ancient healing systems, such as Yoga, Qigong, and tribal practices, are a rich source of group healing methods that can be studied and optimized for prevention and recovery during current and future disasters. Modern research is shedding light on a myriad of mechanisms that underly the healing properties of voluntarily regulated breathing practices. We selectively review the neurophysiological effects of evidence-based, breath-centered mind-body practices and use Breath-Body-Mind as an example of a program that can safely and efficiently ameliorate psychological and somatic symptoms in child and adult survivors of mass disasters. Online virtual programs can be used to train thousands of practitioners to deliver evidence-based mind-body programs to people who are unlikely to receive individual mental health treatment for coronavirus-related anxiety, depression, and PTSD. For those who have access to individual mental health care, adjunctive mind-body therapies can hasten recovery and may reduce the need for medication. Voluntarily regulated breathing practices shift psychophysiological states from defense mode to the feeling of safety wherein we are best able to feel connect and relate to others with empathy, compassion, and cooperation. Knowing how to regulate our physiology in this direction is essential for stress resilience, trauma recovery, and community wellness

Breath Practices for Survivor and Caregiver Stress, Depression, and Post- traumatic Stress Disorder: Connection, Co-regulation, Compassion

Does compassion itself benefit the healing process or does the activation of neurophysiological processes, from which the experience of compassion arises, trigger a cascade of physical and psychological changes that support health and well-being? Exploration of the neurological substrates of compassion reveals multiple healing pathways that can be activated by mind-body practices. Furthermore, these pathways affect physical health, emotion regulation, and how we perceive and relate to others. Physiological states affect the capacity for empathy, compassion and understanding. A state of calm alertness based on sympatho-vagal balance may support such high-level prosocial functions. Evidence suggests that polyvagal-informed mind-body practices, particularly Voluntarily Regulated Breathing Practices (VRBPs), efficiently induce such physiological states and that these same states can reduce inflammation and oxidative stress, while improving cardiovascular function, respiratory efficiency, and physical health. Mind-body practices, such as Coherent or Resonant Breathing can balance, strengthen, and increase the adaptive flexibility of stress response systems, potentially counteracting the detrimental effects of excess stress, neglect, and trauma on emotion regulation, physical health, and the ability to experience love and compassion. Research is needed to support integration of mind-body practices into healthcare systems. The methods being used to study mind-body techniques may be further refined by considering the target symptoms, population being studied, specific parameters of each practice, and methods of teaching subjects. The current state of global health calls for treatments that can be delivered to large populations by small numbers of healthcare providers under conditions where resources are limited. Slow gentle Coherent or Resonant Breathing and related mind-body practices are low cost, low risk, easily taught, rapidly effective, scalable, non-stigmatizing, and sustainable. At the convergence of neurophysiological research with contemplative and other mind-body practices, we marvel at the possibilities for relieving emotional and physical suffering as well as improving how we relate to one another

Effects of Yoga on Thalamic Gamma-Aminobutyric Acid, Mood and Depression: Analysis of Two Randomized Controlled Trials

Objective: The Vagal-Gamma-Aminobutyric Acid (GABA) theory proposes that some yoga postures and breathing practices exert their effects through stimulation of vagal nerves (parasympathetic system) with associated brain GABA increases. To evaluate this theory, we compared results from a 12-week randomized controlled trial (RCT) of yoga in participants with Major Depressive Disorder (MDD) with those of a similar RCT in healthy control participants (HC). Methods: In an RCT, magnetic resonance spectroscopy (MRS) and mood measures were acquired in subjects with MDD (n=15) prior to and following a 12-week yoga intervention. The same measures were obtained in the HC (n=17) group. In both studies, thalamic GABA/Creatine was obtained using MEGAPRESS at 4 Telsa at baseline (Scan-1), post-intervention (Scan-2), and immediately following a yoga session (Scan-3). Clinical scales were completed prior to each scan. Results: The MDD-group had significantly lower GABA compared to the HC at baseline (Scan-1, p=0.001), but not after 12 weeks of yoga, either before (Scan-2, p=0.12) or after a yoga session (Scan-3, p=0.20). Depressive symptoms decreased significantly in the MDD-group (p=0.0001), and anxiety improved in both groups. Conclusion: After a 12-week yoga intervention, MDD-group mood and anxiety measures improved with scores equivalent to those of non-depressed individuals. This study provides the first evidence of brain GABA increases associated with specific yoga postures and breathing practices in MDD. These results suggest potential benefits of specific yoga postures and breathing practices as monotherapy or augmentation to other treatments to reduce anxiety and depression in MDD

A Randomized Controlled Dosing Study of Iyengar Yoga and Coherent Breathing for the Treatment of Major Depressive Disorder: Impact on Suicidal Ideation and Safety Findings

BACKGROUND: Yoga interventions offer promise for the treatment of major depressive disorder (MDD), yet their safety and potential impact on suicidal ideation (SI) have not been well documented. This study evaluated the safety of a randomized controlled dose-finding trial of Iyengar yoga plus coherent breathing for individuals with MDD, as well as the potential effects of the intervention on SI without intent. METHODS: Participants with Beck Depression Inventory-II (BDI-II) scores \u3e/=14 and a diagnosis of MDD (using DSM-IV criteria) were randomized to either a low dose group (LDG) or high dose group (HDG) and received a 12-week manualized intervention. The LDG included two 90-min yoga classes plus three 30-min homework sessions weekly. The HDG offered three 90-min classes plus four 30-min homework sessions weekly. RESULTS: Thirty-two individuals with MDD were randomized, of which 30 completed the protocol. At screening, SI without intent was endorsed on the BDI-II by 9 participants; after completing the intervention, 8 out of 9 reported resolution of SI. There were 17 adverse events possibly-related and 15 definitely-related to the intervention. The most common protocol-related adverse event was musculoskeletal pain, which resolved over the course of the study. CONCLUSIONS: The Iyengar yoga plus coherent breathing intervention was associated with the resolution of SI in 8 out of 9 participants, with mild side effects that were primarily musculoskeletal in nature. This preliminary evidence suggests that this intervention may reduce SI without intent and be safe for use in those with MDD

Theanine, Lavender, Lemon Balm, and Chamomile

With its unrivaled scope, easy readability, and outstanding clinical relevance, Complementary and Integrative Treatments in Psychiatric Practice is an indispensable resource for psychiatric and other health care professionals. It is also well suited for individuals with mental disorders and their family members who are seeking updated, practical information on complementary, alternative, and integrative medicine (CAIM). An international group of experts, researchers, and clinicians examines an expansive range of treatments that have been chosen on the basis of their therapeutic potential, strength of evidence, safety, clinical experience, geographic and cultural diversity, and public interest. This guide offers advice on how to best tailor treatments to individual patient needs, combine and integrate treatments for optimal patient outcomes, identify high-quality products, administer appropriate doses, and deal with concerns about liability, safety, and herb-drug interactions. Treatments discussed include: Nutrients and neutraceuticals Plant-based medicines Mind-body practices—breathing techniques, yoga, qigong, tai chi, and meditation Art therapy and equine therapy for children and adolescents Neurotherapy, neurostimulation, and other technologies Psychiatrists and other physicians, residents, fellows, medical students, psychologists, nurses, and other clinicians will benefit from guidelines for decision making, prioritizing, and combining CAIM treatments, as well as safely integrating CAIM with standard approaches. That the treatments considered in this clinician’s guide are applied to five of the major DSM-5 categories—depressive disorders, anxiety disorders, trauma- and stressor-related disorders, bipolar and related disorders, and schizophrenia spectrum and other psychotic disorders—ensures its applicability, timeliness and timelessness