Yoga for Depression, Part I

A number of yogic practices can not only help relieve depression but may put your students in touch with a deep source of joy and peace.

By Timothy McCall, M.D.

When physicians use the word "depression," they don't mean feeling disappointed or blue, or grieving a loss—normal moods that everyone experiences from time to time. Clinical depression is a persistently sad, hopeless, and sometimes agitated state that profoundly lowers the quality of life and that, if untreated, can result in suicide. Doctors aim, with drugs and sometimes psychotherapy, to raise their patients' moods, but yoga has much loftier goals. As a yoga therapist, you want not only to help lift your students out of depression but to quiet their restless minds, put them in touch with their deeper purpose in life, and connect them with an inner source of calm and joy that yoga insists is their birthright.

My work with students with depression has been deeply influenced by my teacher Patricia Walden, who, as a younger woman, struggled with recurrent depression. Yoga, particularly after she began her studies with B.K.S. Iyengar in the 1970s, spoke to her in a way that no other treatments had, including psychotherapy and antidepressant medication.

Are Antidepressants Bad?

In recent years, doctors have increasingly focused their efforts in treating depression on changing the biochemistry of the brain, specifically by using drugs to raise the levels of neurotransmitters such as serotonin. This is the mechanism of action of the most commonly prescribed antidepressants, the so-called selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, and Zoloft. But there are many other ways—including aerobic exercise and practicing yoga—to raise the levels of serotonin and other neurotransmitters linked to depression.

While many people in the yoga world have a negative view of antidepressant medication, I believe that there are times when these medications are necessary and even lifesaving. While they have side effects and not everyone responds to them, some people with recurrent severe depression appear to do best if they go on and stay on medication. Others may benefit from using antidepressants for a shorter time to help them feel good enough to establish behaviors—such as an exercise regimen and a regular yoga practice—that can help keep them out of the depths of depression after the drugs are discontinued.

Still, many people with mild to moderate depression may be able to avoid drug therapy entirely. For them, in addition to yoga and exercise, psychotherapy, the herb St.-John's-wort, and increased amounts of omega-3 fatty acids in their diets can help lift mood. These measures can also help in cases of severe depression, though St.-John's-wort should not be combined with prescription antidepressants.

One caution to yoga teachers: I have seen a lot of guilt-tripping of patients considering antidepressants, which people wouldn't dare do if the medication in question was for diabetes or heart disease. I think that's partly a remnant of the outdated notion that, when it comes to psychological problems, you should just buck up and will yourself to feel better. This approach, of course, rarely works and results in a lot of unnecessary suffering. As Patricia Walden says of drug therapy, "Thank God we've got this option."

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