Yoga & Medicine

Aging and Yoga

Cardiology

Pain

Headache (Audio)

Musculoskeletal Problems

Preventive Medicine

Obesity and Eating Disorders

Sleep (Audio)

Smoking and alcohol dependence

Epilepsy

Psoriasis

Menopause

Carpal Tunnel Syndrome

Cancer

Sexual Problems

Urological Problems

Psychiatry

• Depresion
• Stress and Psychosomatic disorders
• Obsessive & Compulsive disorder (OCD)
• Yoga for ADHD
• Yoga for Autistic Children

Western medicine is a 'disease discreet' model referring to pathology with little emphasis on normality. In conventional medicine we have learnt the art of medicalising almost all presentations and people.

A biological "disease discreet" model suggests a defect in the body's machinery or dysregulation of defense mechanism may explain to some extent the pathological processes, however, it does not address the normal physiological and psychological stressors in daily living. Yoga lifestyle is a time tested intervention that addresses this issue effectively and scientifically.

Pharmacological intervention certainly looks lucrative deal to address our somatic and psychological problems. We tend to accept the medical explanation, and pharmacological interventions so as to blame the neurotransmitters and other pathological changes, rather than change our self destructive life style. It is a fact that drugs are cheaper and fast acting, however they are not devoid of side effects. Presently, we are aware of immediate side effects of given drugs, but we are still blind to the long term effects of the drugs on the human genes and human race. It would be relevant to cite and recall the thalidomide experience, where its use lead to congenital abnormalities in the fetus.

The pharmacological intervention is a collective illusion by the patients, physicians, drug manufacturers, and researchers. The reality is that all the medical and psychological problems are not explainable exclusively based on the neurotransmitters. If it had been so, then a pertinent question would be "WHO ARE WE? and WHAT ARE WE?". The answer to these questions are multifaceted. We may not be able to live the answer.

In a nutshell, We unconsciously evade the real causal factors of our misery, that is our poor lifestyle, food habits (cholesterol), and daily life stressors (work stress, living in big cities, financial stress etc). Moreover, physicians find it easy to prescribe drugs, rather than ask for a change in lifestyle. To make things more complicated, the motivation aspect by clients due to ignorance and expectation of quick results have further hampered the acceptance of yoga and meditation in daily hectic life. Certainly, yoga needs to be reintroduced into our present chaotic lifestyle, with scientific understanding and problem based interventional approach.

Aging and Yoga

Concept of Youth and ageing / Caring for our body

• Today, there is a paradigm shift around the concepts of health, illness, and treatment options. We are living in a time where medical physicians largely rely on technology and drugs to treat illness and disease. Yet in the midst of the best health care system that western medicine has to offer, millions of people are seeking alternative health care (Barnes,2004 ). In the recent past, efficacy and therapeutic effects of yoga have been reported in various medical journals using latest technology, suggesting that yoga has scientific basis. Moreover, millions of people are exploring and paying for such complementary treatment primarily out of their own pocket, which again emphasizes and acknowledges the positive and healing effect of yoga.
• Man has unconsciously tried to be forever young. Man has adopted various methods to achieve this goal, which has been futile and vain to a larger extent. They forget that use of revitalizing lotions or toners to erase the wrinkles is not sufficient. Pharmacological and other toxic substances (viz Botox- Botulin for wrinkles) would not help, to attain youthfulness, vigor and vitality. Yoga and meditation is suggested here, which is devoid of side effects and has lasting effect. (Infant, 2001; Travis, 1999;Travis,2001).It enhances flexibility, regulates blood circulation, toning muscles, and redistributing body mass and enhances alertness and clarity of faculties of mind.
• Yoga is a divine science, taking the mankind on the path of positive thinking. Its basis is banked on the homeostasis of all the systems as proposed by George Engel. The learned saints of ancient India discovered this process. Yoga is complete in every aspect as it touches the every sphere of human life. It is a complete science that provides a healthy lifestyle and a complete preventive medication system. Above all, it is an enlightening spiritual art. Saint Patanjali brought Yoga 5000 years ago, in a disciplined manner to preserve and produce the eight yogic practices in the form of Yoga Sutra.
• Moreover, the popularity of Yoga lies in the fact that it has never bounded itself within the narrow-minded attitude of sex, community, area, religion, caste, and language.

Cardiology : (Hypertension & Ischemic Heart Disease)

Heart disease is leading killer in the western population. This is also catching up in the eastern population with one in ten people suffering from heart disease and is anticipated to rise by 300%. This growing trend in the heart disease across the globe makes the practice of yoga vital in our daily life.

Yoga and meditation is found to be beneficial in patients with heart disease who have undergone angioplasties and bypass. A study done in patients who had angioplasties showed reduction in all risk factors and parameters such as cholesterol, blood pressure and body mass index. It also retards progression of plaque formation in the arteries in patients with severe coronary artery disease.

The special breathing techniques(Pranayam) in the cardiac patients helps in deep breathing and as a result increases blood oxygen levels and helps in performing better exercise tests.

Most women are worried about breast cancer than heart disease. In fact heart disease is the number one killer both in men and women.

Modern medicine and Ayurveda are both in agreement on the cause of heart disease and that it can be prevented by adopting healthy eating, exercising moderately and controlling stress levels. Heart diseases are preventable and to a large extent reversible.

Rhythmic formulas like rosary and yoga mantras can synchronise and reinforce cardiovascular rhythms and baroreflexitivity which can in turn help in controlling blood pressure and coronary heart disease.

In one study the effects of recitation of mantra or Ave maria were compared with controlled and spontaneous breathing and their effects were noted on heart rate, respiratory rate and blood pressure. It was found that both prayer and mantra formulas caused powerful and synchronous rhythms when recited 6 times per minute and produced striking psychological and physiological effects that were favourable.

From the ayurvedic point of view heart has 2 aspects that take into account physical heart organ that pumps blood and the emotional heart that experiences emotion such as joy and sorrow.

There is substantial amount of evidence that has been accumulated over last 3 decades that breathing exercises are vital in health and well being.(Dr Benson mind body spirit)

Yoga and meditation work by reducing stress levels which is a major risk factor causing coronary artery disease.

Chest pain with normal coronary angiogram is often resistant to the conventional antianginal treatment and is associated with anxiety, depression and sympathetic activation over a long period. The practice of meditation twice daily for 3months is found to be beneficial in improving exercise tolerance and anginal episodes.

One of the leading causes of global burden of disease is cardiac problems such as ischaemic heart disease, hypertensive heart disease and coronary heart disease as per the World Health Report (WHO). Hypertension is the third leading cause of global burden of diseases as per the World Health Report. In patients with anxiety, there is an increased level of catecholamine, particularly norepinephrine and epinephrine. Patients performing transcendental meditation have been found to have stable levels of catecholamine. This in turn regulates the sympatho-adrenenal medulla system, resulting in stable blood pressure (Infante, 2001). There is evidence that multicomponent stress management techniques have been found to be efficacious in controlling and managing hypertension, one of them is through yoga (Cohen, 2007).

Ischemic heart diseases can be minimized with performance of light yoga and breathing exercises, a time tested and ancient answer to heart problems. Seeing the growing trend of the disease in the present lifestyle, the need for practicing yoga has become essential. Introducing yoga at an early age and integrating it into our lifestyle can have beneficial long term results on health and can be used as preventative medicine.

Cardiac Rehabilitation Yoga has shown to decrease the heart blocks. Studies using yoga have shown promising results in cardiac rehabilitation programmes. Yoga reduces the stress and improves the delivery of oxygen to the heart and blood circulation. Yoga mantras synchronizes and reinforces inherent cardiovascular rhythms and modify baroreflex sensitivity (Carruthers, 1980, Dostalek, 1982; Edy, 2000; Mamtani, 2004; Ogendra, 2004; Jayasinghe, 2004).

In another study, yoga and meditation programme along with dietary changes for a period of 3months, showed beneficial effects in cardiovascular risk factors by reducing Blood pressure, Serum cholesterol and LDL, Body mass index with significant reduction in those who had raised levels. Also a reduction in urinary excretion of hormones like adrenaline, noradrenaline, catecholamines, dopamine, aldosterone, testosterone and leutenizing hormone was seen while cortisol excretion increased significantly.

Length of course 12 weeks to 24 Months with 2-3 sessions per week with self practice.

Heart Yoga Pranayam Program (HYPP).

Sessions- Are 1.5-2 hours long and can be Group sessions or one to one sessions as required.

Precaution- This program is undertaken with initial consultation with the yogaphysician to determine the suitability of the right programme one needs to be in. It is highly recommended to learn these yogic practices under the guidance of a yoga specialist. Not all yoga teachers are yoga specialist and detailed knowledge of one's medical condition is important in following a correct regime. Certain exercises (eg inverted poses in hypertension) and faster rate of breathing in pranayam exercises are to be avoided in hypertension and in other heart conditions. Such exercises can be more harmful and a generic yoga class at a local gym might not be suitable for one. A yogaphysician takes this into consideration while designing your programme and supervises you through the program and assists you to learn the correct technique.

Pain

Chronic back pain

Back pain is a significant public health problem globally and is the most commonly reported reason for use of complimentary alternative medicine particularly yoga. Asthnga yoga and Iyengar yoga, have been found to be efficacious in patients with low back pain. Iyenger yoga has derived from Asthanga yoga, which consists of eight limbs including morale injunctions, rules for personal conduct, posture, breath control, sense withdrawal, concentration, meditation and self realization (Williams, 2005). Krusen, known as one of the early fathers of physical medicine, has credited yoga posture exercises as a means to correct spinal slumping, and thereby improve the respiratory capacity. Stretching of muscles, which produces propioceptive stimulation thereby relaxing muscle tension and restoring optimal muscle tone and posture.

The shape of our spine allows us to stand erect and our strong muscles maintain the posture by partial contraction. This however makes them prone to spasm a state of constant over contraction that results in back pain.

Stress is one of the main causes although injury could also induce protective spasm and delay healing process.

Requirements- Please bring your own yoga mat for optimum hygienic.

Length of course- 12 weeks, 2 sessions per week.

Sessions- are 2 hours long which can either be Group sessions or can be one to one sessions.

Precaution- Where back pain is due to slip disc, inflammation, or infection you will need the guidance of your yoga specialist to practice yoga safely. A yogaphysician will be able to supervise you and help you learn the right kind of asanas, pranayam, diet and yoga plan for you. Yoga practice is to be learned under a yoga specialist as these exercises if done incorrectly, can cause more harm than good. Hence it is recommended that one chooses a yoga specialist to supervise while learning.

Musculoskeletal Problems

Yoga and Work related Musculoskeletal disorders

Our career presents many mental and physical challenges. Most of us these days have sedentary, sit at the desk all day job. We may not work in a warehouse where heavy boxes are being thrown around or heavy furniture and delivery boxes are moved. However, you will be surprised to know that our sitting at desk job is as much at risk for workplace injuries as a warehouse or furniture moving job. In modern times we have shift work and excessive telephone and computer use and job related injuries involving neck, shoulder and wrist.

In GP practice we are seeing a lot of computer shoulder, telephone shoulder, office chair backache, mouse tendonitis and carpel tunnel syndrome.

Carpel Tunnel syndrome-Studies have shown benefits of yoga in carpal tunnel syndrome in comparison to use of splints. The patients in randomized control trials found better grip strength, better sleep and reduced pain intensity after an 8 week intervention with yoga therapy.

Although many of these injuries might not be seen in medical text books but they feature in real life and can be crippling for the patients.

Rounded shoulders, slumped posture causing undue stress on the spine leads to upper back and neck problems. Hunching over the keyboard, sitting in the office chair for hours on end and cradling the receiver on a long telephone conversation can all lead to stiff shoulders and painful spine.

The symptoms often reported by employees are that of pain, fatigue, tingling, forearms numbness, swelling, burning, headaches, heaviness, awakening at night, temperature change and difficulties in carrying out activities of daily living. The pounding the fingers, wrists and arms take during a long session at the computer can lead to Carpel Tunnel Syndrome as can gripping something hard for hours on end such as pen.

Yoga has been found beneficial in carpel tunnel syndrome and in cervical spondylosis. It is also been found to be helpful in resolving symptoms in chronic backache.

Myofascial pain syndrome involves a large group of muscles and is characterized by hypersensitive areas also called 'trigger points' within one or a group of muscles leading to localized and referred pain. The syndrome can involve contracture, weakness, restricted movement, tenderness and autonomic dysfunction.

Chronic fatigue syndrome and immune dysfunction syndrome- is a chronic debilitating condition characterized by pain, fatigue and cognitive dysfunction. Yoga has been found beneficial in improving symptoms of pain and restoring function and improving quality of life.

Fibromyalgia-Studies have shown that Iyengar yoga was found to be efficacious in fibromyalgia and that it improved pain, body awareness, body weight, psychological and emotional health and ease in carrying out activities of daily living and quality of life.

Repetitive strain injury-Symptoms of musculoskeletal pain originating from physical and psychological stresses on the body affecting work and daily activities have been found to benefit from yoga.

Requirements- Please bring your own yoga mat to the session for optimum hygiene.

Length of Course- 8 weeks-12 weeks ( Carpal tunnel syndrome and other repetitive strain injuries).

12 weeks to 36 months.

Precaution- Yoga practice has to be learned under a yoga specialist as these exercises if done incorrectly, can cause more harm than good. Hence it is recommended that one chooses a yoga specialist to supervise while learning. Not all yoga teachers are specialist with good understanding of yoga exercises and medical conditions that might cause precipitation of certain conditions and cause injuries. For eg Not all exercises for backache will be the same for a person who is suffering from chronic conditions like cervical spondylosis, prolapsed disc and malignancy. These have to be taken into consideration while organizing a regime which cannot be addressed in generic yoga class as attended by most in gyms, health clubs, spas and Videos. However a yogaphysician will be to address this on individual basis taking into account their medical history and limitations.

Preventive Medicine

Preventive Medicine: Aging and illness are part of life. Early identification and intervention is the mantra of preventive medicine. A proper case history should be evaluated for every patient so that they can be counselled for any factors that could be detrimental to good health and leading to decline in quality of life. Correct diagnosis and intervention is paramount in preventing and recognizing the aetiology of poor health so that negative effects can be minimized. Yoga has various beneficial effects and has been proven to be efficacious in numerous chronic illnesses. Regular and persistent practice of yoga as a part of life is recommended. It may be highlighted that yoga is not an acute intervention for any physical illness or mental disorder.

Obesity and Eating Disorders

With the practice of asanas and meditation one can achieve weight loss to a greater degree in a short span of time. Weight can be reduced faster then most diets. Yoga has been used in cases of eating disorders (Scime, 2007).

Yoga is ideal form of exercise in obesity. It is gentle and carefully graded, reducing the chances of fatigue and injury in overweight individuals and also avoids strain to the heart.

Yoga diet can help in maintaining optimum weight as it is low in calorie and high in fibre. Yoga can help in controlling eating habits by achieving a control over mind.

Requirements- Can be done on the chair, indoors and outdoors. Bringing your own yoga mat to the sessions is hygienic.

Length of course- 12 weeks, 2 sessions per week.

Sessions- are 2 hours long which can either be Group sessions or can be one to one sessions.

Precaution- Yoga practice has to be learned under a yoga specialist as these exercises if done incorrectly, can cause more harm than good. Hence it is recommended that one chooses a yoga specialist to supervise while learning. Not all yoga teachers are specialist with good understanding of yoga exercises and medical conditions that might cause precipitation of certain conditions and cause injuries.

Relaxation with yoga helps in building an inner self mastery and reduces cravings while the autosuggestion can inhibit the urge to eat.

Sleep

Insomnia

Sleep Problem- Today, one of the common problems reported to the physicians is sleep disorder. The use of over the counter and prescribed hypnotics has increased in the recent past. We are forgetting the art of initiating and maintaining a good sleep for various reasons like night shifts, travel (jet lag), medical problems, etc. Studies using yoga have shown encouraging results (Gooneratne, 2008).

Sleep is an important physiological phenomenon that rejuvenates us each day and rids us of tiredness and worries. Excessive tension and anxiety may cause insomnia and prevent the brain from switching off.

Chronic insomnia is divided into 2 categories namely sleep onset and sleep maintenance or primary and secondary insomnia. Yoga and meditation has also been found beneficial in chronic insomnia. One study evaluated yoga treatment and studied its effect in population with chronic insomnia. The results were analysed from the sleep wake diaries at 2 week intervals. Intervention with yoga and meditation was seen to be efficacious. Daily practice resulted in reduced arousal time, improvement in total sleep time (TST), sleep efficiency (SE), sleep onset latency (SOL) wake time after onset (WASO) and number of awakenings. Yoga is multicomponent practice and has positive results in reducing arousal and improving sleep efficiency. Meditation has also been shown to be beneficial in sleep related problems (Gooneratne, 2008; Manjunath,2005; Khalsa, 2004).

Length of course- 8 weeks, 2 sessions per week.

Sessions- are 2 hours long which can either be Group sessions or can be one to one sessions.

Substance Dependence:- Smoking and alcohol dependence

There is good scientific literature to support that yoga and relaxation helps in addiction. It has been found to be efficacious in preventive programmes. Yoga is integrated into various treatment plans. The advantages are relieving stress, anxiety and depression during withdrawals. It improves and promotes safer social network, and increases self awareness both on mental and physical level, resulting in self control. Incorporating yoga into treatment plans enhances therapeutic relationship and decreases the number of patient dropout.

A study by Bowen et al. (2007), in a population of alcohol dependent explored the role of Vipassana, a mindfulness meditation practice that emphasizes acceptance rather than suppression of unwanted thoughts. They concluded that Vipassana was effective in reduction in substance use as compared to controls. This was achieved as Vipassana meditation course volunteers reported greater reduction in attempts to avoid unwanted thoughts.

Epilepsy

Transcendental meditation: A double-edged sword in epilepsy: Transcendental Meditation is derived from ancient yogic teachings. Both short- and long-term physiological correlates of TM practice have been studied. EEG effects include increased alpha, theta, and gamma frequencies and increased coherence and synchrony. Neuronal hyper synchrony is a cardinal feature of epilepsy, and subjective psychic symptoms, apnoea, and myoclonic jerking are characteristic of epileptic seizures. Clinical studies of similar techniques suggest that meditation has a potential antiepileptic therapy.

In various studies, it has been suggested that behavioural phenomena have an underlying epileptic basis, and the potential efficacy for seizure reduction may translate into improved quality of life. However, more understanding is warranted by clinical trials before a blanket statement regarding the efficacy in seizure disorder is made (Yardi, 2000). Yoga regulates body physiology through control of posture, breathing, and meditation. Recent research in yoga as an adjuvant therapy in the management of autonomic dysfunction in patients with refractory epilepsy as been promising and needs more exploration (Satyaprabha, 2008).

Psoriasis

In a study by Frankel (1998), in patients with psoriasis found that meditation helped as an adjuvant therapy. The rate of recovery of plaques was 3.8 times faster in the meditation group as compared to control, this was achieved in as little as four weeks time.

Perimenopause/Menopause

Restorative yoga for treatment of hot flushes has been found to be effective as there was a significant decrease in mean number of hot flushes by 34% from baseline after 8 weeks of intervention. It has no adverse effects and has been suggested to be efficacious in middle-aged women (Cohen, 2007; Khalsa, 2004).

Length of course-8 weeks

Carpal Tunnel Syndrome

Yoga is used in treatment of carpal-tunnel syndrome (Winston, 1999) : Carpel tunnel syndrome is compressive neuropathy of the medial nerve. It is more common in women than men, as women have smaller carpel bone, therefore there is less space to accommodate the nerve of similar diameter. With the extensive use of computer keyboard and sitting for many hours in the wrong posture has led to an increase in the number of new cases in the recent past. In a randomized control trial, it has been shown that eight weeks of Yoga has been found to be beneficial along with significant reduction in the pain and better grip strength (Sequeira, 1999).

Cancer

Similar to breast cancer, studies of people with prostate cancer suggest that melatonin levels are lower compared to men without cancer, and test tube studies have found that melatonin inhibits the growth of prostate cancer cells. Meditation is a valuable addition to the treatment of prostate cancer. The positive effects of meditation may be due to a rise in levels of melatonin in the body.

Yoga is helpful in terminally ill and cancer patients. A study done on breast cancer patients on chemotherapy showed significant reduction in symptoms like nausea and vomiting measures of Morrow Assessment of Nausea and Emesis(MANE).Improvement in anxiety, depression, quality of life and distressful symptoms and treatment related toxicity was also reported. Hence yoga is concluded to be helpful in stress reduction and complementing the conventional antiemetics in chemotherapy to reduce nausea and vomiting.

Sexual Problems

Many population surveys around the world indicate the increasing prevalence of the sexual problem in general population. The surveys indicate that 40% of women and 30% of men have evidence of psychosexual dysfunction. There are a number of causes in men causing erectile dysfunction such as diabetes, vascular disease, age, cigarette smoking, high cholesterol and depression.

Sexual problems can be divided into two-1) difficulty in getting erection 2) difficulty in maintaining erection, also referred to as premature ejaculation.

It is important to note that apart from depression there are other mental disorders that are associated with sexual dysfunction such as anxiety, schizophrenia. The impact of sexual dysfunction on men suffering from various sexual dysfunctions are less relationship satisfaction, greater depressive symptomatology, negative reactions from partners, less job satisfaction and low self esteem.

Amongst women this is reported as low libido, trouble with orgasm, difficulty with lubrication.

The recent focus on pharmacological and other biological treatments of sexual dysfunction unfortunately takes away attention and emphasis from psychological and other alternative therapies that might be beneficial. Yoga has been noted to give statistically significant improvement in sexual dysfunction.

Yoga has been found to be efficacious in premature ejaculation as compared to Selective Serotinine Reuptake Inhibitors (SSRI's) (Dhikv, 2007).

Urological Problems

Yoga is a useful adjunct in the treatment of the chronic urological conditions.

The musculoskeletal function improves with regular practice of yoga and helps to regain muscle strength and aerobic capacity. The practice of yoga has shown to increase the release of endorphins, better pain control and reduction in stress. The person practicing yoga also experiences a change in the perception of stress resulting in increased sense of well being.

Chronic urological conditions are difficult to diagnose and treat, as their presentation can be atypical and may mimic other medical conditions. Treatment of these conditions can be frustrating for both the patients and the physicians as many conventional and traditional treatments are often unsuccessful. The physicians are forced to look elsewhere at other treatment options to provide pain relief and improve quality of life.

Chronic urological disorders like Stress incontinence , urinary incontinence, rectocoele, cystocoele, vaginal and uterine prolapse, interstital cystitis, vulvadynia, prostadynia, orchalgia, epidimalgia are associated with poor musculoskeletal, neural and myofascial function of the back and pelvis. Most of these conditions are multifactorial and difficult to diagnose. These urological conditions can be benefited with yoga postures specific for each of these.

The pelvic floor muscle weakness leads to many urological conditions. These fall in 2 categories pelvic floor hypertonicity and pelvic floor hypotonicity.

Pelvic floor hypertonicity can be helped by asanas that aim at relaxing the deep muscles of the pelvic floor and increase muscle awareness in the patient.

The other category involves those due to hypotonicity of the muscles of the pelvis floor leading to urinary incontinence namely stress and urge incontinence. This can be addressed by the asanas that aim at strengthening the superficial muscle layer of the urethral and the anal sphincters and the deep muscle layer(levator ani) of the pelvic floor.

Since the pelvic floor is not working in isolation and moves with the bony pelvis and the lower back , a program has to be designed carefully to maintain this balance of the major muscles that influence the structure and the function of the pelvis.

Any sacroiliac joint dysfunction or symphysis pubis dysfunction can result in pathology and aggravate these chronic conditions.

Requirements- Please bring your own yoga mat to the sessions for optimum hygiene.

Length of course- 12 weeks, 2 sessions per week.

Sessions- are 2hours long which can be one to one sessions. Group sessions can also be booked.

Precaution- Yoga practice has to be learned under a yoga specialist as these exercises if done incorrectly, can cause more harm than good. Hence it is recommended that one chooses a yoga specialist to supervise while learning. Not all yoga teachers are specialist with good understanding of yoga exercises and medical conditions that might cause precipitation of certain conditions and cause injuries.

Psychiatry

Adult Psychiatry

• Depresion & Stress and Psychosomatic disorders

Depression is among the five most common disorders seen in primary care. Disability caused by depressive disorder rivals that of coronary artery disease and is greater than disability caused by chronic lung disease and osteoarthritis according to medical outcome study. Cost of depressive disorders in terms of treatment, missed work and loss of function is $43 billion in the US and around €17 billion in the UK annually. The World health organization reports that mental illness makes up to fifteen percent of disease of the world. A recent study done at Boston university of medicine found that practicing yoga elevates the gamma aminobutyric acid(GABA) levels, brains primary inhibitory neurotransmitter. Depression and anxiety disorders both are associated with low levels of GABA. Currently these disorders are being treated with pharmacological agents to increase GABA levels. There have been various other studies that have shown to be efficacious as an adjuvant therapy in patients with depressive disorder. (Pilkington et. al., 2005). It has been found to improve the self-esteem in persons practicing yoga, which is one of the negative symptoms of depressions (Elavsky, 2007). Yoga has positive impact on the neuro- cognitive function of persons suffering with depression (Sharma, 2006).

Yoga has been studied in patients suffering from schizophrenia as an add on therapy with reduction of negative symptoms of schizophrenia (Duraiswamy, 2007).

Requirements- Meditation useful here can be done anywhere, anytime, on the bus, in the tube, in workplace, sitting in the park or walking. Bringing your own yoga mat is hygienic to the sessions. A small blanket as a yoga mat is highly recommended for the CY sessions.

Length of course- 12weeks, 2 sessions per week.

Sessions- Are 2 hours long which can either be Group sessions or can be one to one sessions.

What is Stress?

• The term "stress" was coined by Hans Seyle, and defines it as a non specific response of the body and mind to any demand, and adaptation to challenge. This physiological and psychological response is called general adaptation syndrome.
• There have been various models that explain the role of stress in the development of an illness.
• Due to the constant hassles of daily living and work in the form of ongoing interpersonal difficulties, persistent threat to security, financial deprivation, and other life events (Eustress, distress) which act as trigger factors in any illness. This precipitates the illness at an early age, a concept known as "brought forward time".
• Stress strains the coping mechanism resulting in sequences of internal changes, which are outwardly expressed as illness. The "crisis theory" as proposed by Lindermann and Sating states that stress produces disequilibrium (crisis) resulting in either adaptive changes or maladaptive changes (emotional and physical illness).
• The cybernetic model by Kagan and Levi suggests that there is a two-way interaction between psychosocial stress and psychobiological program which determines the physiological and psychological reaction leading to precursor of disease.
• Yoga has been found to be efficacious in resolving this stress by enhancing the internal power, rather than banking on the chemical agents.
  It delays the expression of illness. It must be emphasized here that yoga is not a substitute to pharmacological intervention in acute cases, it has an augmenting and supplementing therapeutic effect with pharmacotherapy in illness.

Requirements- Meditation here can be done on the chair, indoors, outdoors, on the tube, in the bus, in the park anywhere and anytime. Please bring your own yoga mat for optimum hygiene. A small blanket as a yoga mat is highly recommended for the sessions.

Length of course- 4 weeks, 2 sessions per week.

Sessions- Are 2 hours long which one to one sessions. Group sessions can be booked also.

Precaution- Yoga practice has to be learned under a yoga specialist as these exercises if done incorrectly, can cause more harm than good. Hence it is recommended that one chooses a yoga specialist to supervise while learning. Not all yoga teachers are specialist with good understanding of yoga exercises and medical conditions that might cause precipitation of certain conditions and cause injuries.

Obsessive & Compulsive disorder (OCD)

Obsessive Compulsive Neurosis(OCD) -The ancient system of Kundalini yoga(KY) has been used in treating several psychiatric disorders. So far the studies undertaken on OCD includes randomized control trials comparing the KY protocol with the Relaxation Response and Mindfulness Meditation(RRMM).The trials showed efficacy on the all the psychological scales in Kundalini Yoga protocol. However the randomized control trials failed to show any benefit on any scales in the Relaxation Response and in Mindfulness Meditation group. The KY protocol applied OCD specific meditation and other techniques specific for fear, anger, and anxiety, meeting mental challenges and converting negative thoughts into positive thoughts. Apart from reduction in the OCD symptoms other symptoms like anxiety and depression were significantly reduced.

These yogic techniques have been found beneficial also in social anxiety disorder, body dysmorphic disorder apart from OCD and other psychiatric disorder. The Chanting yoga(CY) protocol involves perfecting the art of breathing and mental focus on sound vibration. The breath cycle being one minute with 15sec per phase. The breathing can be perfected in 5-6 months with regular daily discipline. Yogic experiments claim that this technique practiced for 31minutes each day for 90 days with perfected breath cycle of 1 breath a minute with 15sec per phase can eliminate all symptoms of the obsessive compulsive disorders.

Requirements- Can be done on the chair, indoors, outdoors, on the bus, on the tube in the park etc. Bringing your own yoga mat is hygienic.

Length of course- 12 weeks, 2 sessions per week.

Sessions- are 2 hours long which can either be Group sessions or can be one to one sessions.

Precaution- Yoga practice has to be learned under a yoga specialist as these exercises if done incorrectly, can cause more harm than good. Hence it is recommended that one chooses a yoga specialist to supervise while learning. Not all yoga teachers are specialist with good understanding of yoga exercises and medical conditions that might cause precipitation of certain conditions and cause injuries.

Child Psychiatry

Yoga For ADHD

Yoga could be the next prescribed treatment for ADHD. It is estimated that 2.5 million children between the ages of 4 and 16 suffering from ADHD take drug treatment such as Ritalin, Adderall XR, Strattera for ADHD. The FDA has reported that some of the drugs unfortunately have long term effects on the brain development and show limited effectiveness after few years. It has been documented that they increase the risk of mania, hypomania and also risk of suicide which is also the reason why parents prefer an alternative non pharmacological treatment option.

Amongst the growing concern about the safety of these drugs used in ADHD studies have shown that children with ADHD show improvement in their concentration with yoga .It is reported that 8 to 13 year olds who practiced yoga once a week for five months were less hyperactive. Yoga practice was found to increase concentration through postures like forward bends and deep breathing exercises.

Another study at the institute of psychiatry, Kings College, London concluded that children with ADHD who learnt how to meditate as compared with the control group showed significant reduction in their main symptoms of impulsiveness, hyperactivity and inattention. Their behaviour at school and home improved and they demonstrated better child-parent relationship and enhanced self esteem.

Length of course- 20 weeks, 2 sessions per week.

Sessions- Are 2hours long which can either be Group sessions or can be one to one sessions.

Yoga for Autistic Childrens

Autism Spectrum Disorder: Every child needs to be cared and receive attention and yoga philosophy values individual differences. Our collective responsibility to rehabilitate the child with his disability is challenging, particularly children with special needs. Yoga has been recommended to children with autism spectrum disorder who show physical symptoms like motor delay, low muscle tone and emotional symptoms. Yoga creates an awareness of the entire body and improves the motor performance, flexibility, and coordination and improves self esteem of the child. Yoga is an excellent medium to help children which is easy to learn as it may be taught through visual instructions and enjoyable to the child. It also gives an opportunity for the parent to have a special bonding with the child.

Yoga based therapy such as Integrated movement therapy(1) is useful in treatment of autistic spectrum disorder as it directly affects the frontal lobe efficiency and improves the physical and cognitive function thus improving the therapeutic outcomes in children with autism. The direct training with specific asanas and pranayam techniques result in significant enhancement in propioreceptive and tactile awareness which ultimately improves the social skills and helps children to respect and maintain appropriate personal spatial boundaries. The regularity of yoga sessions reinforces rules that help in developing internal control that is required to inhibit impulsive responses.

Yoga practice helps to develop awareness between nervous system, thoughts and feelings. Yoga therapy in autism helps through core principles such as physical stimulation, social interaction, language stimulation, self calming and direct self esteem building.