role of yoga in geriatric psychiatric disorders

7/27/2019 ROLE OF YOGA IN GERIATRIC PSYCHIATRIC DISORDERS

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ROLE OF YOGA IN GERIATRIC

PSYCHIATRIC DISORDERSYogacharya

Dr ANANDA BALAYOGI BHAVANANIMBBS, ADY, DSM, DPC, PGDFH, PGDY, FIAY, MD (AM)

Deputy Director,

Centre for Yoga Therapy, Education & Research,(CYTER),MGMC&RI, Puducherry, South India.

Email: [email protected]
mailto:[email protected]:[email protected]


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A nervous breakdown is actually an

opportunity for a spiritualbreakthrough if we can realise the

positive implications in our moment

of despair and dejection

-

YogamaharishiDr Swami Gitananda Giri

Guru Maharaj


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Introduction

Yoga: primarily a Moksha Shastra Restores homeostatic balance

Good health is a by-product of Yogic life

Preventive, adjunct & restorative capabilities Yogic concept of Positive Health a unique

contribution to modern healthcare

Geriatric psychiatry: mental disorders in elderly

Chronic and seemingly never ending

Requires care, compassion, patience & empathy


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Geriatric Psychiatric Disorders

Dementia

Depression

Delirium

Psychosis

Anxiety

Substance abuse

Sleep disorders

Cognitive impairment

Behavioural disturbances

Lack of suitable physical activity & stimulation are

common problems in geriatric psychiatry

- Dr Karel Nespor, Czech psychiatrist (1993)


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Role of Various Facets of Yoga

Wholistic approach of Yoga

Bahiranga practices - physical health

Antaranga practices - mental health

Becoming one with the breath

Shifting from individuality to universality

Kriya Yoga of Maharishi Patanjali

Simple Yogic techniques for elderly


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Becoming One with the Breath

Synchronization of body movement and breathproduces psychosomatic harmony

Bhastrika strengthens solar plexus improvedstamina, endurance and internal cleansing

Kapalbhathi, Surya Nadi and Ujjayi - break out ofdepression through activation

Bandha Trayam /Aswini Mudra - revitalize psycho-neuro-endocrine axis & induce sense ofwellbeing

Pranava and Bhramari Pranayama create innerharmony / mental calmness- inherent regenerativeprocesses are brought into play.


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Shifting from Individuality

to Universality

Yoga emphasizes the Universal, wider perspective

The ego only runs into the blank wall of depressionand despair, overwhelmed by its own superficiality.

Yoga helps us to shift from I-centric to WE-centricapproach

The striving spirit which looks within at the universalaspect of its own nature and sees the oneness of the

whole of creation will find an endless fountain ofinspiration and joy.


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Wholistic Approach of Yoga

Everything is important

Use of early morning sunlight

Use of water for internal & external cleansing

Careful attention to aspects of diet & hydration Need for balance between exertion &relaxation

Yogic counseling - a workingphilosophy in boththe face of triumph & defeat.

Increased self-awareness sensitizes us to our ownbio-rhythms (physical, mental and emotionalcycles).


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Kriya Yoga of Maharishi Patanjali

Tapa as disciplined facing of challenges

Swadhyaya as introspectional self-analysis

Ishwara Pranidhana as doing ones best and

leaving the rest Adoption of a healthy Yogic lifestyle with

cultivation of Karma, Bhakti and Raja Yogaprinciples in daily life helps create a sense of

inner happiness. Reduces friction that tends to build up in

families during the senior years.


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Simple Yogic Techniques

For The Elderly

Gentle stretching and strengthening practices

Breath-body coordination to restore psycho-somaticharmony

Gentle Hatha Yoga Kriya-s helps facilitatepsychosomatic balance: Chatus Pada, Ardha KatiChakra, Pawan Mukta, Chri, Sethu and VyagrahaPranayama

Potential activation of Thymus through- Vakra &Bharadwaja / Paryanka Asana with Hastha Mudras

Brahma Mudra when done with the breathsequences and appropriate nada


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Partner Work:

Betterment of physical, emotional & mentalhealth.

Helping push a bit more in forward bending,

Supporting the partner in back bending,

Helping improve range of joint movement

and Giving isometric resistance to movement thus

improving strength of the musculature.

Pranayama: important link between body,emotions and mind: Vibhaga, Pranava, NadiShuddhi, Bhramari& Chandra Nadi Pranayama


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Dharana and Dhyana: Brumadhya Drishti Tratakaand Prana Kriya to activateAjna Chakra

Mandala & Chakra Dharana / Dhyana on Anahathato activate Thymus and on Ajna to normalize neuro-endocrine axis.

Om Japa andAjapa Japamental calm

Yoga relaxation: Shavasana with Savitri Pranayama,Spanda - Nishpanda Kriya, Kaya Kriya, Tala Kriya andYoga Nidra

The relaxed state is the state in which healing,

regeneration and recuperation can occur. This state of relaxation is vital to maximize our

inherent healing potential - restore normalcy at thephysical, emotional and mental levels.


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Studies on Yoga and Psychiatry

Yoga may be a useful to reduce stress during in-patient psychiatric treatment (Lavey R et al -2005)

Yoga produced improvement in various psycho-physiological parameters in geriatric population

following 6 months integrated Yoga programme (NKManjunath 2005-06)

He also reported improved semantic, primary andworking short term memory as well as episodic

memory. Depression scores and self rated quality of sleep

showed improvement

Interestingly wait list control group showeddeterioration in different aspects of functioning.


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Karel Nespor (1993) has suggested that gentle jointexercise and relaxation are well accepted by patientsand are found to be beneficial.

Yogic relaxation & meditation relieve stress, anxietyand depression.

Provides a safer social network

Increased self awareness & self control opposes the

feeling of helplessness often found in patients ofabuse these problems.

Reduced use of addictive analgesics - provides asafer, non-pharmacological management of

psychosomatic problems such as insomnia,headaches & general bodily pain.

Yoga enables those coming out of substance abuse toovercome stress of early abstinence after thewithdrawal symptoms.


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Yoga, a promising intervention for depression, cost -effective & easy to implement (Shapiro D et al 2007) .

Many beneficial emotional, psychological and

biological effects, as supported by significantreductions in depression, anger, anxiety, neuroticsymptoms and low frequency HRV withimprovement in mood.

11 of 17 patients who completed the programmeachieved remission levels.

Studies by Sharma VK et al (2006) & KrishnamurthyMN and Telles S (2007) have shown efficacy of Yogain managing depression.

Extensive work on Sudarshan Kriya Yoga anddepression at NIMHANS. SKY recommended as apotential alternative to drugs in melancholia as afirst line treatment.


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Sharma VK (2006) demonstrated improvement inexecutive functions (information manipulation inverbal working memory & improved attention span

& visuo-motor speed of depressives. Krishnamurthy MN and Telles S (2007) reported that

an integrated approach of Yoga was useful forinstitutionalized older persons.

MOA of Yoga increased GABA levels? -Streeter CCet al (2007)

Streeter CC and colleagues (2010) recently alsoreported greater improvement in mood and anxietywith Yoga as compared to a metabolically matchedwalking exercise programme.

This is 1st time (?) a behavioral intervention (Yoga)has been associated with +ve correlation betweenacute increases in thalamic GABA levels &

improvement in mood & anxiety scales.


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Caring For The Caregiver

Dementia caregivers spend much more time on caregiving than in other illnesses.

Great physical, mental, emotional and economicalstrain - reduced rest and recreation.

Feelings of anger, resentment, guilt, andhopelessness ----- Depression

Fountainhead of Yogic philosophy: Karma, Dharma,Shraddha, Veerya & Seva develops inner strength

that carries both towards a better state ofbeing. Yoga-meditation programme may be a feasible &

effective intervention for family caregivers and mayimprove affect, coping, physical well-being, andstress management (Waelde LC 2004) .


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Practical Issues in Integrating

Yoga With Psychiatry

Compliance of the patients

Social and family support

Attitudes of the treating doctors

Tendency of the patients to overexert

themselves

Lack of competent Yoga therapists andstandard Yoga therapy protocols


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Conclusion

Yoga as a way of life is a panacea forpsychosomatic, stress related physical, emotionaland mental disorders

With the adoption of Yogic attitudes & lifestyle -old age becomes a time of variety, creativity, and

fulfillment. The Kriya Yoga of Maharishi Patanjali can help

our Silver Citizens develop and maintain a healthyand harmonious state of being during the

challenging twilight years of their life. Major challenges of dementia, depression and

substance abuse can be countered with the Yogicway ofrightliving and positive support groups


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Many who were in depressed despair before they

came to Yoga have now become beacon lights to

hundreds of their fellow humans A lighted lamp gives off more light when it shares

itself by giving to other lamps thus enlightening

the universe.

So also, these harmonious human beings are

spreading the Joy of Yoga all over the world and

in doing so fulfilling their destiny.

May we all grow old gracefully through Yoga, themother of all sciences.


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role of yoga in geriatric psychiatric disorders

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