Mental disorders have been described as one of the most devastating disorders of mankind
for two reasons. The first is its relatively widespread incidence, i.e., around 2%
in India and a prevalence averaging to about 6% in a meta-analytical study (Math and
Srinivasaraju, 2010). The other reason is the extent to which it renders a person
incapable of taking care of him/herself. Majority of the papers submitted in this
special issue, depict the effectiveness of yoga on varied parameters for mental disorders
such as schizophrenia, depression, attention deficit hyper-activity disorder and patients
with functional disorders. The few papers, which have looked at the effect of yoga
on elderly or healthy caregivers also, have focused on mental health outcome variables.
In this context, we need to understand the mechanisms that work in making yoga effective
for mental disorders/mental health.
Yoga practice may specifically help persons with mental illness in at least five ways:
Calming effect: The more agitated a person is, the more difficult they find it to
practice yoga and to relax. However, with more physical practices as Asanas, breathing
practices and Kriyas (cleansing techniques as kapalabhati, Trataka, Neti, etc.) most
patients with mental illness will be able to benefit by reducing the agitations they
Increasing awareness: Yoga practice increases awareness of oneself and of ones’ surroundings.
As a patient begins to be aware of the most basic physical sensations as heartbeat,
pulse, etc., it becomes easier to suggest increasing the scope of awareness to include
awareness of the surroundings and of other people
Increasing the attention span: One of the reasons why it is very difficult for a mentally
ill-patient to return to work even after the acute phase is because of the markedly
reduced attention span and easy distractibility. A short attention span and the tendency
to be easily distracted, make it very difficult for a schizophrenia patient to see
any task through to completion, successfully. By practicing yoga, a patient may be
able to maintain a state of focused attention with greater ease and for longer periods
Acceptance and adaptability: One of the challenges for rehabilitation of persons with
mental illness is that even if they are adequately rehabilitated in their homes, the
environment there is often so unhealthy that they get a relapse. Certain ideas of
acceptance and adaptability, which are part of yoga counseling, help the subjects
to make a good transition from the therapy center to the world outside
A sense of security: Bhakti yoga or indeed any form of devotion and surrender to a
supreme entity or a role model of a person will be of great source of strength to
a “recovered” patient (i.e., a person who, through medication, no longer has symptoms
such as hallucinations, delusions, or bizarre behavior, in general). Very often, during
the course of a long and difficult illness a patient may lose contact with his family.
For a recovered patient this lack of support may give rise to feelings of insecurity,
reduce the chances of further improvement and even bring about a relapse. This is
where a sense of bhakti or devotion and surrender to a supreme or ideal being may
give the person an anchor with a feeling of reassurance and of security.
The traditional texts believe that all these mental disorders arise out of imbalances
in the Manomaya Kosa (mental and emotional levels). Knowing fully well that what I
am doing is wrong, a person is drawn to do wrong things due to enslavement of the
emotions. These imbalances amplify themselves resulting in mental illnesses called,
“Adhis.” Prompted by the perceptual growth of desires, leading to anger, jealousy
and such other powerful emotions, these mental diseases congeal within an individual
and they begin to manifest themselves externally. Another explanation for psychosomatic
illnesses is that when the mind is agitated during our interactions with the world
at large, the uncontrolled speed of mind backed by powerful emotions lead to agitations
and violent fluctuations in the flow of Prana (life force) in the Nadis (channels
of Prana as blood vessels carrying blood) The Prana flows in wrong paths moving from
one to another without rhythm and harmony. The Nadis can no more, in this condition,
maintain stability and steadiness. These disturbances in the Prana and unsteadiness
in the Nadis show up as breathing imbalances. Due to these imbalances, the food does
not get properly digested. When this improperly digested food settles down in the
body amidst such commotion, it results in ailments of psychosomatic type.
To tackle these problems, we at Swami Vivekananda Yoga Anusandhana Samsthana advocate
and have conclusively found benefits of the “Integrated approach of Yoga Therapy”
(IAYT) [Figure 1]; which targets all five levels of existence (Pancha Kosas - i.e.,
physical, (Prana or) subtle energies, mental and intellectual levels), a holistic
approach to treat patients with mental illnesses.
Integrated Yoga Therapy Approach (IAYT)
Excessive speed and demanding situation at the mental and physical levels (Annamaya
Kosa and Pranamaya Kosa), upsurges caused by strong likes and dislikes at the emotional
level (Manomaya Kosa) and conflicts, ego-centric behavior at the psychological level
(Vijnanamaya Kosa) are responsible for imbalances found at gross levels [Figures 2
Pancha Kosa – Five sheaths of existence
Yogic definition of stress
IAYT through “successive stimulation-relaxation helps break the loop of uncontrolled
speed of thoughts (stress) [Figure 4 and 5]” as postulated in the commentary on
Mandukya Upanishat mentioned below.
Panchakosaha model of IAYT – Slide 1
Panchakosha model of IAYT – Slide 2
Laye sambodhayet Cittam; Viksiptam samayet punah Sakasayam vijaniyat samapraptam na
Awaken a drowsy or sleepy mind; calm down an agitated random mind; recognise the deep
rooted stresses; releasing them all when balance and stability occurs, maintain it
for long durations.
As mentioned by Patanjali in his Sutras (Ibid, 2008;)
Yogah cittavrtti nirodhah (Patanjali Yoga Sutra: 1.2)
Yoga is to “gain mastery over the mind or control over the mind” (consisting of
development of concentration on one hand and a capacity to calm down the mind or silence
it effortlessly) and, harmonizes the disturbances at each of the five levels [Figure
6] Samatvam Yoga Ucyate (Bhagavad Gita).
Definition of Yoga
Balance and equanimity is Yoga to tackle psychosomatic problems and psychiatric disorders.
There are different yoga practices, which act at different levels. This is tered IAYT
using the four streams of yoga: Jnana Yoga; Bhakti Yoga; Raja Yoga and Karma Yoga.
It is recommended that one begins with the “physical” practices learning to relax
the body and then to be ready for the more specific, mental state practices. In this
manner through the practice of yoga one can gain mastery over the mind.
It is often difficult to get persons with mental illness to feel motivated to do these
yoga practices, but if they can be gently persuaded, they often begin to enjoy the
practices and are eager to carry on.
I sincerely appreciate the efforts of the National Institute of Mental Health and
Neurosciences (NIMHANS) team in educating and motivating the patients with mental
illnesses to practice yoga (a relatively new treatment methodology in psychiatry)
as an alternative and complementary treatment method. This special issue in the Indian
Journal of Psychiatry on “yoga for mental disorders” is another step forward in creating
awareness about the yogic practices that could be therapeutic for patients with mental