Published in: Natural Solutions
Date: February 2008
Breathe to Beat the Blues: Pranayama offers a drug-free solution to depression.
by Stephanie Gold

When my father took sick with depression, gravity seemed to claim him, body and soul. Everything sagged. I wish I'd known then about pranayama, yoga's ancient treatment for the blues.

The word pranayama comes from Sanskrit-prana means life force or breath, and yama, restraint (although some see the second word as ayama, which means extension). Yogis consider depression a prana disorder; the shallow breath, the slumped shoulders my father evinced so sadly, all demonstrate paucity of prana. Yogis have long believed that conscious breathing (pranayama) can have a dramatic effect on depression, anxiety, and even insomnia. What these breathing exercises do, explains Sudha Prathikanti, MD, associate clinical professor of psychiatry at the University of California, San Francisco, is stimulate the vagus nerve-the command post of the parasympathetic nervous system-allowing blood pressure to normalize, heart rate to slow, muscles to relax, and the digestive system to pick up where it left off.

What the research reveals
Yoga boasts hundreds of pranayamas, but most research has focused on Sudarshan Kriya Yoga, a series of breathing exercises (see "4 Depression-Easing Exercises" below) developed in India by Sri Ravi Shankar, founder of the Art of Living Foundation. One study found that severely depressed patients who practiced pranayama three times a week for 30 minutes a day over four weeks recovered as well as patients taking an antidepressant. Mildly depressed patients did well too. In fact, everyone who practiced the minimum three times a week improved dramatically. "There's valid, scientific evidence that this works for depression," says Patricia Gerbarg, MD, assistant professor of clinical psychiatry at New York Medical College.

What makes this therapy so useful, says Prathikanti, is how easy it is to sit still, close your eyes, and breathe-a welcome alternative if you're a newcomer to yoga. "Yoga poses are good, but breathing's the key to working with mood," says asserts Amy Weintraub, founder of LifeForce Yoga Institute in Tucson, Arizona, and author of Yoga for Depression (Broadway Books, 2004). This is excellent news for the elderly --a depression-prone group for whom rigorous exercise, yoga poses, and medical treatments may not be an option. "Most seniors take a lot of medications," says Prathikanti, "so non-pharmacological treatments become very attractive."

How pranayama works
Most people can do yogic breathing. The four exercises featured on page 80 focus primarily on the exhale, which produce a calming, balancing effect on the central nervous system.

Alternate nostril breathing (Nadi Shodhana). This simple breathing exercise cleanses the respiratory system while bringing equilibrium to the right and left brain. Throughout the day, the breath will naturally alternate about every two hours, favoring either the right or left nostril. Just close your nostrils once at a time to see which one is more open, Nadi Shodhana (pronounced NAH-dee SHOW-duh-na) balances the brain by equalizing oxygen flow through both nostrils. By making the exhalation twice as long as the inhalation and retaining the breath in between, you increase the oxygen-CO2 exchange in the body, thus ridding the blood of stale air and waste.

Victorious breathing (Ujjayi). Characterized by taking deep, slow nasal breaths while partially constricting the muscles in the back of the throat, this form of breath control encourages the vagus nerve to emit more of its soothing messages and slow the heart rate to peaceful levels. The deep, slow breaths trigger the pituitary and limbic systems to broadcast "anti-worry" signals in the form of hormones like oxytocin to organs such as the heart and lungs. Ujjayi (OO-jai-ee) also enhance respiratory sinus arrhythmia (RSA)-the natural cycle of inhalations and exhalations that speed and slow the heart. Increased RSA calms the heartbeat, whereas low RSA often coincides with depression, anxiety, chronic intestinal troubles, and panic disorders.

Bellows breathing (Bhastrika). Paradoxically, the quick, sharp breaths of Bhastrika (buh-STREE-ka) bring about a state of composure. Bhastrika is actually a mild stimulant to the sympathetic nervous system-your "fight or flight" response-but just like physical exercise, it shakes off lethargy and strengthens your response to stress. When the buzz of Bhastrika simmers down, you're left feeling calm yet alert.

Bumblebee breathing (Brahmari). This rhythmic breath creates a chant-like cranial vibration that stimulates the limbic system, which contains the thalamus, aka the emotional brain. This thalamic activity eases worry and stress, and sparks feelings of pleasure. "Brahmari (BRAH-mar-ee) works well for people with obsessive-compulsive disorder and anxiety," says Weintraub. "Creating a vibration in the skull…leaves no room for negative spiraling thoughts. And that calms the mind."

A word of caution
Steer clear of Bhastrika pranayama if you suffer from seizures, asthma, or cardiac conditions, or if you're pregnant. Pregnant women should also skip the breath retention in Nadi Shodhana. People with bipolar disorder should avoid rapid breathing techniques, unless working with a certified instructor, as these could launch a manic state.

4 Depression-Easing Exercises

Studies have shown that these pranayama techniques can help you breathe through emotional distress.

Alternate Nostril Breathing | Nadi Shodhana
Brings fresh oxygen to the brain, balances nasal cycles, and calm nerves.
o Close your right nostril with your thumb, and inhale through your left nostril for three counts: om one, om two, om three. o Closing your left nostril with your pinky and ring fingers, hold the breath for three to six counts. Release the thumb and exhale through your right nostril for six counts. o Inhale through the right nostril for three counts, close right nostril with thumb, and retain the breath for three to six counts. o Lift pinkie and ring fingers from left nostril, and exhale six counts. This constitutes one round. Continue for five to 10 rounds.

Bellows Breathing | Bhastrika
Eases sadness by releasing happy hormones.
o Fold you arms across your stomach, hands in fists. o Inhale quickly through your nose, and raise your arms above your head, palms open. o Exhale forcefully through your nose, bringing hands, arms and gaze back down. o Do 20 fast, forceful breaths; rest 30 seconds. o Repeat for four minutes, resting between rounds.

Bumble Bee Breath | Brahmari
The skull-vibrating hum reduces worry, heightens relaxed attention, and generates feelings of bliss.
o Close your eyes using the top three fingers of each hand, place your pinkie fingers on the base of your nostrils, and use your thumbs to close both openings of your ears. o Inhale a regular breath, and on exhalation make a humming sound, drawing it out as long as you can. o Continue for two to eight minutes.

Victorious Breathing | Ujjayi
Soothes the heart and calms turbulent emotions.
o Inhale very slowly and deeply through your nose, constricting your epiglottis (that flap in the back of the throat that controls air flow from the nose to the larynx) slightly to produce a snoring tone like the ocean (or Darth Vader). o Hold for two counts, then exhale slowly through an open mouth, making a "haaa" sound as if you were fogging up glasses. Pause for two counts at the bottom of the breath. o Repeat for two to eight minutes.