Yoga for anxiety

The clearest picture comes from a 2021 trial in JAMA Psychiatry, which randomised 226 adults with diagnosed generalised anxiety disorder to twelve weeks of group Kundalini yoga, cognitive behavioural therapy, or stress education. Response rates were 54.2 percent for yoga, 70.8 percent for CBT, and 33.0 percent for the control. Yoga clearly beat the control. It did not pass the test for being as good as CBT, and at six months only the CBT advantage was still statistically present.

A 2018 meta-analysis of eight randomised trials found a small effect against no treatment, and then found something that matters more: no significant effect in people with a formally diagnosed anxiety disorder. The benefit sat with people who had raised anxiety without a diagnosis. A 2016 meta-analysis of seventeen studies found a moderate controlled effect, larger in people who practised more hours and in those with higher anxiety to begin with.

Read together, the fair summary is: yoga is a genuinely useful practice for everyday anxiety, overthinking and the tension that comes with a stressful life, and it is second best to proper treatment for a diagnosed anxiety disorder. It supports treatment and does not replace it. If you are on medication or in therapy, keep both. Stopping an SSRI or a benzodiazepine abruptly is its own hazard, and any change belongs with the prescriber.

This is the most important paragraph on the page, and it is missing from almost every article about yoga for anxiety. Fast breathing and breath holding are laboratory methods for inducing panic attacks. That is not a metaphor. In a study of 85 people with panic disorder, 81.2 percent had a panic attack during at least one respiratory challenge, with 28.2 percent panicking specifically during the hyperventilation test and 23.5 percent during breath holding.

• Kapalbhati. Rapid forced exhalation is functionally voluntary hyperventilation. In a person prone to panic, the tingling in the hands, the light head and the tightness in the chest that follow are precisely the sensations that start an attack, and they arrive with a plausible story attached.
• Bhastrika. The same, faster, with the inhalation forced as well.
• Kumbhaka, breath retention, including the long holds sometimes taught inside alternate nostril breathing. Leave the retention out and keep the alternation.
• Sirsasana and sarvangasana. Not because of anxiety but because a beginner attempting them is a beginner being frightened while upside down, and because the injury literature is concentrated there.

If you have panic attacks, start with slow breathing with a long exhale and nothing else, and treat tingling, dizziness or a spinning head as a signal to stop and breathe normally, not as a sign the practice is working.

The avoid column here is unusual and it is the important half: the two practices most often recommended for energy are the two most likely to make an anxious person feel worse.

If you are having panic attacks, or anxiety is stopping you sleeping or working, see a doctor. This page is a support alongside treatment and not a substitute for one. In the evening, the bedtime sequence is the routine written to go with it.

The order matters more than the content. An anxious body is a physically activated body, and asking it to sit still first almost always fails. Move, then be still.

• Standing balance, and specifically vrikshasana. A balance occupies the attention completely because it must. Ten seconds of genuinely not being able to think about anything else is worth more than twenty minutes of trying not to think.
• Adho mukha svanasana and a slow surya namaskar to discharge the physical restlessness.
• Nadi shodhana and anulom vilom, nine rounds, no retention, exhale longer than inhale. The long exhale is the whole mechanism worth caring about.
• Bhramari, nine rounds, eyes closed, ears lightly covered. Students report it works when nothing else does, particularly at night. It is the practice I hand people for the three in the morning wakefulness.
• Savasana, eight to ten minutes, at the end of every session without exception.
• Yoga nidra, twenty minutes, once or twice a week. Lying down, guided, with nothing to achieve.

Please see a doctor or a mental health professional, rather than starting with a yoga class, if any of this is true.

• You have thoughts of harming yourself. This is urgent, today.
• Anxiety is stopping you working, eating, sleeping or leaving the house.
• You are having panic attacks more than occasionally.
• Anxiety arrived suddenly with palpitations, weight loss or tremor, which can be a thyroid problem and is worth a blood test.
• You are using alcohol or sleeping tablets to manage it.
• You are already on medication and are thinking about stopping it. Talk to the prescriber first.

A class is a good place to be while getting treatment. It is a poor substitute for it, and the trial evidence says so plainly.

Week one to two: nothing in the mind, but the body sleeps a little better. Almost everyone reports sleep before they report mood, which is a useful thing to know so you do not conclude too early that it is not working.

Week three to six: the gap between a trigger and the reaction widens slightly. Students describe it as noticing the tightening rather than only noticing the thought that follows it.

Week eight to twelve: this is where the trial effects sit. In the JAMA Psychiatry trial roughly half the yoga group met the criterion for improvement at twelve weeks. Roughly half did not, and that is worth saying too.

Beyond three months: the effect depends on continuing, and in the 2016 meta-analysis it scaled with total hours practised. The practice that helps anxiety is short, daily and dull, not long, occasional and impressive.

Anxiety narrows life quietly. People stop going to things, and then stop noticing they have stopped. A class is an ordinary weekly appointment where nothing is demanded, nobody asks how you are in the searching way, and you leave having done something with your body for an hour. I have come to think that being in the class at all does at least as much as the postures.

These are traditional yoga classes, taught slowly by one teacher, at a residents' association hall in north Bangalore. Nobody has to speak, nobody is looked at, and nobody is asked why they came. If you have been searching for yoga for anxiety near me, the in person classes are in north Bangalore, near MSR Nagar and Mathikere. If leaving the house is currently the hardest part, that is exactly what the live online classes are for, and you can keep the camera on only as much as you want to. Start with the free class, and if you are having panic attacks, tell me before we do any breathing at all.